The Role of Parent-Adolescent Relationships in the Development of (Pre)Hypertension in Young Adulthood in the U.S

Associations Between Mother-Adolescent and Father-Adolescent Relationships and Young Adult Health

IMPORTANCE

Studies linking the quality of parent-adolescent relationships with young adult health outcomes could inform investments to support these complex relationships.

OBJECTIVE

To evaluate whether consistently measured, modifiable characteristics of parent-adolescent relationships are associated with young adult health across multiple domains.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study used data from waves I (1994-1995; ages 12-17 years) and IV (2008-2009; ages 24-32 years) of the US National Longitudinal Study of Adolescent to Adult Health. Of 20 745 adolescents enrolled in wave I, 15 701 of 19 560 who were eligible completed wave IV (response rate, 80.3%). Data analyses were conducted from February 2019 to November 2020.

EXPOSURES

Parental warmth, parent-adolescent communication, time together, relationship and communication satisfaction, academic expectations, and maternal inductive discipline as reported at wave I by adolescent participants.

MAIN OUTCOMES AND MEASURES

Wave IV participant-reported self-rated health, depression, stress, optimism, nicotine dependence, substance abuse symptoms (alcohol, cannabis, or other drugs), unintended pregnancy, romantic relationship quality, physical violence, and alcohol-related injury. Separate regression models were run for mother-adolescent and father-adolescent relationships while controlling for age, biological sex, race and ethnicity, parental educational level, family structure, and child maltreatment experiences.

RESULTS

A total of 10 744 participants (mean [SD] age at wave IV, 28.2 [1.8] years; 52.0% female; 67.3% non-Hispanic White) and 8214 participants (mean [SD] age at wave IV, 28.2 [1.8] years; 50.8% female; 71.9% non-Hispanic White) had valid sampling weights and complete data for mother-adolescent and father-adolescent relationship characteristics, respectively. Adolescents who reported higher levels of mother-adolescent warmth (β = 0.11 [95% CI, 0.06-0.15]), communication (β = 0.02 [95% CI, 0.00-0.04]), time together (β = 0.07 [95% CI, 0.05-0.09]), academic expectations (β = 0.05 [95% CI, 0.02-0.08]), relationship or communication satisfaction (β = 0.07 [95% CI, 0.04-0.10]), and inductive discipline (β = 0.03 [95% CI, 0.01-0.05]) reported significantly higher levels of self-rated general health in young adulthood. Adolescents who reported higher levels of father-adolescent warmth (β = 0.07 [95% CI, 0.03-0.11]), communication (β = 0.03 [95% CI, 0.01-0.05]), time together (β = 0.06 [95% CI, 0.03-0.08]), academic expectations (β = 0.04 [95% CI, 0.01-0.06]), and relationship satisfaction (β = 0.07 [95% CI, 0.04-0.10]) also reported significantly higher levels of self-rated general health in young adulthood. Adolescents reporting higher levels of all exposures also reported significantly higher levels of optimism and romantic relationship quality in young adulthood (β coefficient range, 0.02 [95% CI, 0.00-0.04] to 0.24 [95% CI, 0.15-0.34]) and lower levels of stress and depressive symptoms (β coefficient range, -0.07 [95% CI, -0.12 to -0.02] to -0.48 [95% CI, -0.61 to -0.35]). Higher levels of parental warmth, time together, and relationship or communication satisfaction were significantly associated with lower levels of nicotine dependence (odds ratio range, 0.78 [95% CI, 0.72-0.85] to 0.89 [95% CI, 0.81-0.98]) and substance abuse symptoms (incidence rate ratio range, 0.60 [95% CI, 0.50-0.73] to 0.94 [95% CI, 0.89-0.99]), as well as lower odds of unintended pregnancy (odds ratio range, 0.81 [95% CI, 0.74-0.88] to 0.93 [95% CI, 0.86-0.99]). Patterns were less consistent for physical violence and alcohol-related injury. Characteristics of mother-adolescent and father-adolescent relationships were similarly associated with young adult outcomes.

CONCLUSIONS AND RELEVANCE

The findings of this cohort study suggest that adolescents' positive perceptions of their relationships with their mothers and fathers are associated with a wide range of favorable outcomes in young adulthood. Investments in improving parent-adolescent relationships may have substantial benefits for young adult population health.

Shared Activities With Parents During Adolescence Predicts Health Risk Across Multiple Biological Systems 22 Years Later

OBJECTIVE

Although affectively focused dimensions of social relationships are associated with differences in health risk, less research has considered nonaffective features of relationships, such as engaging in shared activities. This study sought to test whether adolescents who engaged in more shared activities with their parents had lower health risk in early midlife across multiple biological markers.

METHODS

Using data from a nationally representative study ( N = 4801), prospective associations between shared activities with parents during adolescence and health risk classifications for measures of inflammation, renal function, glucose homeostasis, and cholesterol 22 years later were examined, along with the potentially confounding roles of childhood socioeconomic status and parent-child relationship satisfaction. Exploratory analyses considered possible indirect effects of cigarette use, alcohol use, and body mass index in adulthood.

RESULTS

Engaging in more shared activities with parents was associated with a reduced likelihood of being classified in a high-risk health category for markers of inflammation ( B = -0.02, standard error [SE] = 0.01, p = .040), renal function ( B = -0.08, SE = 002, p = .001), glucose ( B = -0.06, SE = 0.23, p = .011), and high-density lipoprotein ( B = - 0.03, SE = 0.01, p = .021), and overall allostatic load ( B = - 0.02, SE = 0.02, p = .001), beyond demographic and health covariates. Controlling for parental income and relationship satisfaction largely did not affect observed associations. Exploratory tests of indirect effects imply that health behaviors in adulthood may partially account for observed associations.

CONCLUSIONS

Engaging in more shared activities predicted more optimal health classifications 22 years later, suggesting that the amount of contact between parents and teenagers may have long-lasting beneficial health effects. Furthermore, consideration of nonaffective dimensions of family relationships may provide additional insight into associations between social relationships and health.

Exploring Extrinsic and Intrinsic Work Values of British Ethnic Minorities: The Roles of Demographic Background, Job Characteristics and Immigrant Generation

Despite the increasingly diverse ethnic composition of the British labor force, there is no research investigating whether ethnic minorities have different work values from the White British demographic (White British). Using nationally representative data (2012–2013), this article fills this gap by comparing extrinsic and intrinsic work values between White British and five ethnic minorities, while distinguishing between first and second generations. The results show that both first- and second- generation minorities have stronger extrinsic work values than White British, but the ethnic differences are more pronounced for the second generations. Compared to White British, while first-generation minorities have weaker intrinsic work values, the second generations have stronger intrinsic work values. Differences in extrinsic work values are partly explained by differences in age, education and income, while differences in intrinsic work values are largely explained by age, education and job autonomy. These results hold significant implications for understanding the career choices of ethnic minorities and labor market outcomes.

COVID-19 and Adolescent Mental Health in the United Kingdom

PURPOSE

This study examines the mental health impact of the COVID-19 pandemic on adolescents in the United Kingdom as well as social, demographic, and economic variations in the impact.

METHODS

Nationally representative longitudinal panel data from the Understanding Society COVID-19 survey were analyzed. The analytical sample comprises 886 adolescents aged 10-16 years surveyed both before and during the pandemic. The Strengths and Difficulties Questionnaire was used to measure adolescents' mental health.

RESULTS

The results from person fixed-effects regression models show that adolescents with better-than-median mental health before the pandemic have experienced an increase in their emotional problems, conduct problems, hyperactivity, and peer relationship problems, but a decrease in their prosocial tendency during the pandemic. In contrast, adolescents with worse-than-median mental health before the pandemic have experienced opposite changes in each Strengths and Difficulties Questionnaire domain. Further results from lagged dependent variable regression models show that compared with girls, boys have experienced a smaller increase in emotional problems but a greater decrease in prosocial tendency. The negative mental health impact is particularly prominent among adolescents in one-parent, one-child, and low-income households. Adult household members' COVID-19 symptoms and illness have undermined adolescents' peer relationships.

CONCLUSIONS

The results reveal the pandemic's diverse impacts on adolescent mental health, which vary with adolescents' prepandemic mental health and sociodemographic backgrounds. The findings underline the need for tailored mental health support for adolescents and targeted measures to mitigate inequalities in the mental health impact of the pandemic.

The Family Health Scale: Reliability and Validity of a Short- and Long-Form

Families strongly influence the health of communities and individuals across the life course, but no validated measure of family health exists. The absence of such a measure has limited the examination of family health trends and the intersection of family health with individual and community health. The purpose of this study was to examine the reliability and validity of the Family Health Scale (FHS), creating a multi-factor long-form and a uniform short-form. The primary sample included 1,050 adults recruited from a national quota sample Qualtrics panel. Mplus version 7 was used to analyze the data using a structural equation modeling framework. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed a 32-item, 4-factor long-form scale. The four factors included (1) family social and emotional health processes; (2) family healthy lifestyle; (3) family health resources; and (4) family external social supports. A 10-item short-form of the FHS was also validated in the initial sample and a second sample of 401 adults. Both the long-form and short-form FHS correlated in the expected direction with validated measures of family functioning and healthy lifestyle. A preliminary assessment of clinical cutoffs in the short-form were correlated with depression risk. The FHS offers the potential to assess family health trends and to develop accessible, de-identified databases on the well-being of families. Important next steps include validating the scale among multiple family members and collecting longitudinal data.

Childhood socioeconomic hardship, family conflict, and young adult hypertension: The Santiago Longitudinal Study

OBJECTIVE

Stress derived from socioeconomic disadvantage can be damaging to mental and physical health. This study uses longitudinal data on a large prospectively studied cohort to examine how socioeconomic hardship during childhood leads to hypertension in young adulthood by its effects on family conflict, anxiety-depression, and body mass.

METHOD

Data are from 1,039 participants of the Santiago Longitudinal Study who were studied in childhood (M age 10 years), adolescence (14-17 years), and young adulthood (21-26 years). As young adults, 26% had elevated blood pressure or hypertension.

RESULTS

Children from more economically disadvantaged families experienced higher levels of family conflict, which related to significant increases in anxiety-depression and body mass over time, both of which were directly linked to hypertension in young adulthood.

CONCLUSIONS

Findings provide an understanding of how early-life adversity associated with socioeconomic hardship manifests as stress-related health problems in adulthood. Intervention efforts that target overweight/obesity and anxiety and depression that stem from childhood poverty might be useful for reducing the socioeconomic disparities in adult health.