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Gasik RE, Madkour AS, Skeen SJ, Clum G, Francis T, Felker-Kantor E, Ferguson T, Welsh DA, Molina PE, Theall KP. The Impact of Childhood Adversity on Life Course Alcohol Use Patterns and Health Status Among People Living with HIV. AIDS Behav 2024; 28:2887-2898. [PMID: 38907764 DOI: 10.1007/s10461-024-04368-1] [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] [Accepted: 05/06/2024] [Indexed: 06/24/2024]
Abstract
Adverse childhood experiences (ACEs) and financial hardship are associated with increased likelihood of heavier alcohol use and health challenges in adulthood among persons living with HIV (PWH). We examined whether retrospectively captured lifetime drinking trajectories are a pathway through which childhood hardships affect current health in a sample of 365 adult PWH. Childhood economic hardship and ACEs were used as main predictors. Measures of alcohol use included age at first drink and lifetime drinking trajectories. Health indicators included health-related quality of life, frailty, number of comorbidities, and symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD). Structural equation modeling (SEM) was applied to estimate both direct and indirect pathways between childhood hardship and physical and mental health. Participants were mostly male; Black (84%); and averaged 48 years of age. SEM results supported both direct and indirect pathways between childhood experiences and adult health. ACEs were connected to physical health directly and mental health both directly and indirectly through age at first drink and drinking heaviness during ages 10-20. Childhood economic hardship related to mental health indirectly through higher drinking levels during ages 10-20. Childhood adverse experiences, economic hardship, and early drinking patterns appear to accumulate, resulting in later life physical and mental health concerns for PWH. Findings support taking a life course approach to health. This includes considering individual trauma histories in HIV care engagement and taking preventative approaches which support the economic and social well-being of vulnerable children to improve health in subsequent decades.
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Affiliation(s)
- Rayna E Gasik
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
| | | | - Simone J Skeen
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- Department of Psychology, Hunter College, City University of New York, New York, NY, USA
| | - Gretchen Clum
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | | | - Erica Felker-Kantor
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Tekeda Ferguson
- Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Comprehensive Alcohol Research Center, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - David A Welsh
- Section of Pulmonary/Critical Care, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Comprehensive Alcohol Research Center, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Patricia E Molina
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Comprehensive Alcohol Research Center, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Katherine P Theall
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
- Comprehensive Alcohol Research Center, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
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Högberg B, Baranowska-Rataj A. Effects of parental job loss on psychotropic drug use in children: Long-term effects, timing, and cumulative exposure. ADVANCES IN LIFE COURSE RESEARCH 2024; 60:100607. [PMID: 38569249 DOI: 10.1016/j.alcr.2024.100607] [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: 06/12/2023] [Revised: 01/26/2024] [Accepted: 02/23/2024] [Indexed: 04/05/2024]
Abstract
Intra-family crossover effects triggered by job losses have received growing attention across scientific disciplines, but existing research has reached discrepant conclusions concerning if, and if so how, parental job losses affect child mental health. Drawing on sociological models of stress and life course epidemiology, we ask if parental job losses have long-term effects on child mental health, and if these effects are conditional on the timing of, or the cumulative exposure to, job losses. We use intergenerationally linked Swedish register data combined with entropy balance and structural nested mean models for the analyses. The data allow us to track 400,000 children over 14 years and thereby test different life-course models of cross-over effects. We identify involuntary job losses using information on workplace closures, thus reducing the risk of confounding. Results show that paternal but not maternal job loss significantly increases the risk of psychotropic drug use among children, that the average effects are modest in size (less than 4% in relative terms), that they may persist for up to five years, and that they are driven by children aged 6-10 years. Moreover, cumulative exposure to multiple job losses are more harmful than zero or one job loss.
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Affiliation(s)
- Björn Högberg
- Department of Social Work, Umeå University, and Centre for Demographic and Ageing Research, Umeå University, Sweden.
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3
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Auderset D, Amiguet M, Clair C, Riou J, Pittet V, Schwarz J, Mueller Y. Gender/Sex Disparities in the COVID-19 Cascade From Testing to Mortality: An Intersectional Analysis of Swiss Surveillance Data. Int J Public Health 2024; 69:1607063. [PMID: 38835806 PMCID: PMC11148283 DOI: 10.3389/ijph.2024.1607063] [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] [Received: 01/08/2024] [Accepted: 05/10/2024] [Indexed: 06/06/2024] Open
Abstract
Objectives This study investigates gender and sex disparities in COVID-19 epidemiology in the Canton of Vaud, Switzerland, focusing on the interplay with socioeconomic position (SEP) and age. Methods We analyzed COVID-19 surveillance data from March 2020 to June 2021, using an intersectional approach. Negative binomial regression models assessed disparities between women and men, across SEP quintiles and age groups, in testing, positivity, hospitalizations, ICU admissions, and mortality (Incidence Rate Ratios [IRR], with 95% Confidence Intervals [CI]). Results Women had higher testing and positivity rates than men, while men experienced more hospitalizations, ICU admissions, and deaths. The higher positivity in women under 50 was mitigated when accounting for their higher testing rates. Within SEP quintiles, gender/sex differences in testing and positivity were not significant. In the lowest quintile, women's mortality risk was 68% lower (Q1: IRR 0.32, CI 0.20-0.52), with decreasing disparities with increasing SEP quintiles (Q5: IRR 0.66, CI 0.41-1.06). Conclusion Our findings underscore the complex epidemiological patterns of COVID-19, shaped by the interactions of gender/sex, SEP, and age, highlighting the need for intersectional perspectives in both epidemiological research and public health strategy development.
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Affiliation(s)
- Diane Auderset
- Department of Family Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Michaël Amiguet
- Department of Epidemiology and Health Systems, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Carole Clair
- Department of Ambulatory Care, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Julien Riou
- Department of Epidemiology and Health Systems, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Valérie Pittet
- Department of Epidemiology and Health Systems, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Joelle Schwarz
- Department of Ambulatory Care, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Yolanda Mueller
- Department of Family Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
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Cheng M, Sommet N, Jopp DS, Spini D. Income-Related Inequalities in Physical and Cognitive Health Domains Over the Later Life Course: Longitudinal Evidence From the U.S. (1992-2016). Res Aging 2024; 46:59-71. [PMID: 37365882 PMCID: PMC10666496 DOI: 10.1177/01640275231183438] [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] [Indexed: 06/28/2023]
Abstract
This study aims to investigate changes in the income-health gradient over the later life course. We test the age-as-leveler, the cumulative advantage/disadvantage, and the persistent inequality pattern for physical and cognitive health domains, and analyze whether these patterns are gendered. We used HRS data (1992-2016) and Poisson growth curve models to predict multimorbidity (33,860 participants) as an indicator of physical health and memory (25,291 participants) as an indicator of cognitive health. We disentangled the within-participant from the between-participant effects. For multimorbidity, the income-health gradient weakened as individuals aged; whereas for memory, the income-health gradient strengthened as individuals aged. The cumulative advantage/disadvantage of higher/lower income on memory may be more pronounced among women than men. Findings were confirmed by sensitivity analyses. Findings suggest that the support for the age-as-leveler or cumulative advantage/disadvantage pattern may depend on health domains and the effect strength may depend on gender.
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Affiliation(s)
- Mengling Cheng
- Swiss Centre of Expertise in Life Course Research, University of Lausanne, Lausanne, Switzerland
- Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Nicolas Sommet
- Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
- Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland
| | - Daniela S. Jopp
- Swiss Centre of Expertise in Life Course Research, University of Lausanne, Lausanne, Switzerland
- Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Research Center for Psychology of Health, Aging and Sport Examination, University of Lausanne, Lausanne, Switzerland
| | - Dario Spini
- Swiss Centre of Expertise in Life Course Research, University of Lausanne, Lausanne, Switzerland
- Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
- Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland
- Life Course and Social Inequality Research Centre, University of Lausanne, Lausanne, Switzerland
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Pająk A, Polak M, Kozela M, Doryńska A, Bobak M. Trajectories in physical functioning at older age in relation to childhood and adulthood SES and social mobility: a population-based cohort study. Front Public Health 2023; 11:1228920. [PMID: 37744505 PMCID: PMC10513394 DOI: 10.3389/fpubh.2023.1228920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Older age is associated with the deterioration of physical functioning (PF), and low PF is strongly related to poor quality of life among older people. We conducted a study to examine the trajectories of PF between middle and old age, considering sex differences as well as the association between socioeconomic status (SES) at different life stages and changes in PF. Methods We analyzed data from the Polish arm of the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study, including 1,116 men and 1,178 women aged 45-64 years at baseline. Adult and childhood SES and social mobility were assessed using a retrospectively focused questionnaire. PF was assessed using the 10-question SF-36 scale at baseline examination, face-to-face re-examination, and three postal surveys, covering up to 20 years (on average, 18 years). We employed Generalized Estimating Equations models to assess changes in PF scores over time and compare PF trajectories across different SES categories. Results After adjusting for age and other covariates, we found that, in both sexes, participants with always middle or high SES, as well as those who reported upward mobility, had higher PF scores at baseline compared to those with always low SES. A decline in PF between middle and old age was observed in all SES groups; however, the decline was slower in participants with always middle or high SES compared to those with always low SES. Conclusion This cohort study revealed that lower SES and downward social mobility were cross-sectionally associated with poorer PF, while upward social mobility seemed to largely reverse the effect of low childhood SES. In addition to the cross-sectional associations observed at baseline, advantaged SES was also significantly associated with a slower decline in PF over an 18-year follow-up period.
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Affiliation(s)
- Andrzej Pająk
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Kozela
- Department of Epidemiology and Population Studies, Faculty of Health Sciences, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Doryńska
- Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland
| | - Martin Bobak
- Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czechia
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
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Procopio A, Samuel R. The association between socioeconomic status and C-reactive protein in Bayesian perspective. SSM Popul Health 2023; 23:101464. [PMID: 37560091 PMCID: PMC10407295 DOI: 10.1016/j.ssmph.2023.101464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/01/2023] [Accepted: 07/02/2023] [Indexed: 08/11/2023] Open
Abstract
•This study analyzed the total health inequality on risks of chronic inflammation.•We used Bayesian multiple and distributional regression models.•Between-group posterior distributions show a robust educational gradient in health.•Within-group posterior distributions show polarized risks for individuals.
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Cabib I, Valencia R, Olea-Durán B. Childhood Socioeconomic Position, Adulthood Employment Trajectories, and Later Life Functional Limitations in Chile. J Appl Gerontol 2023; 42:474-486. [PMID: 36345712 DOI: 10.1177/07334648221137055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Relying on a life course perspective, we explored the association between childhood socioeconomic position (SEP), adulthood employment trajectories, and their interactions, with different domains of functional limitations among older people in Chile. We used data from a face-to-face, comprehensive and representative life history survey of older people (N = 802), and weighted bivariate, multivariate, and longitudinal quantitative methods. As a way to address potential problems of reverse causality, we adjust multivariate analyses by lifetime health indicators. Our results show that low childhood SEP and non-standard adulthood employment trajectories characterized by part-time work negatively affect later life functional limitations. The increased risk among people with low childhood SEP is higher if they follow a "part-time employment trajectory" in adulthood. In the conclusion, we emphasize that analyzing life course determinants of functional limitations serves to inform and help design strategies to reduce dependency in later life and promote healthy aging.
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Affiliation(s)
- Ignacio Cabib
- Instituto de Sociología, 28033Pontificia Universidad Católica de Chile, Santiago, Chile.,Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile.,Centro UC Estudios de Vejez y Envejecimiento, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rocío Valencia
- Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Bastián Olea-Durán
- Departamento de Ingeniería Industrial, Universidad de Chile, Santiago, Chile
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Tsakos G, Watt RG, Guarnizo-Herreño CC. Reflections on oral health inequalities: Theories, pathways and next steps for research priorities. Community Dent Oral Epidemiol 2023; 51:17-27. [PMID: 36744970 DOI: 10.1111/cdoe.12830] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 02/07/2023]
Abstract
Health inequalities, including those in oral health, are a critical problem of social injustice worldwide, while the COVID-19 pandemic has magnified previously existing inequalities and created new ones. This commentary offers a summary of the main frameworks used in the literature of oral health inequalities, reviews the evidence and discusses the potential role of different pathways/mechanisms to explain inequalities. Research in this area needs now to move from documenting oral health inequalities, towards explaining them, understanding the complex mechanisms underlying their production and reproduction and looking at interventions to tackle them. In particular, the importance of interdisciplinary theory-driven research, intersectionality frameworks and the use of the best available analytical methodologies including qualitative research is discussed. Further research on understanding the role of structural determinants on creating and shaping inequalities in oral health is needed, such as a focus on political economy analysis. The co-design of interventions to reduce oral health inequalities is an area of priority and can highlight the critical role of context and inform decision-making. The evaluation of such interventions needs to consider their public health impact and employ the wider range of methodological tools available rather than focus entirely on the traditional approach, based primarily on randomized controlled trials. Civil society engagement and various advocacy strategies are also necessary to make progress in the field.
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Affiliation(s)
- Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, UK
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Chanfreau J, Barclay K, Keenan K, Goisis A. Sibling group size and BMI over the life course: Evidence from four British cohort studies. ADVANCES IN LIFE COURSE RESEARCH 2022; 53:100493. [PMID: 36652211 DOI: 10.1016/j.alcr.2022.100493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/06/2022] [Accepted: 06/07/2022] [Indexed: 06/17/2023]
Abstract
Only children, here defined as individuals growing up without siblings, are a small but growing demographic subgroup. Existing research has consistently shown that, on average, only children have higher body mass index (BMI) than individuals who grow up with siblings. How this difference develops with age is unclear and existing evidence is inconclusive regarding the underlying mechanisms. We investigate BMI trajectories for only children and those with siblings up to late adolescence for four British birth cohorts and across adulthood for three cohorts. We use data on BMI from ages 2-63 years (cohort born 1946); 7-55 years (born 1958); 10-46 (born 1970) and 3-17 years (born 2000-2002). Using mixed effects regression separately for each cohort, we estimate the change in BMI by age comparing only children and those with siblings. The results show higher average BMI among only children in each cohort, yet the difference is substantively small and limited to school age and adolescence. The association between sibling status and BMI at age 10/11 is not explained by differential health behaviours (physical activity, inactivity and diet) or individual or family background characteristics in any of the cohorts. Although persistent across cohorts, and despite the underlying mechanism remaining unexplained, the substantively small magnitude of the observed difference and the convergence of the trajectories by early adulthood in all cohorts raises doubts about whether the difference in BMI between only children and siblings in the UK context should be of research or clinical concern. Future research could usefully be directed more at whether only children experience elevated rates of disease, for which high BMI is a risk factor, at different stages of the life course and across contexts.
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Affiliation(s)
- Jenny Chanfreau
- UCL Social Research Institute, University College London, London WC1H 0AA, UK.
| | | | | | - Alice Goisis
- UCL Social Research Institute, University College London, London WC1H 0AA, UK
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The Healthy Lifestyle Habits Screening Questionnaire: A pilot study in the Canary Islands. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Vacková J, Rimárová K, Motlová L, Švestková R, Fichtnerová E, Kuželková A, Dorko E, Kaňuková L, Diabelková J, Shuranová L, Bendová M. Generational differences in selected aspects of social situation and health status of foreigners living in the Czech Republic. Cent Eur J Public Health 2022; 30 Suppl:S68-S74. [PMID: 35841229 DOI: 10.21101/cejph.a7243] [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: 12/12/2021] [Accepted: 01/26/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Demographic differentiation caused by the history of migration in the Czech and Slovak Republics led the authors of this article to analyse generational differences in the groups of foreigners living in the Czech Republic (CR) and the impact of generational differences on selected aspects of their social situation and perceived health. The crucial research question was whether and to what degree do different generations of foreigners vary from each other and what impact this has had on their social situation and health determinants. METHODS The main goal was to examine mutual relationships between selected characteristics of social situation and health determinants in various groups of foreigners living in the CR. A total of 1,003 questionnaires among foreigners officially living in the Czech Republic were collected and analysed. In the area of subjective perception of health, a comparison of foreigners with Czech citizens (representative sample of Czech seniors; 1,172 respondents) in the age category 65+ was made in order to find out whether this perception differs between senior foreign nationals and senior Czechs. RESULTS Older individuals (50-64 years and 65+ years) appeared to have the best integration into Czech society. This age generation felt positive about stay and migration status in the CR. Older foreigners differ from older Czech citizens who tend to refer to their health as very good to rather good compared to foreigners who described their health as neither good nor bad. The middle generation (30-49 years) of foreigners was characterized by hard work and the initial stages of integration into Czech society. This group also reported positive feelings about living in the CR relative to their home country. CONCLUSION The oldest generation of foreigners is the best integrated in the Czech Republic (with regard to selected aspects tested in this article). This generation is able to offer new immigrant effective integration strategies. However, they assess their subjective health one degree worse in comparison with Czech seniors (representative sample), this finding should lead to the setting of preventive programmes related to a healthy lifestyle, including lifestyle for foreigners living in the Czech Republic.
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Affiliation(s)
- Jitka Vacková
- Institute of Social and Special-Pedagogical Sciences, Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Kvetoslava Rimárová
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Lenka Motlová
- Institute of Social and Special-Pedagogical Sciences, Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Renata Švestková
- Institute of Social and Special-Pedagogical Sciences, Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Eva Fichtnerová
- Institute of Social and Special-Pedagogical Sciences, Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Anna Kuželková
- Institute of Social and Special-Pedagogical Sciences, Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Erik Dorko
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Lívia Kaňuková
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Jana Diabelková
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Lesia Shuranová
- Institute of Social and Special-Pedagogical Sciences, Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Markéta Bendová
- Institute of Social and Special-Pedagogical Sciences, Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
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Fairbrother H, Woodrow N, Crowder M, Holding E, Griffin N, Er V, Dodd-Reynolds C, Egan M, Lock K, Scott S, Summerbell C, McKeown R, Rigby E, Kyle P, Goyder E. 'It All Kind of Links Really': Young People's Perspectives on the Relationship between Socioeconomic Circumstances and Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3679. [PMID: 35329365 PMCID: PMC8950291 DOI: 10.3390/ijerph19063679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/03/2022] [Accepted: 03/12/2022] [Indexed: 02/01/2023]
Abstract
Meaningful inclusion of young people's perceptions and experiences of inequalities is argued to be critical in the development of pro-equity policies. Our study explored young people's perceptions of what influences their opportunities to be healthy within their local area and their understandings of health inequalities. Three interlinked qualitative focus group discussions, each lasting 90 to 100 min, with the same six groups of young people (n = 42) aged 13-21, were conducted between February and June 2021. Participants were recruited from six youth groups in areas of high deprivation across three geographical locations in England (South Yorkshire, the North East and London). Our study demonstrates that young people understand that health inequalities are generated by social determinants of health, which in turn influence behaviours. They highlight a complex interweaving of pathways between social determinants and health outcomes. However, they do not tend to think in terms of the social determinants and their distribution as resulting from the power and influence of those who create and benefit from health and social inequalities. An informed understanding of the causes of health inequalities, influenced by their own unique generational experiences, is important to help young people contribute to the development of pro-equity policies of the future.
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Affiliation(s)
| | - Nicholas Woodrow
- ScHARR, University of Sheffield, Sheffield S1 4DA, UK; (N.W.); (M.C.); (E.H.); (E.G.)
| | - Mary Crowder
- ScHARR, University of Sheffield, Sheffield S1 4DA, UK; (N.W.); (M.C.); (E.H.); (E.G.)
| | - Eleanor Holding
- ScHARR, University of Sheffield, Sheffield S1 4DA, UK; (N.W.); (M.C.); (E.H.); (E.G.)
| | - Naomi Griffin
- Department of Sport and Exercise Science, Fuse|Durham University, Durham DH1 3HN, UK; (N.G.); (C.D.-R.); (C.S.); (P.K.)
| | - Vanessa Er
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (V.E.); (M.E.); (K.L.)
| | - Caroline Dodd-Reynolds
- Department of Sport and Exercise Science, Fuse|Durham University, Durham DH1 3HN, UK; (N.G.); (C.D.-R.); (C.S.); (P.K.)
| | - Matt Egan
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (V.E.); (M.E.); (K.L.)
| | - Karen Lock
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (V.E.); (M.E.); (K.L.)
| | - Steph Scott
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne NE1 4LP, UK;
| | - Carolyn Summerbell
- Department of Sport and Exercise Science, Fuse|Durham University, Durham DH1 3HN, UK; (N.G.); (C.D.-R.); (C.S.); (P.K.)
| | - Rachael McKeown
- Association for Young People’s Health, London SE1 4YR, UK; (R.M.); (E.R.)
| | - Emma Rigby
- Association for Young People’s Health, London SE1 4YR, UK; (R.M.); (E.R.)
| | - Phillippa Kyle
- Department of Sport and Exercise Science, Fuse|Durham University, Durham DH1 3HN, UK; (N.G.); (C.D.-R.); (C.S.); (P.K.)
| | - Elizabeth Goyder
- ScHARR, University of Sheffield, Sheffield S1 4DA, UK; (N.W.); (M.C.); (E.H.); (E.G.)
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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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14
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Hoenink JC, Waterlander W, Beulens JWJ, Mackenbach JD. The role of material and psychosocial resources in explaining socioeconomic inequalities in diet: A structural equation modelling approach. SSM Popul Health 2022; 17:101025. [PMID: 35097184 PMCID: PMC8783096 DOI: 10.1016/j.ssmph.2022.101025] [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: 10/05/2021] [Revised: 12/12/2021] [Accepted: 01/11/2022] [Indexed: 12/30/2022] Open
Abstract
We examined whether material and psychosocial resources may explain socioeconomic differences in diet quality. Cross-sectional survey data from 1461 Dutch adults (42.5 (SD 13.7) years on average and 64% female) on socio-demographics, diet quality, psychosocial factors and perceptions of and objective healthiness of the food environment were used in a structural equation model to examine mediating pathways. Indicators for socioeconomic position (SEP) were income, educational, and occupational level and the 2015 Dutch Healthy Diet (DHD15) index assessed diet quality. Material resources included food expenditure, perceptions of healthy food accessibility and healthfulness of the food retail environment. Psychosocial resources were cooking skills, resilience to unhealthy food environments, insensitivity to food cues and healthy eating habits. Higher SEP was associated with better diet quality; Beducation 8.5 (95%CI 6.7; 10.3), Bincome 5.8 (95%CI 3.7; 7.8) and Boccupation 7.5 (95%CI 5.5; 9.4). Material resources did not mediate the association between SEP and diet quality and neither did the psychosocial resources insensitivity to food cues and eating habits. Cooking skills mediated between 13.3% and 19.0% and resilience to unhealthy food environments mediated between 5.9% and 8.6% of the relation between SEP and the DHD15-index. Individual-level factors such as cooking skills can only explain a small proportion of the SEP differences in diet quality. On top of other psychosocial and material resources not included in this study, it is likely that structural factors outside the individual, such as financial, work and living circumstances also play an important role.
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Affiliation(s)
- Jody C Hoenink
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, the Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, the Netherlands
| | - Wilma Waterlander
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, the Netherlands
| | - Joline W J Beulens
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Joreintje D Mackenbach
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, De Boelelaan, 1117, Amsterdam, the Netherlands
- Upstream Team, www.upstreamteam.nl, Amsterdam UMC, the Netherlands
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15
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Dys S, Steeves-Reece A, Carder PC. Lifelong Instability and Perceived Risk of Future Homelessness in Older Adults. JOURNAL OF AGING AND ENVIRONMENT 2021. [DOI: 10.1080/26892618.2021.2001706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sarah Dys
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA
- Institute on Aging, College of Urban and Public Affairs, Portland State University, Portland, OR, USA
- Vital Research, LLC, Los Angeles, CA, USA
| | - Anna Steeves-Reece
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA
- Oregon Rural Practice-Based Research Network, Oregon Health & Science University, Portland, OR, USA
| | - Paula C. Carder
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA
- Institute on Aging, College of Urban and Public Affairs, Portland State University, Portland, OR, USA
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16
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Madero-Cabib I, Azar A, Bambs C. Lifetime employment, tobacco use, and alcohol consumption trajectories and cardiovascular diseases in old age. SSM Popul Health 2021; 13:100737. [PMID: 33553569 PMCID: PMC7848642 DOI: 10.1016/j.ssmph.2021.100737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/30/2020] [Accepted: 01/16/2021] [Indexed: 12/19/2022] Open
Abstract
Despite the great advances of life course epidemiology studies during the last decade in understanding the general health effects of employment trajectories, research has yet to evaluate the effects of employment trajectories along with other major risk factors, such as tobacco and alcohol consumption, on cardiovascular diseases (CVDs)-the main cause of deaths worldwide. This is highly relevant, since health advantages in one domain (e.g., being a permanent formal full-time worker) may offset health disadvantages in other domains (e.g., being a regular smoker or alcohol consumer); conversely, disadvantages in both domains may interact, leading to even greater health risks. Considering these knowledge gaps, this research has two main objectives: (1) to reconstruct simultaneous employment, tobacco use, and alcohol consumption trajectories over the life course (from birth to old age) and (2) to measure the association between these trajectories and CVD in old age. Drawing on a rich and comprehensive life history dataset and using multichannel sequence and regression analyses, we analyzed a cohort of individuals aged 65-75 in Chile, a Latin American country with high social inequalities and scarce research on this matter. Our study shows that following a trajectory of formal employment together with no tobacco and alcohol use reduces CVD risk by 36 percentage points relative to a similar employment trajectory but with regular tobacco and alcohol use. Even with an employment trajectory characterized by constant informal employment or permanent inactivity, a life course free of regular tobacco and alcohol use shows protective effects against CVD. This study stresses the importance of health policies that consider CVD as a condition that strongly depends on individual experiences in multiple life domains and across different life stages.
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Affiliation(s)
- Ignacio Madero-Cabib
- Instituto de Sociología & Departamento de Salud Pública, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Chile
| | - Ariel Azar
- Millennium Nucleus for the Study of the Life Course and Vulnerability (MLIV), Chile
- Department of Sociology, The University of Chicago, Chicago, IL, USA
| | - Claudia Bambs
- Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Advanced Center for Chronic Diseases(ACCDiS), Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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17
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Bhatta TR. Intercohort Variations in the Education-Health Gradient: Sociohistorical Changes in Early-Life Selection Mechanisms in the United States. J Gerontol B Psychol Sci Soc Sci 2021; 76:330-342. [PMID: 32674150 DOI: 10.1093/geronb/gbaa100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Most prior studies on cohort-specific changes in the education gradient relative to health treat the distribution of education within a particular cohort as a "starting place" for understanding later-life health disparities. This premise has obfuscated the role that sociohistorical changes in early-life selection mechanisms play in the widening of education-based inequalities in functional limitations across birth cohorts. METHODS Drawing from the Health and Retirement Survey (1992-2016; n = 20,920), this study employs inverse probability weight (IPW) to account for early-life selection mechanisms that are likely to affect both educational attainment and functional limitations. IPW-adjusted generalized linear mixed-effects models were used to estimate the total effect of education on functional limitations across birth cohorts (born 1924-1959). RESULTS A significant linear decline in the negative effects of childhood socioeconomic disadvantage on education (β = 0.005, p < .01) over the birth year was documented. By contrast, the same variable's negative effect on functional health increased significantly (β = 0.006, p < .001) across cohorts. Adjustment for childhood socioeconomic status did yield narrower education-based inequalities in functional limitations, but the difference between IPW-adjusted and unadjusted results was not statistically significant. The pattern of significant widening of education-based inequalities (β = -0.05, p < .001) in functional limitations across birth cohorts was maintained. DISCUSSION This study underscores the role that sociohistorical changes in early-life selection mechanisms play in modifying patterns of education-based inequalities in health across cohorts.
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Affiliation(s)
- Tirth R Bhatta
- Department of Sociology, University of Nevada, Las Vegas
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18
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Beyond the social gradient: the role of lifelong socioeconomic status in older adults' health trajectories. Aging (Albany NY) 2020; 12:24693-24708. [PMID: 33349620 PMCID: PMC7803509 DOI: 10.18632/aging.202342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/22/2020] [Indexed: 11/25/2022]
Abstract
Inequalities in older adults' health rarely consider life-course aspects of socioeconomic status (SES). We examined the association between lifelong SES and old-age health trajectories, and explored the role of lifestyle factors and depressive symptoms in this association. We followed 2760 adults aged 60+ from the Swedish National Study on Care and Aging, Kungsholmen. SES groups were derived using latent class analysis incorporating seven socioeconomic measures spanning childhood, midlife, and late life. We measured health using the Health Assessment Tool, which combines gait speed, cognition, multimorbidity, and disability. Linear mixed models were used to estimate health trajectories. Four SES groups were identified: High (34.9%), Middle (40.2%), Low (21.2%), and Mixed (3.8%). The Mixed group reported greater financial difficulties in childhood and older age, but varying SES attainment in midlife. Baseline health scores indicated that Mixed SES experienced substantial cognitive and physical deficits 12 years earlier than the High SES group. Compared to the High SES group, the Mixed SES group had the fastest health deterioration (β×time=-0.07, 95% CI:-0.11,-0.02); other groups followed a gradient (High>Middle>Low). Lifestyle factors and depressive symptoms attenuated the gradient but did not explain Mixed group's health disadvantage. Life-long SES measures are crucial for understanding older adults' health inequalities.
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19
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Liu Y, Diao L, Xu L. The impact of childhood experience of starvations on the health of older adults: Evidence from China. Int J Health Plann Manage 2020; 36:515-531. [PMID: 33331669 DOI: 10.1002/hpm.3099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 11/21/2020] [Accepted: 12/06/2020] [Indexed: 11/07/2022] Open
Abstract
This paper used pooled cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey to comprehensively investigate how childhood experiences of starvation affect the health of older Chinese adults. The study found that the childhood experience of starvation was negatively correlated with self-rated health, functional health and cognitive health among older adults. After using the model and variable substitution methods to address the endogeneity problems caused by omitted variables, the negative effects of childhood experiences of starvation on the health of older adults were still present. The Karlson-Holm-Breen decomposition method was used to test the mediation effects, and it was found that childhood experiences of starvation had adverse effects on the health of older adults through endowment insurance, household income, education and nutrition. Consequently, the government should strengthen nutrition or other related health interventions for children and make longer-term plans for improving the health of older adults.
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Affiliation(s)
- Yiwei Liu
- School of Government, Central University of Finance and Economics, Beijing, China
| | - Li Diao
- Center for Social Security Studies, Wuhan University, Wuhan, China
| | - Ling Xu
- School of Social Work, University of Texas, Arlington, Texas, USA
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20
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Mollborn S, Lawrence EM, Hummer RA. A gender framework for understanding health lifestyles. Soc Sci Med 2020; 265:113182. [PMID: 32942201 PMCID: PMC7738408 DOI: 10.1016/j.socscimed.2020.113182] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/03/2020] [Accepted: 06/28/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE A health lifestyles approach holds promise for understanding change in women's and men's health behaviors and reducing gendered health disparities. The emerging theoretical and empirical literature on health lifestyles (individuals' bundled health behaviors that are shaped by group-based identities and norms) helps elucidate complex disparities in health behaviors, but research is needed on how gender shapes the development of health lifestyles. This study proposed and assessed a dynamic multilevel framework for understanding health lifestyles that draws on insights from contemporary gender and life course scholarship. DATA Using the transition from adolescence into adulthood as an empirical case, we analyzed US data from the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 6605), which followed adolescents through young adulthood, collecting information on their health behaviors and social contexts. FINDINGS Latent class analyses showed that health lifestyles differed significantly by gender. Results supported the dynamic multilevel framework, finding more variation in health lifestyle behaviors within genders than between, high levels of change across ages, intersections of gender with age, and socioeconomic status as a structural pathway for gender's influence. CONCLUSION Taken together, these findings suggest that conceptualizing gender as a dynamic multilevel system intersecting with other social statuses is fruitful for understanding how health lifestyles form and change. These findings can inform more effective policies to change health behaviors.
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Affiliation(s)
- Stefanie Mollborn
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, 1440 15th St, Boulder, CO, 80309-0483, USA.
| | - Elizabeth M Lawrence
- Department of Sociology, University of Nevada-Las Vegas, 4505 S. Maryland Pkwy, Las Vegas, NV, 89154, USA
| | - Robert A Hummer
- Carolina Population Center and Department of Sociology, University of North Carolina, Chapel Hill, 123 W. Franklin St, Chapel Hill, NC, 27516, USA
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21
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Chronological quarantine and ageism: COVID-19 and gerontology's relationship with age categorisation. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20001324] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIn March 2020, the government of the United Kingdom advised all people aged 70 and above to self-isolate stringently for a minimum of 12 weeks in response to COVID-19. The British Society of Gerontology criticised the government for ignoring individual differences, deeming the approach ageist. Former British Geriatrics Society president David Oliver contested accusations of ageism, arguing that the approach was pragmatic discrimination based on epidemiological evidence. This debate catalyses core gerontological tensions regarding ageism, discrimination, categorisation and heterogeneity. A critical realist perspective reveals that both the government and gerontology are struggling to negotiate these irresolvable tensions. Contrary to the binary debate, age-based isolation simultaneously represents pragmatic discrimination and value-driven ageism. However, it does so partly because it relies on a chronologic epistemology that positions age as a potent biosocial axis of meaningful difference, thereby reflecting gerontology's own ageism. The ethical purism of gerontological accusations of ageism is thus somewhat misplaced, potentially obscuring an opportunity for reflection on value-laden engagements with age in social research.
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22
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Holman D, Walker A. Understanding unequal ageing: towards a synthesis of intersectionality and life course analyses. Eur J Ageing 2020; 18:239-255. [PMID: 33082738 PMCID: PMC7561228 DOI: 10.1007/s10433-020-00582-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 11/24/2022] Open
Abstract
Intersectionality has received an increasing amount of attention in health inequalities research in recent years. It suggests that treating social characteristics separately—mainly age, gender, ethnicity, and socio-economic position—does not match the reality that people simultaneously embody multiple characteristics and are therefore potentially subject to multiple forms of discrimination. Yet the intersectionality literature has paid very little attention to the nature of ageing or the life course, and gerontology has rarely incorporated insights from intersectionality. In this paper, we aim to illustrate how intersectionality might be synthesised with a life course perspective to deliver novel insights into unequal ageing, especially with respect to health. First we provide an overview of how intersectionality can be used in research on inequality, focusing on intersectional subgroups, discrimination, categorisation, and individual heterogeneity. We cover two key approaches—the use of interaction terms in conventional models and multilevel models which are particularly focussed on granular subgroup differences. In advancing a conceptual dialogue with the life course perspective, we discuss the concepts of roles, life stages, transitions, age/cohort, cumulative disadvantage/advantage, and trajectories. We conclude that the synergies between intersectionality and the life course hold exciting opportunities to bring new insights to unequal ageing and its attendant health inequalities.
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Affiliation(s)
- Daniel Holman
- Department of Sociological Studies, The University of Sheffield, Elmfield, Northumberland Road, Sheffield, S10 2TU UK
| | - Alan Walker
- Department of Sociological Studies, The University of Sheffield, Elmfield, Northumberland Road, Sheffield, S10 2TU UK
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23
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O'Neil A, Russell JD, Thompson K, Martinson ML, Peters SAE. The impact of socioeconomic position (SEP) on women's health over the lifetime. Maturitas 2020; 140:1-7. [PMID: 32972629 PMCID: PMC7273147 DOI: 10.1016/j.maturitas.2020.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 12/18/2022]
Abstract
The "social gradient of health" refers to the steep inverse associations between socioeconomic position (SEP) and the risk of premature mortality and morbidity. In many societies, due to cultural and structural factors, women and girls have reduced access to the socioeconomic resources that ensure good health and wellbeing when compared with their male counterparts. Thus, the objective of this paper is to review how SEP - a construct at the heart of the Social Determinants of Health (SDoH) theory - shapes the health and longevity of women and girls at all stages of the lifespan. Using literature identified from PubMed, Cochrane, CINAHL and EMBASE databases, we first describe the SDoH theory. We then use examples from each stage of the life course to demonstrate how SEP can differentially shape girls' and women's health outcomes compared with boys' and men's, as well as between sub-groups of girls and women when other axes of inequalities are considered, including ethnicity, race and residential setting. We also explore the key consideration of whether conventional SEP markers are appropriate for understanding the social determinants of women's health. We conclude by making key recommendations in the context of clinical, research and policy development.
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Affiliation(s)
- Adrienne O'Neil
- Heart & Mind Research, iMPACT Institute, Deakin University, 3220, VIC, Australia.
| | - Josephine D Russell
- Heart & Mind Research, iMPACT Institute, Deakin University, 3220, VIC, Australia
| | - Kelly Thompson
- Global Women's Health, The George Institute for Global Health, University of New South Wales, Australia
| | | | - Sanne A E Peters
- The George Institute for Global Health, University of Oxford, Oxford, UK; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; The George Institute for Global Health, University of New South Wales, Sydney, Australia
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24
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Social inequalities over the lifecourse and healthy ageing in Aotearoa/New Zealand: differences by Māori ethnicity and gender. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20001130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Lifecourse approaches to healthy ageing recognise that health in older age is affected by long-term cumulative inequalities between socio-economic status (SES), gender and ethnicity groups, which begin in childhood. Combining longitudinal survey data with lifecourse history interviews from 729 older New Zealanders aged 61–81 (mean = 72, standard deviation = 4.5), we tested a lifecourse model of predictors of physical, mental and social health in older age. Latent growth curve and mediation analysis showed that the link between childhood SES and late-life health (over 10 years) was mediated by education, occupation and adult wealth. To account for the moderating effects of gender and ethnicity, we modelled the effects for sub-groups separately (225 non-Māori women, 158 Māori women, 219 non-Māori men and 127 Māori men). Childhood SES was an important predictor of later-life health, mediated by education and adult SES for all participants and for non-Māori men. However, there were significantly different pathways for Māori men and for women. Māori men and women and non-Māori women did not attain the same health benefits from higher childhood SES and education as non-Māori men. Findings point to the importance of considering the mediators of lifelong impacts on health in older age, and recognition of how membership of different socially structured groups produces different pathways to late-life health.
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25
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The Association between Longest-Held Lifetime Occupation and Late-Life Cognitive Impairment: Korean Longitudinal Study of Aging (2006-2016). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176270. [PMID: 32872224 PMCID: PMC7504050 DOI: 10.3390/ijerph17176270] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 11/24/2022]
Abstract
The association between longest-held lifetime occupation and late-life cognitive impairment: Korean Longitudinal Study of Aging (2006–2016). Backgrounds: Our study hypothesized that occupation in adulthood may be one of the modifiable factors in cognitive performance. This follow-up study aimed to examine whether there was an association between the longest-held occupation in a lifetime and cognitive impairment. Methods: This study used data from the 2006, 2012, and 2016 waves of the Korean Longitudinal Study of Aging, and a total of 1733 subjects aged over 65 were included. Longest-held occupation in a lifetime was classified into blue-collar, pink-collar, and white-collar. Cognitive function was evaluated using the Korean version of the Mini-Mental State Examination. Results: In males, no significant associations were observed. In females, on the contrary, risk of cognitive impairment in the blue-collar occupation was consistently higher than in the white-collar occupation over the 10-year follow-up (2006, OR = 2.49, 95% CI 1.05–5.88; 2016, OR = 2.17, 95% CI 1.02−4.65). Conclusions: Lifetime occupation should be taken into consideration in the process of screening for cognitive decline in the elderly, especially females. This study needs to be interpreted cautiously in view of inherent data and methodological limitations.
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26
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Magaña I, Martínez P, Loyola MS. Health outcomes of unpaid caregivers in low- and middle-income countries: A systematic review and meta-analysis. J Clin Nurs 2020; 29:3950-3965. [PMID: 32786156 DOI: 10.1111/jocn.15450] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 07/15/2020] [Accepted: 07/24/2020] [Indexed: 01/21/2023]
Abstract
AIMS AND OBJECTIVES To explore differences in health outcomes between unpaid caregivers and noncaregivers living in low- and middle-income countries (LMICs). BACKGROUND Previous meta-analyses found worse health outcomes for unpaid caregivers in high-income nations. However, no meta-analysis has considered unpaid caregivers from LMICs. A systematic integration of this topic may contribute to nursing care for unpaid caregivers in LMICs. DESIGN Systematic review and meta-analysis of observational studies. METHODS Following PRISMA statement, studies were searched for using the CINAHL, PubMed and SciELO databases, limited to publications until 31 December 2019. Random- and fixed-effects meta-analyses were used for data synthesis. RESULTS Fourteen studies from Africa, Asia and South America were included. Unpaid caregivers of people with ill-health were more anxious and depressed than noncaregivers. Studies conducted in Asia and South America reported poorer health outcomes for unpaid caregivers than noncaregivers, whereas the trend for African studies was the opposite. Unpaid caregivers of healthy individuals may have better health status than noncaregivers, particularly those caring between 1-14 hr per week. Of the six studies which examined gender differences, two studies informed worse health outcomes for women, one presented the opposite effect, and three found no differences. CONCLUSIONS Individual, social, cultural and systemic factors play an important role in the health outcomes of unpaid caregivers in LMICs. More evidence is needed from LMICs. As unpaid caregivers are predominantly female, urgent attention to the health outcomes of female unpaid caregivers is required. RELEVANCE TO CLINICAL PRACTICE The management of mental health problems, particularly anxiety and depression, should be an integral part of nursing care for unpaid caregivers living in LMICs. To further promote the health of unpaid caregivers in developing countries, stakeholders should consider launching educational campaigns that assist caregivers in finding ways to meet their cultural obligations while also reinforcing caregiver self-care.
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Affiliation(s)
- Irene Magaña
- Escuela de Psicología, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.,Centros de Estudios Migratorios (CEM), Universidad de Santiago de Chile, Santiago, Chile
| | - Pablo Martínez
- Escuela de Psicología, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.,Departamento de Psiquiatría y Salud Mental, Hospital Clínico Universidad de Chile, Santiago, Chile.,Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes, Imhay, Santiago, Chile.,Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Santiago, Chile
| | - María-Soledad Loyola
- Escuela de Psicología, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.,Centros de Estudios Migratorios (CEM), Universidad de Santiago de Chile, Santiago, Chile
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27
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Bíró A, Branyiczki R. Transition shocks during adulthood and health a few decades later in post-socialist Central and Eastern Europe. BMC Public Health 2020; 20:698. [PMID: 32414350 PMCID: PMC7227088 DOI: 10.1186/s12889-020-08839-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 05/03/2020] [Indexed: 11/24/2022] Open
Abstract
Background Health of the population of post-socialist Central and Eastern European (CEE) countries lags behind the European Union average. Our aim in this paper is to analyse the link between transition shocks and health two-three decades later. Methods We use retrospective data from the Survey of Health, Ageing and Retirement in Europe. We estimate the implications of stressful periods, financial hardships and job loss occurring around the transition (1987–1993) on subjective and objective measures of health in 2017. We compare these implications across groups of CEE countries and with the health implications of similar difficulties reported by individuals from Western Europe. We also compare the health implications of difficulties occurring around the transition to difficulties occurring before or after the transition. Results In the CEE region there is a peak in the timing of difficulties around the transition. Stressful periods, financial difficulties and job loss around the period of transition are generally associated with worse subjective and objective health at older ages in all groups of CEE countries, even after netting out the effect of childhood health and demographic factors. However, the consequences of hardships due to the transition are not specific, health implications of these difficulties seem to be similar to the implications of other shocks possibly unrelated to the transition. Conclusions The high fraction of individuals experiencing stress, financial difficulties and job loss around the transition contributed to the current health disadvantage in the CEE region. As similar shocks in the West and before or after the transition had similar health implications, our results draw the attention to the long-lasting impacts of psychosocial stress and financial hardship during adulthood on later health over the life course.
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Affiliation(s)
- Anikó Bíró
- Health and Population "Lendület" Research Group at the Centre for Economic and Regional Studies, Tóth Kálmán utca 4, Budapest, 1097, Hungary.
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Knöchelmann A, Günther S, Moor I, Seifert N, Richter M. Social mobility, accumulation of disadvantages and health. An analysis with retrospective data from the GSOEP (2002-14). Eur J Public Health 2020; 30:98-104. [PMID: 31298281 DOI: 10.1093/eurpub/ckz128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Socioeconomic position (SEP) in different life stages is related to health-related quality of life (HRQoL). Yet, research on the relevance of life course processes is scarce. This study aims to analyse the association between accumulation of disadvantages, social mobility and HRQoL. METHODS Analyses were conducted using population-averaged panel-data models and are based on data from the German Socio-Economic Panel 2002-14, including retrospective biographical information, comprising 25 473 observations from 8666 persons. Intergenerational and intragenerational mobility included the occupational positions in childhood (parental position), first job and middle age. Accumulation of disadvantages was measured using an accumulation index. HRQoL was assessed using the Mental and Physical Component Summary Scores of the SF12v2. RESULTS Accumulation of disadvantages was the main predictor for the Physical Component Summary in mid-age. Men and women in a stable low SEP or with a steep downward mobility showed the least favourable physical HRQoL. This holds for intergenerational and intragenerational mobility. Mental HRQoL did not seem to be associated with accumulation or social mobility. CONCLUSION The results show that physical HRQoL is related to social mobility and accumulation of (dis-)advantages. Further research is needed thoroughly analysing this association.
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Affiliation(s)
- Anja Knöchelmann
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sebastian Günther
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Irene Moor
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Nico Seifert
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Lu P, Shelley M. Cumulative Dis/Advantage and Health Pattern in Late Life: A Comparison between Genders and Welfare State Regimes. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:686-700. [PMID: 31771483 PMCID: PMC7367435 DOI: 10.1080/19371918.2019.1695035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study provides a cross-national perspective to apply Cumulative Dis/Advantage (CDA) in explaining health inequality between developing and developed countries in the context of Welfare State Theory. Cross-sectional data from the international Health Retirement Study (United States, China, Mexico, and England) in 2013-2014 were used (n = 97,978). Four health indicators were included: self-reported health, depressive symptoms, functional ability, and memory. Regression models were fitted to examine the moderation roles of country and gender. Results indicated older Chinese and Mexican had poorer health status than their British and American counterparts consistently except for Mexicans' memory. Cumulative health gaps between developing and developed countries existed only for functional ability. There is no evidence of a widening gap in health status between genders in late life. CDA explains the increasing gaps of functional ability across age groups between countries. General health and mental health, may however, depend more on individuals' intrinsic capacity and human agency.
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Affiliation(s)
- Peiyi Lu
- Gerontology Program, Iowa State University, Ames, Iowa, USA
| | - Mack Shelley
- Statistics, and School of Education, University Professor of Political Science, Iowa State University, Ames, Iowa, USA
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Vable AM, Gilsanz P, Kawachi I. Is it possible to overcome the 'long arm' of childhood socioeconomic disadvantage through upward socioeconomic mobility? J Public Health (Oxf) 2019; 41:566-574. [PMID: 30811528 PMCID: PMC7967879 DOI: 10.1093/pubmed/fdz018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/21/2019] [Accepted: 01/30/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Socioeconomically disadvantaged children have worse adult health; we test if this 'long arm' of childhood disadvantage can be overcome through upward socioeconomic mobility in adulthood. METHODS Four SES trajectories (stable low, upwardly mobile, downwardly mobile and stable high) were created from median dichotomized childhood socioeconomic status (SES; childhood human and financial capital) and adult SES (wealth at age 67) from Health and Retirement Study respondents (N = 6669). Healthy ageing markers, in tertiles, were walking speed, peak expiratory flow (PEF), and grip strength measured in 2008 and 2010. Multinomial logistic regression models, weighted to be nationally representative, controlled for age, gender, race, birthplace, outcome year and childhood health and social capital. RESULTS Upwardly mobile individuals were as likely as the stable high SES group to be in the best health tertile for walking speed (OR = 0.81; 95% CI: 0.63, 1.05; P = 0.114), PEF (OR = 0.97; 95% CI: 0.78, 1.21; P = 0.810) and grip strength (OR = 0.97; 95%CI: 0.74, 1.27; P = 0.980). DISCUSSION Findings suggest the 'long arm' of childhood socioeconomic disadvantage can be overcome for these markers of healthy ageing through upward socioeconomic mobility.
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Affiliation(s)
- Anusha M Vable
- Department of Family and Community Medicine, University of California, San Francisco, 550 16th Street, San Francisco CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th Street, San Francisco CA, USA
| | - Paola Gilsanz
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland CA, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston MA, USA
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Madero-Cabib I, Azar A, Pérez-Cruz P. Advantages and disadvantages across the life course and health status in old age among women in Chile. Int J Public Health 2019; 64:1203-1214. [DOI: 10.1007/s00038-019-01300-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/22/2019] [Accepted: 09/11/2019] [Indexed: 12/28/2022] Open
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Durham J, Fa'avale N, Fa'avale A, Ziesman C, Malama E, Tafa S, Taito T, Etuale J, Yaranamua M, Utai U, Schubert L. The impact and importance of place on health for young people of Pasifika descent in Queensland, Australia: a qualitative study towards developing meaningful health equity indicators. Int J Equity Health 2019; 18:81. [PMID: 31159820 PMCID: PMC6547525 DOI: 10.1186/s12939-019-0978-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/03/2019] [Indexed: 11/10/2022] Open
Abstract
Background Health equity is a priority in the global sustainable development agenda. Available health equity indicators often focus on health outcomes, access to healthcare, risk factors and determinants such as income, education, and gender. Less attention has been given to other social determinants, including those related to place and ethnicity. Measures such as income, education, and gender, however, may not provide policy-makers with sufficient information to redress inequities. In this paper, we begin to develop health equity indicators for young Pasifika peoples in Logan, Queensland, Australia. While health data on Pasifika young people in Queensland is scant, available data suggests significant inequalities. The purpose of the study was to develop an understanding of the drivers of these disparities through the lens of the social determinants of health, to create health equity indicators. Methods Following meetings with community stakeholders to develop respectful and collaborative partnership processes, we took a youth participatory action research approach. Six peer researchers (3 male, 3 female) were recruited from the Logan area for the project. Following training, the peer researchers undertook 31 qualitative interviews with young Pasifika (16–24 years old). Data was manually analysed, coded and grouped into themes to develop the draft indicators. Interviews used the culturally appropriate Talanoa storytelling approach. Results Six key themes were identified from the interviews and were used to develop example indicators related to: spiritual and socio-cultural dimensions, place, access to culturally responsive services, economic and material dimensions and political dimensions. The results demonstrate health inequities experienced by Pasifika populations are strongly linked to place and their economic, social and cultural position. Conclusions This study emphasises the need to understand the multiplicity of place-based factors that interact in complex ways to shape health inequities for young Pasifika peoples. It highlights health equity indicators must go beyond healthcare services, outcomes and a limited number of objective determinants, to include a more holistic focus. Starting to measure health and wellbeing via the lens of the social determinants of health will help to identify where policy-makers and programmes can intervene to begin to more adequately address inequities.
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Affiliation(s)
- Jo Durham
- University of Queensland, Brisbane, Australia.
| | | | | | | | - Eden Malama
- University of Queensland, Brisbane, Australia
| | - Sarai Tafa
- University of Queensland, Brisbane, Australia
| | | | - Jori Etuale
- University of Queensland, Brisbane, Australia
| | | | - Ueta Utai
- University of Queensland, Brisbane, Australia
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King DM, Donley T, Mbizo J, Higgins M, Langaigne A, Middleton EJ, Stokes-Williams C. The Use of a Community-Based Preconception Peer Health Educator Training Intervention to Improve Preconception Health Knowledge. J Racial Ethn Health Disparities 2019; 6:686-700. [PMID: 30838558 DOI: 10.1007/s40615-019-00567-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 01/03/2019] [Accepted: 01/25/2019] [Indexed: 12/22/2022]
Abstract
This paper highlights the use of an adapted Office of Minority Health (OMH) Preconception Health Peer Educator program to address persistent infant mortality health disparities. The community-based Attack Infant Mortality (AIM Escambia) initiative was established to increase preconception health knowledge among African American women at risk for adverse birth outcomes. Participants (N = 122) attended a 6-h AIM peer educator training, completed pretest and posttest questionnaires about their health knowledge, health attitudes, and planned engagement in health behaviors. Study results support the use of preconception health education training to inform health knowledge, health attitudes, and planned health sharing behaviors. Multidisciplinary collaborations and targeted interventions should be considered when seeking to improve community health conditions and increase health knowledge and health literacy for minority populations.
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Affiliation(s)
- Dione Moultrie King
- Department of Social Work, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
| | - Tiffany Donley
- Department of Population Health, NYU Langone Health, New York, NY, 10016, USA
| | - Justice Mbizo
- Usha Kundu, MD College of Health, Department of Public Health, University of West Florida, Pensacola, FL, 32514, USA
| | - Melody Higgins
- School of Social Work, University of Alabama, Tuscaloosa, AL, 35487, USA
| | - Anika Langaigne
- Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, 33199, USA
| | - Erica Jordan Middleton
- Department of Psychological Health & Learning Sciences, University of Houston, Houston, TX, 77004, USA
| | - Charu Stokes-Williams
- Family Medicine Residency Clinic, 55th Medical Group, United States Air Force, 2501 Capehart Rd, Bellevue, NE, 68113, USA
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Sankar UV, Kutty VR, Anand TN. Measuring childhood socioeconomic position in health research: Development and validation of childhood socioeconomic position questionnaire using mixed method approach. Health Promot Perspect 2019; 9:40-49. [PMID: 30788266 PMCID: PMC6377695 DOI: 10.15171/hpp.2019.05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 11/12/2018] [Indexed: 12/31/2022] Open
Abstract
Background: There is no single best indicator to assess the childhood socioeconomic position (CSEP) in public health research. The aim of the study is to develop and validate a new questionnaire, with adequate psychometric properties, to measure the childhood SEP of the young adults. Methods: The first phase consisted of a qualitative phase to identify the variables to measure childhood SEP through the in-depth interviews among 15 young adults (18-45 years) of rural Kerala. The second phase was a quantitative phase to validate the questionnaire through a cross sectional survey among 200 young adults of Kerala. We did content validity, reliability tests and construct validity by using exploratory factor analysis of the questionnaire to demonstrate its psychometric properties. Results: The qualitative analysis reported 26 variables spread across 5 domains to measure the CSEP. Finally, the questionnaire has 11 questions with 3 domains named as value added through paternity, maternal occupation-related factors and parental education. The questionnaire has good reliability (Cronbach's α=0.88) also. Conclusion: We have developed a reliable and valid questionnaire to measure the childhood SEP of younger adults and can be used in various public health research.
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Affiliation(s)
- Uma Vadassery Sankar
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Science and Technology, Trivandrum, Kerala, India
| | - V Raman Kutty
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Science and Technology, Trivandrum, Kerala, India
| | - T N Anand
- Research Fellow, Health Action by People, Thiruvananathapuram, Kerala, India
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Polak M, Szafraniec K, Kozela M, Wolfshaut-Wolak R, Bobak M, Pająk A. Socioeconomic status and pulmonary function, transition from childhood to adulthood: cross-sectional results from the polish part of the HAPIEE study. BMJ Open 2019; 9:e022638. [PMID: 30782683 PMCID: PMC6340009 DOI: 10.1136/bmjopen-2018-022638] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Previous studies have reported inverse associations between socioeconomic status (SES) and lung function, but less is known about whether pulmonary function is affected by SES changes. We aimed to describe the relationship of changes of SES between childhood and adulthood with pulmonary function. DESIGN Cross-sectional study. PARTICIPANTS The study sample included 4104 men and women, aged 45-69 years, residents of Krakow, participating in the Polish part of the Health, Alcohol and Psychosocial Factors in Eastern Europe Project. MAIN OUTCOME Forced expiratory volume (FEV1) and forced vital capacity (FVC) were assessed by the standardised spirometry procedure. Participants were classified into three categories of SES (low, moderate or high) based on information on parent's education, housing standard during childhood, own education, employment status, household amenities and financial status. RESULTS The adjusted difference in mean FVC between persons with low and high adulthood SES was 100 mL (p=0.005) in men and 100 mL (p<0.001) in women; the differences in mean FEV1 were 103 mL (p<0.001) and 80 mL (p<0.001), respectively. Upward social mobility and moderate or high SES at both childhood and adulthood were related to significantly higher FEV1 and FVC compared with low SES at both childhood and adulthood or downward social mobility. CONCLUSIONS Low SES over a life course was associated with the lowest lung function. Downward social mobility was associated with a poorer pulmonary function, while upward mobility or life course and moderate or high SES were associated with a better pulmonary function.
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Affiliation(s)
- Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Krystyna Szafraniec
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Magdalena Kozela
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Renata Wolfshaut-Wolak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrzej Pająk
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
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Whitley JC, Peralta CA, Haan M, Aiello AE, Lee A, Ward J, Zeki Al Hazzouri A, Neuhaus J, Moyce S, López L. The association of parental and offspring educational attainment with systolic blood pressure, fasting blood glucose and waist circumference in Latino adults. Obes Sci Pract 2018; 4:582-590. [PMID: 30574351 PMCID: PMC6298209 DOI: 10.1002/osp4.307] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/14/2018] [Accepted: 09/22/2018] [Indexed: 12/29/2022] Open
Abstract
Objective The objective of the study is to evaluate the association of intergenerational educational attainment with cardiovascular disease (CVD) risk factors among US Latinos. Methods We used cross‐sectional data from the Niños Lifestyle and Diabetes Study, an offspring cohort of middle‐aged Mexican‐Americans whose parents participated in the Sacramento Latino Study on Aging. We collected educational attainment, demographic and health behaviours and measured systolic blood pressure (SBP), fasting glucose and waist circumference. We evaluated the association of parental, offspring and a combined parent–offspring education variable with each CVD risk factor using multivariable regression. Results Higher parental education was associated only with smaller offspring waist circumference. In contrast, higher offspring education was associated with lower SBP, fasting glucose and smaller waist circumference. Adjustment for parental health behaviours modestly attenuated these offspring associations, whereas adjustment for offspring health behaviours and income attenuated the associations of offspring education with offspring SBP and fasting glucose but not smaller waist circumference, even among offspring with low parental education. Conclusions Higher offspring education is associated with lower levels of CVD risk factors in adulthood, despite intergenerational exposure to low parental education.
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Affiliation(s)
- J C Whitley
- University of California, San Francisco San Francisco CA USA
| | - C A Peralta
- University of California, San Francisco San Francisco CA USA
| | - M Haan
- University of California, San Francisco San Francisco CA USA
| | - A E Aiello
- Gillings School of Public Health University of North Carolina Chapel Hill NC USA
| | - A Lee
- University of California, San Francisco San Francisco CA USA
| | - J Ward
- Gillings School of Public Health University of North Carolina Chapel Hill NC USA
| | | | - J Neuhaus
- University of California, San Francisco San Francisco CA USA
| | - S Moyce
- College of Nursing Montana State University MT USA
| | - L López
- University of California, San Francisco San Francisco CA USA
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MacEntee MI, Wong ST, Chi I, Lo ECM, Minichiello V, Soheilipour S, Mariño R. Developmental regulation of lifelong dental experiences and beliefs in Guangzhou and Hong Kong. Gerodontology 2018; 36:18-29. [PMID: 30549089 DOI: 10.1111/ger.12383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/13/2018] [Accepted: 11/05/2018] [Indexed: 11/27/2022]
Abstract
AIMS The aim of this study was to explain through the life-course and life-span perspectives of developmental regulation theory the controls on dental experiences and beliefs throughout the lives of older people in Guangzhou and Hong Kong. BACKGROUND Dental diseases and disabilities among older people are serious public health concerns in China. METHODS A facilitator conducted eight focus groups, three in Hong Kong and five in Guangzhou, involving a total of 51 participants. She encouraged discussions about lifetime events to explain dental experiences and beliefs. Transcripts were coded and analysed using a constant comparative approach to identify themes that explained the regulators of dental experiences throughout the participants' lives. RESULTS Participants explained the influence of culture and history through critical events, and how external and internal factors regulated their current oral health status and beliefs. They emphasised the role of Traditional Chinese Medicine and family, and the stress of social upheaval compounded by a scarcity of dental services. They revealed also how current choice of dental services and health promotional programs, helped by personal food choice, self-reliance, and scepticism, helped them to adjust and cope with dental diseases and disabilities and the commercialisation of dental services. CONCLUSIONS Dental experiences and beliefs of older people living in Guangzhou and Hong Kong were regulated strongly during personal development by culture and history during critical events, and by various controlling factors, such as health promotion and choice of services supplemented by food choice, nutritional balance, self-reliance, scepticism and social adjustments.
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Affiliation(s)
- Michael I MacEntee
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sabrina T Wong
- School of Nursing, and Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Edward C M Lo
- Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - Victor Minichiello
- School of Health, Faculty of the Professions, University of New England, Armidale, New South Wales, Australia
| | - Shimae Soheilipour
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Oral Public Health, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rodrigo Mariño
- Cooperative Research Centre for Oral Health Science Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
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Hamad R, Collin DF, Rehkopf DH. Estimating the Short-Term Effects of the Earned Income Tax Credit on Child Health. Am J Epidemiol 2018; 187:2633-2641. [PMID: 30188968 DOI: 10.1093/aje/kwy179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 08/13/2018] [Indexed: 11/13/2022] Open
Abstract
The Earned Income Tax Credit (EITC) is the largest US poverty-alleviation program, yet few studies examine its effects on the health of recipients' children. We employed quasiexperimental techniques to test the hypothesis that EITC refund receipt is associated with short-term improvements in child health. The data set included children in families surveyed in the Third National Health and Nutrition Examination Survey (n = 7,444). We employed a difference-in-differences approach, exploiting the seasonal nature of EITC refund receipt. We compared children of EITC-eligible families interviewed immediately after refund receipt (February to April) with those interviewed during other months (May to January), differencing out seasonal variation among non-EITC-eligible families. We examined outcomes that were likely to be affected immediately after refund receipt, including general health, nutrition, metabolic and inflammatory biomarkers, and test scores. There were improvements in physician-reported overall health after refund receipt but no changes in infection, serum metabolic or inflammatory markers, or test scores, and there were contradictory findings for food insufficiency. In summary, EITC refunds are not strongly associated with most short-term health outcomes among recipients' children, although numerous previous studies have demonstrated impacts on longer-term outcomes. This highlights the importance of examining the effects of public policies on beneficiaries and their children using varying study designs.
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Affiliation(s)
- Rita Hamad
- Philip R. Lee Institute for Health Policy Studies, Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
| | - Daniel F Collin
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, California
| | - David H Rehkopf
- Department of Medicine, School of Medicine, Stanford University, Palo Alto, California
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Finkel D, Ernsth Bravell M. Cohort by Education Interactions in Longitudinal Changes in Functional Abilities. J Aging Health 2018; 32:208-215. [PMID: 30466342 DOI: 10.1177/0898264318814108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Investigations of cohort differences in relationships between education and health tend to focus on mortality or self-reported health. We report one of the first analyses of cohort differences in relationships between education and objective measures of functional abilities across the lifespan. Method: Up to 26 years of follow-up data were available from 859 adults from the Swedish Adoption/Twin Study of Aging. The sample was divided into two cohorts by birth year: 1900-1924 and 1925-1948. Latent growth curve models (LGCM) were compared across cohort and educational levels. Results: LGCM indicated divergence between adults with lower and higher educational attainment in longitudinal trajectories of change with age in the Balance and Flexibility factors for the later born cohort only. Discussion: Results support the cumulative advantage theory and suggest that education-health disparities are increasing in recent cohorts, even in counties with national health care systems and strong support of education.
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Affiliation(s)
- Deborah Finkel
- Indiana University Southeast, New Albany, USA.,Jönköping University, Sweden
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Bhatta TR, Albert JM, Kelley J, Kahana E. Gendered "Long Arm" of Parental Education? Life Course Influences on Later Life Functional Limitations in India. J Aging Health 2018; 32:175-188. [PMID: 30466343 DOI: 10.1177/0898264318812668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: We adopt a novel approach to mediation analysis to account for interrelated life course social processes that constitute later life health disparities. We examine gender-specific direct effect of parental education on functional limitations in later life. Method: Based on the first wave (2007-2010; n = 7,150) of the Study on Global Ageing and Adult Health (SAGE), we estimate both (natural) direct and indirect effects of parental education on functional limitations in later life. Results: We observed a significant indirect and positive effect of parental education on functional health. Contrary to prior literature, we documented adverse direct effect of parental education on later life functional health. The direct effect is statistically significant only for father's education, and is greater, though not statistically significantly so, for women than men. Discussion: The intersection of gender status and interrelated social stratification documented by this study highlights the need for gender-sensitive life course research. Such research can enhance our understanding of the ways patriarchal social systems produce heterogeneous effects of interrelated structural factors on later life health for men and women.
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Affiliation(s)
| | | | | | - Eva Kahana
- Case Western Reserve University, Cleveland, OH, USA
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Involuntary and Delayed Retirement as a Possible Health Risk for Lower Educated Retirees. JOURNAL OF POPULATION AGEING 2018. [DOI: 10.1007/s12062-018-9234-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Partnership trajectories and cardiovascular health in late life of older adults in England and Germany. SSM Popul Health 2018; 6:26-35. [PMID: 30128350 PMCID: PMC6098208 DOI: 10.1016/j.ssmph.2018.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives Previous studies have shown marital status differences in incidence and prevalence of cardiovascular disease and cardiovascular mortality. This study examines the consequences of partnership on biomarkers related to cardiovascular health of older men and women in Germany and England (C-reactive protein, HbA1c, systolic and diastolic blood pressure; and total cholesterol). Methods Data used is from older adults (60 +) from the German Survey of Health and Retirement Europe SHARE (n=955) and the English Longitudinal Study of Ageing ELSA (n=9707). Life course partnership is measured using the timing (age at first partnership), quantum (number of partnerships) and partnership trajectory. OLS for C-reactive protein, logistic regressions for systolic and diastolic blood pressure, and multinomial logistic regressions for cholesterol are used to investigate the associations between life course partnership characteristics and biomarkers, accounting for early age socioeconomic and health conditions. Results Timing of first partnership is associated with poor cardiovascular health in England, number of partnership transitions with poor health in Germany, and partnership trajectories are associated with cardiovascular health both in Germany and England. Men in trajectories with multiple marriages have higher CRP, and are more likely to have elevated systolic and diastolic BP. Trajectories containing single marital disruption for men and women are no longer associated with poor health after accounting for selection effects of childhood conditions. Respondents in widowed partnership trajectories have poorer cardiovascular health compared to those in intact committed relationships, whereas cohabitation trajectories do not differ in the associations with biomarkers from those in intact marriage. Conclusion The results offer better understanding of the pathways through which family events and processes are linked to health and support the hypothesis that adversity related to partnerships over the life course accumulates and contributes to worse cardiovascular health in later life measured by objective health measures. This study investigates the longitudinal accumulated effects of partnership on cardiovascular health using haemostatic and inflammatory biomarkers in later-life, C-reactive protein, HbA1c, systolic and diastolic blood pressure; and total cholesterol. Based on life course theory of cumulative disadvantage, the study finds support that the benefits and risks of marital status accumulate over the life-course. The effects are visible on biomarkers of older adults in both Germany and England in models that account for conditions in early life, health behaviors in adult life and sociodemographic factors. Data used is from older adults (60 +) form the German Survey of Health and Retirement Europe SHARE (n=955) and the English Longitudinal Study of Ageing ELSA (n=9707). Life course partnership is measured using the timing (age at first partnership), quantum (number of partnerships) and partnership sequence type.
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Hale JM. Cognitive Disparities: The Impact of the Great Depression and Cumulative Inequality on Later-Life Cognitive Function. Demography 2018; 54:2125-2158. [PMID: 29164499 DOI: 10.1007/s13524-017-0629-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Population aging has driven a spate of recent research on later-life cognitive function. Greater longevity increases the lifetime risk of memory diseases that compromise the cognitive abilities vital to well-being. Alzheimer's disease, thought to be the most common underlying pathology for elders' cognitive dysfunction (Willis and Hakim 2013), is already the sixth leading cause of death in the United States (Alzheimer's Association 2016). Understanding social determinants of pathological cognitive decline is key to crafting interventions, but evidence is inconclusive for how social factors interact over the life course to affect cognitive function. I study whether early-life exposure to the Great Depression is directly associated with later-life cognitive function, influences risky behaviors over the life course, and/or accumulates with other life-course disadvantages. Using growth curve models to analyze the Health and Retirement Study, I find that early-life exposure to the Great Depression is associated with fluid cognition, controlling for intervening factors-evidence for a critical period model. I find little support for a social trajectory model. Disadvantage accumulates over the life course to predict worse cognitive function, providing strong evidence for a cumulative inequality model.
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Affiliation(s)
- Jo Mhairi Hale
- Max Planck Institute for Demographic Research, Konrad-Zuse-Str. 1, 18057, Rostock, Germany.
- Department of Sociology, University of California, Davis, CA, USA.
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Craciun C, Gellert P, Flick U. Aging in Precarious Circumstances: Do Positive Views on Aging Make a Difference? THE GERONTOLOGIST 2018; 57:517-528. [PMID: 26511272 DOI: 10.1093/geront/gnv135] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 08/04/2015] [Indexed: 11/14/2022] Open
Abstract
Purpose of the study Precariousness, defined as low income combined with lack of security for retirement, can influence the way people grow old and result in health inequalities in old age. Design and methods A sequential mixed methods approach was used to identify differences in behavioral (physical activity), social (social network), and psychological resources (positive views on aging) that middle-aged individuals from both precarious and financially secure backgrounds use in preparation for positive aging and keep high levels of health and well-being. It was investigated whether positive views on aging can compensate the detrimental association of a lack of resources with health and well-being in midlife. Data from the German Aging Survey (N = 1,992 in the secure group, N = 240 in the precarious group) were analyzed to understand the relationship between resources on the one hand and health and well-being on the other, as well as to compare the strategies of individuals with precarious and financially secure backgrounds. Semistructured interviews with middle-aged individuals (N = 20) from these two categories were analyzed in order to further explain the quantitative findings. Results Precarious individuals are indeed disadvantaged in terms of behavioral, social, and psychological resources as well as in health and well-being. However, having a positive view on aging can compensate for insufficient resources. Qualitative findings showed differences in strategies for resource management and perceptions of positive aging. Implications Secondary analysis of quantitative and qualitative data reflects the importance of positive views on aging as a resource for a healthy old age despite aging in precarious circumstances.
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Affiliation(s)
- Catrinel Craciun
- Department of Education and Psychology, Division of Qualitative Social and Educational Research, Freie Universität Berlin, Germany.,Department of Psychology, Babes-Bolyai University, Cluj Napoca, Romania
| | - Paul Gellert
- Charité - CC1 - Universitätsmedizin Berlin, Germany
| | - Uwe Flick
- Department of Education and Psychology, Division of Qualitative Social and Educational Research, Freie Universität Berlin, Germany
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Ahonen EQ, Fujishiro K, Cunningham T, Flynn M. Work as an Inclusive Part of Population Health Inequities Research and Prevention. Am J Public Health 2018; 108:306-311. [PMID: 29345994 DOI: 10.2105/ajph.2017.304214] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Despite its inclusion in models of social and ecological determinants of health, work has not been explored in most health inequity research in the United States. Leaving work out of public health inequities research creates a blind spot in our understanding of how inequities are created and impedes our progress toward health equity. We first describe why work is vital to our understanding of observed societal-level health inequities. Next, we outline challenges to incorporating work in the study of health inequities, including (1) the complexity of work as a concept; (2) work's overlap with socioeconomic position, race, ethnicity, and gender; (3) the development of a parallel line of inquiry into occupational health inequities; and (4) the dearth of precise data with which to explore the relationships between work and health status. Finally, we summarize opportunities for advancing health equity and monitoring progress that could be achieved if researchers and practitioners more robustly include work in their efforts to understand and address health inequities.
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Affiliation(s)
- Emily Quinn Ahonen
- Emily Quinn Ahonen is with the departments of Environmental Health Science and Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis. Kaori Fujishiro is with the Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Cincinnati, OH. Thomas Cunningham is with the Training Research and Evaluation Branch, Education and Information Division, NIOSH. Michael Flynn is with the Occupational Health Equity Program, NIOSH
| | - Kaori Fujishiro
- Emily Quinn Ahonen is with the departments of Environmental Health Science and Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis. Kaori Fujishiro is with the Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Cincinnati, OH. Thomas Cunningham is with the Training Research and Evaluation Branch, Education and Information Division, NIOSH. Michael Flynn is with the Occupational Health Equity Program, NIOSH
| | - Thomas Cunningham
- Emily Quinn Ahonen is with the departments of Environmental Health Science and Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis. Kaori Fujishiro is with the Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Cincinnati, OH. Thomas Cunningham is with the Training Research and Evaluation Branch, Education and Information Division, NIOSH. Michael Flynn is with the Occupational Health Equity Program, NIOSH
| | - Michael Flynn
- Emily Quinn Ahonen is with the departments of Environmental Health Science and Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis. Kaori Fujishiro is with the Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Cincinnati, OH. Thomas Cunningham is with the Training Research and Evaluation Branch, Education and Information Division, NIOSH. Michael Flynn is with the Occupational Health Equity Program, NIOSH
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Hu Y, Leinonen T, Myrskylä M, Martikainen P. Changes in Socioeconomic Differences in Hospital Days With Age: Cumulative Disadvantage, Age-as-Leveler, or Both? J Gerontol B Psychol Sci Soc Sci 2018; 75:4801261. [PMID: 29340636 DOI: 10.1093/geronb/gbx161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Length of hospital stay is inversely associated with socioeconomic status (SES). It is less clear whether socioeconomic disparities in numbers of hospital days diverge or converge with age. METHOD Longitudinal linked Finnish registry data (1988-2007) from 137,653 men and women aged 50-79 years at the end of 1987 were used. Trajectories of annual total hospital days by education, household income, and occupational class were estimated using negative binomial models. RESULTS Men and women with higher education, household income, and occupational class had fewer hospital days in 1988 than those with lower SES. Hospital days increased between 1988 and 2007. For some age groups, higher SES was associated with a faster annual rate of increase, resulting in narrowing rate ratios of hospital days between SES groups (relative differences); the rate ratios remained stable for other groups. Absolute SES differences in numbers of hospital days appeared to diverge with age among those aged 50-69 years at baseline, but converge among those aged 70-79 years at baseline. DISCUSSION The hypotheses that socioeconomic disparities in health diverge or converge with age may not be mutually exclusive; we demonstrated convergence/maintenance in relative differences for all age groups, but divergence or convergence in absolute differences depending on age.
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Affiliation(s)
- Yaoyue Hu
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Taina Leinonen
- Population Research Unit, Department of Social Research, University of Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Rostock, Germany
- Population Research Unit, Department of Social Research, University of Helsinki, Finland
- Department of Social Policy, London School of Economics and Political Science, United Kingdom
| | - Pekka Martikainen
- Max Planck Institute for Demographic Research, Rostock, Germany
- Population Research Unit, Department of Social Research, University of Helsinki, Finland
- Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Sweden
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Schaap R, de Wind A, Coenen P, Proper K, Boot C. The effects of exit from work on health across different socioeconomic groups: A systematic literature review. Soc Sci Med 2017; 198:36-45. [PMID: 29275274 DOI: 10.1016/j.socscimed.2017.12.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 11/17/2017] [Accepted: 12/11/2017] [Indexed: 12/20/2022]
Abstract
Exit from work leads to different effects on health, partially depending on the socioeconomic status (SES) of people in the work exit. Several studies on the effects of exit from work on health across socioeconomic groups have been performed, but results are conflicting. The aim of this review is to systematically review the available evidence regarding the effects of exit from work on health in high and low socioeconomic groups. A systematic literature search was conducted using Pubmed, Embase, Web of Science, CINAHL and PsycINFO. Search terms related to exit from work, health, SES and design (prospective or retrospective). Articles were included if they focused on: exit from work (early/statutory retirement, unemployment or disability pension); health (general, physical or mental health and/or health behaviour); SES (educational, occupational and/or income level); and inclusion of stratified or interaction analyses to determine differences across socioeconomic groups. This search strategy resulted in 22 studies. For general, physical or mental health and health behaviour, 13 studies found more positive effects of exit from work on health among employees with a higher SES compared to employees with a lower SES. These effects were mainly found after early/statutory retirement. In conclusion, the effects of exit from work, or more specific the effects of early/statutory retirement on health are different across socioeconomic groups. However, the findings of this review should be interpreted with caution as the studies used heterogeneous health outcomes and on each health outcome a limited number of studies was included. Yet, the positive effects of exit from work on health are mainly present in higher socioeconomic groups. Therefore, public health policies should focus on improving health of employees with a lower SES, in particular after exit from work to decrease health inequalities.
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Affiliation(s)
- Rosanne Schaap
- VU University Medical Center, Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Van der Boechorststraat 7, 1007 MB Amsterdam, The Netherlands.
| | - Astrid de Wind
- VU University Medical Center, Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Van der Boechorststraat 7, 1007 MB Amsterdam, The Netherlands.
| | - Pieter Coenen
- VU University Medical Center, Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Van der Boechorststraat 7, 1007 MB Amsterdam, The Netherlands; Curtin University, School of Physiotherapy and Exercise Groups Science, GPO Box U1987, WA 6845, Perth, Australia.
| | - Karin Proper
- National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands.
| | - Cécile Boot
- VU University Medical Center, Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Van der Boechorststraat 7, 1007 MB Amsterdam, The Netherlands.
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Rigles B. The Relationship Between Adverse Childhood Events, Resiliency and Health Among Children with Autism. J Autism Dev Disord 2017; 47:187-202. [PMID: 27807754 DOI: 10.1007/s10803-016-2905-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Previous research has shown a negative relationship between adverse childhood events (ACEs) and health and resiliency among the general population, but has not examined these associations among children with autism. Purpose To determine the prevalence of ACEs among children with autism and how ACEs are associated with resiliency and health. Methods A quantitative analysis was conducted using data from the 2011-2012 National Survey of Children's Health. Results Children with autism experience significantly more ACEs than their peers, which is negatively associated with their health. However, resiliency is not significantly associated with ACEs in this population. ACEs disproportionately affect children with autism, which is negatively associated with health, but not resiliency. Further investigation into why children with autism experience more ACEs but maintain resiliency is warranted.
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Affiliation(s)
- Bethany Rigles
- Department of Sociology, The University of Colorado Boulder, 327 UCB, Boulder, CO, 80309-0327, USA.
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Palumbo AJ, De Roos AJ, Cannuscio C, Robinson L, Mossey J, Weitlauf J, Garcia L, Wallace R, Michael Y. Work Characteristics Associated with Physical Functioning in Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040424. [PMID: 28420131 PMCID: PMC5409625 DOI: 10.3390/ijerph14040424] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/30/2017] [Accepted: 04/11/2017] [Indexed: 01/09/2023]
Abstract
Women make up almost half of the labor force with older women becoming a growing segment of the population. Work characteristics influence physical functioning and women are at particular risk for physical limitations. However, little research has explored the effects of work characteristics on women’s physical functioning. U.S. women between the ages of 50 and 79 were enrolled in the Women’s Health Initiative Observational Study between 1993 and 1998. Women provided job titles and years worked at their three longest-held jobs (n = 79,147). Jobs were linked to characteristics in the Occupational Information Network. Three categories of job characteristics related to substantive complexity, physical demand, and social collaboration emerged. The association between job characteristics and physical limitations in later life, measured using a SF-36 Physical Functioning score <25th percentile, was examined using modified Poisson regression. After controlling for confounding variables, high physical demand was positively associated with physical limitations (RR = 1.09 CI: 1.06–1.12) and substantively complex work was negatively associated (RR = 0.94, CI: 0.91–0.96). Jobs requiring complex problem solving, active learning, and critical thinking were associated with better physical functioning. Employers should explore opportunities to reduce strain from physically demanding jobs and incorporate substantively complex tasks into women’s work to improve long-term health.
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Affiliation(s)
- Aimee J Palumbo
- Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA 19104, USA.
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Drexel University, Dornsife School of Public Health, Philadelphia, PA 19104, USA.
| | - Carolyn Cannuscio
- Section on Public Health, Perelman School of Medicine, University of Pennsylvania PA 19104, USA.
| | - Lucy Robinson
- Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA 19104, USA.
| | - Jana Mossey
- Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA 19104, USA.
| | - Julie Weitlauf
- Veterans Affairs, Palo Alto Health Care System, Palo Alto, CA 94304, USA.
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Lorena Garcia
- Department of Public Health Sciences, UC Davis School of Medicine, Sacramento, CA 95616, USA.
| | - Robert Wallace
- Department of Epidemiology, University of Iowa, Iowa City, IA 52242, USA.
| | - Yvonne Michael
- Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA 19104, USA.
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Park S, Kim B, Han Y. Differential Aging in Place and Depressive Symptoms: Interplay Among Time, Income, and Senior Housing. Res Aging 2017; 40:207-231. [PMID: 29298629 DOI: 10.1177/0164027517697106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We examined cumulative and differential experiences of aging in place. METHOD Data came from the 2002 and 2010 wave of the Health Retirement Study. We modeled the trajectory of later-life depressive symptoms, and how senior-housing environments moderate the negative association between economic disadvantages and depressive symptoms. RESULTS At baseline, economically disadvantaged older adults were more likely to exhibit depressive symptoms. However, detrimental effects of income group (non-low income vs. moderate income; non-low income vs. low income) on depressive symptoms did not significantly change over time. The age-leveler hypothesis may account for nonsignificant effects of disadvantaged income groups over time. DISCUSSION Findings suggest that moderate-income seniors may experience positive differentials if they age in place in a supportive senior-housing environment. Moderate-income seniors may have broader opportunities in senior housing compared to private-home peers. Senior housing might partially counter risks such as low mental health, emerging from life-course disadvantage.
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Affiliation(s)
- Sojung Park
- 1 George Warren Brown School of Social Work, Washington University in Saint Louis, St. Louis, MO, USA
| | - BoRin Kim
- 2 University of New Hampshire, Durham, NH, USA
| | - Yoonsun Han
- 3 Sungkyunkwan University, Jongno-gu, Seoul, Korea
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