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Houweling TAJ, Grünberger I. Intergenerational transmission of health inequalities: towards a life course approach to socioeconomic inequalities in health - a review. J Epidemiol Community Health 2024; 78:641-649. [PMID: 38955463 PMCID: PMC11420752 DOI: 10.1136/jech-2022-220162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/19/2024] [Indexed: 07/04/2024]
Abstract
Adult health inequalities are a persistent public health problem. Explanations are usually sought in behaviours and environments in adulthood, despite evidence on the importance of early life conditions for life course outcomes. We review evidence from a broad range of fields to unravel to what extent, and how, socioeconomic health inequalities are intergenerationally transmitted.We find that transmission of socioeconomic and associated health (dis)advantages from parents to offspring, and its underlying structural determinants, contributes substantially to socioeconomic inequalities in adult health. In the first two decades of life-from conception to early adulthood-parental socioeconomic position (SEP) and parental health strongly influence offspring adult SEP and health. Socioeconomic and health (dis)advantages are largely transmitted through the same broad mechanisms. Socioeconomic inequalities in the fetal environment contribute to inequalities in fetal development and birth outcomes, with lifelong socioeconomic and health consequences. Inequalities in the postnatal environment-especially the psychosocial and learning environment, physical exposures and socialisation-result in inequalities in child and adolescent health, development and behavioural habits, with health and socioeconomic consequences tracking into adulthood. Structural factors shape these mechanisms in a socioeconomically patterned and time-specific and place-specific way, leading to distinct birth-cohort patterns in health inequality.Adult health inequalities are for an important part intergenerationally transmitted. Effective health inequality reduction requires addressing intergenerational transmission of (dis)advantage by creating societal circumstances that allow all children to develop to their full potential.
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Affiliation(s)
- Tanja A J Houweling
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ilona Grünberger
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Balasooriya NN, Bandara JS, Rohde N. Multigenerational inequalities of opportunity in health outcomes. Int J Equity Health 2024; 23:140. [PMID: 38987776 PMCID: PMC11234677 DOI: 10.1186/s12939-024-02144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/03/2024] [Indexed: 07/12/2024] Open
Abstract
This paper studies multigenerational health transmission mechanisms in Australian panel data. Using inequality-of-opportunity (IOP) models, we demonstrate that grandparental socioeconomic status (SES) is an important determinant of personal health, even after controlling for health and SES at the parental level. Our findings hold over a range of health/biomarkers of individuals' physical and mental well-being and appear to be especially sensitive to educational outcomes on the father's side. Since ingrained socioeconomic (dis)advantages that persist over multiple generations may be indicative of social class, our results suggest that subtle attitudinal and behavioural characteristics associated with this variable may be a key factor driving health disparities.
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Affiliation(s)
- Namal N Balasooriya
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, UQ Health Sciences Building, RBWH Campus Central, Fig Tree Dr, Herston, Brisbane, QLD, 4006, Australia.
| | - Jayatilleke S Bandara
- Department of Accounting, Finance and Economics, Griffith University, Brisbane, Australia
| | - Nicholas Rohde
- Department of Accounting, Finance and Economics, Griffith University, Gold Coast, Australia
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Wu W, Liao H, Yang X. Education disrupts the intergenerational transmission of health disadvantage across three generations in China. PLoS One 2024; 19:e0302963. [PMID: 38848425 PMCID: PMC11161082 DOI: 10.1371/journal.pone.0302963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 04/17/2024] [Indexed: 06/09/2024] Open
Abstract
This article utilizes survey data from the China Family Panel Studies (CFPS) to examine whether grandparents' health disadvantage have both direct and indirect effects on the health disadvantage of their grandchildren, and whether the completion of compulsory education by parents disrupts these intergenerational transmissions in China. The findings suggest that grandparents' health disadvantage significantly increases the probability of grandchildren's health disadvantage with and without controlling parental health disadvantage and other characteristics. Moreover, the study identifies a disruptive influence of parental education on this transmission process. Rigorous robustness tests, including the use of the Compulsory Education Law as an instrumental variable to control for unobserved factors, validate these results. Mechanism analysis shows that parents completing compulsory education contribute to improving their nutritional balance and adopting healthy behaviors, attaining higher social status, earning higher income, which ultimately reduce the probability of health disadvantage for both themselves and their children. These findings highlight the persistent intergenerational transmission of health disparities within families and emphasize the importance of enhancing individuals' education levels to disrupt this transmission. By doing so, it may be possible to mitigate health inequalities and disparities across the population.
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Affiliation(s)
- Weijuan Wu
- School of Economics and Management, South China Normal University, Panyu District, Guangzhou City, Guangdong Province, China
| | - Haokai Liao
- College of Humanities and Arts, Heyuan Polytechnic, Yuancheng District, Heyuan City, Guangdong Province, China
| | - Xuelin Yang
- The School of Marxism, Jiangxi University of Technology, Gaoxin District, Nanchang City, Jiangxi Province, China
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Yan D, Ji H, Fu H, Jiang J, Su B, Ye B. The effect of fine particulate matter (PM 2.5) pollution on health inequality: an intergenerational perspective. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:195. [PMID: 38696046 DOI: 10.1007/s10653-024-01982-9] [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: 02/23/2024] [Accepted: 04/03/2024] [Indexed: 06/17/2024]
Abstract
Air pollution poses a serious challenge to public health and simultaneously exacerbating regional & intergenerational health inequality. This research introduces PM2.5 pollution into the intergenerational health transmission model, and estimates its impact on health inequality in China using Ordered Logit Regression (OLR) and Multi-scale Geographically Weighted Regression (MGWR) model. The results indicate that PM2.5 pollution exacerbate the intergenerational health inequality, and its impacts show inconsistency across family income levels, parental health insurance status, and area of residence. Specifically, it is more difficult for offspring in low-income families to escape from the influence of unhealthy family to become upwardly mobile. Additionally, this health inequality is more significant in households in which at least one parent does not have health insurance. Moreover, the intergenerational solidification caused by PM2.5 pollution is higher in the east and lower in the west. Both the PM2.5 level and solidification effect are high in Beijing-Tianjin-Hebei region, Yangtze River Delta region and central areas of China, which is the focus of air pollution management. These findings suggest that more emphasis should be placed on family-based health promotion. In areas with high PM2.5 pollution levels, resources, subsidies and air pollution protection should be provided for less healthy families with lower incomes and no health insurance.
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Affiliation(s)
- Dan Yan
- School of Public Administration, Zhejiang University of Technology, Hangzhou, 310023, China
- Zhejiang Institution of Talent Development, Hangzhou, 310023, China
| | - Honglu Ji
- Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, China
| | - Hong Fu
- School of Public Administration, Zhejiang University of Technology, Hangzhou, 310023, China
| | - Jingjing Jiang
- School of Economics and Management, Harbin Institute of Technology (Shenzhen), Shenzhen, 518055, China
| | - Bin Su
- Energy Studies Institute, National University of Singapore, Singapore, Singapore
| | - Bin Ye
- School of Environmental Science and Engineering, Southern University of Science and Technology, NO. 1088, Xueyuan Road, Nanshan District, Shenzhen, 518055, Guangdong, China.
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Tamayo Martinez N, Serdarevic F, Tahirovic E, Daenekindt S, Keizer R, Jansen PW, Tiemeier H. What maternal educational mobility tells us about the mother's parenting routines, offspring school achievement and intelligence. Soc Sci Med 2024; 345:116667. [PMID: 38364725 DOI: 10.1016/j.socscimed.2024.116667] [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: 02/19/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Educational mobility at the macro-level is a common measure of social inequality. Nonetheless, the correlates of mobility of education at the individual level are less well studied. We evaluated whether educational mobility of the second generation (compared to the first generation level) predicts differences in parenting practices of the second generation and school achievement and intelligence in the third generation. METHODS Data from a population-based cohort of children in the Netherlands (N = 3547; 49.4% boys) were analyzed. Maternal, grandparental education and family routines, a parenting practice, were reported by the mother. Child school achievement at the end of primary school (∼12 years, with the national Dutch academic test score) and child intelligence (∼6 and 13 years) were measured in a standardized manner. Also, a child genome-wide polygenic score of academic attainment was calculated. To estimate the effect of educational mobility, inverse probability-weighted linear models and Diagonal Reference Models (DRM) were used. RESULTS Upward maternal educational mobility was associated with better offspring school achievement, higher intelligence, and more family routines if compared to offspring of mothers with no upward mobility. However, mothers did not implement the same level of family routines as similarly educated mothers and grandfathers who already had achieved this educational level. Likewise, children of mothers with upward educational mobility had lower school achievement and intelligence than children of similarly educated mothers with no mobility. Child's genetic potential for education followed a similar association pattern with higher potential in children of upward mobile mothers. CONCLUSION Policymakers might overlook social inequalities when focused on parental socioeconomic status. Grandparental socioeconomic status, which independently predicts child school achievement, intelligence, and parental family routines, should also be assessed. The child's genetic endowment reflects the propensity for education across generations that partly underlies mobility and some of its effect on the offspring.
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Affiliation(s)
- Nathalie Tamayo Martinez
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Fadila Serdarevic
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Emin Tahirovic
- Association South East European Network for Medical Research-SOVE, Sarajevo, Bosnia and Herzegovina.
| | | | - Renske Keizer
- Erasmus School of Social and Behavioral Sciences, Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - Pauline W Jansen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands.
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, USA.
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Fletcher J. Decoupling genetics from attainments: The role of social environments. ECONOMICS AND HUMAN BIOLOGY 2023; 50:101259. [PMID: 37220672 PMCID: PMC10524755 DOI: 10.1016/j.ehb.2023.101259] [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: 01/05/2023] [Revised: 03/15/2023] [Accepted: 05/15/2023] [Indexed: 05/25/2023]
Abstract
This paper examines the extent to which growing up in a socially mobile environment might decouple genetic endowments related to educational attainment with actual attainments. Many models of intergenerational transmission of advantage contain both a transmission channel through endowments (i.e. genetics) from parents to children as well as from parental investments and "luck". Indeed, many scholars consider the intergenerational links due to the transmission of genetically-based advantage to place a lower bound on plausible levels of social mobility-genetics may be able to "lock in" advantage across generations. This paper explores this idea by using genetic measurements in the Health and Retirement Study to examine potential interactions between social environments and genetics related to attainments. The results suggest evidence of gene environment interactions: children born in high mobility states have lower genetic penetrance-the interaction between state-level mobility and the polygenic score for education is negative. These results suggest a need to incorporate gene-environment interactions in models of attainment and mobility and to pursue the mechanisms behind the interactions.
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Affiliation(s)
- Jason Fletcher
- La Follette School of Public Affairs, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI 53706, USA.
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Ahammer A, Halla M. The intergenerational persistence of opioid dependence: Evidence from administrative data. HEALTH ECONOMICS 2022; 31:2425-2444. [PMID: 35969540 PMCID: PMC9804411 DOI: 10.1002/hec.4589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 07/09/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
To address the opioid crisis, it is crucial to understand its origins. We provide descriptive evidence for the intergenerational persistence of opioid dependence. Our analysis is based on administrative data covering the universe of Austrian births from 1984 to 1990. We consider prescription opioids and a new proxy for addiction to illicit opioids. We find that, if at least one parent is using illicit opioids, the likelihood of the child using increases from 1% to 7%. For prescription opioids, we observe an increase from 3.6% to 6.7%. Both associations are stable and do not change when controlling for environmental variables.
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Affiliation(s)
- Alexander Ahammer
- Department of EconomicsJohannes Kepler UniversityLinzAustria
- Christian Doppler Laboratory Aging, Health, and the Labor MarketLinzAustria
| | - Martin Halla
- Department of EconomicsJohannes Kepler UniversityLinzAustria
- Christian Doppler Laboratory Aging, Health, and the Labor MarketLinzAustria
- IZA, Institute for the Study of LaborBonnGermany
- GÖG, Austrian Public Health InstituteViennaAustria
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Noghanibehambari H. Intergenerational health effects of Medicaid. ECONOMICS AND HUMAN BIOLOGY 2022; 45:101114. [PMID: 35074717 DOI: 10.1016/j.ehb.2022.101114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 06/14/2023]
Abstract
This paper investigates the effects of the introduction of Medicaid during the 1960s on next generations' birth outcomes. A federal mandate that all states must widen the coverage to all cash welfare recipients generated cross-state variations in Medicaid eligibility, specifically among nonwhites who largely overrepresented the target population. I implement a reduced-form difference-in-differences strategy that compares the birth outcomes of mothers born in states with higher cash welfare recipiency versus low welfare recipiency and different years relative to the Medicaid implementation year. Using Natality data (1970-2004), I find that Medicaid significantly improves birth outcomes. The effects are considerably larger among nonwhites, specifically blacks. The effects do not appear to be driven by preexisting trends in birth outcomes, preexisting trends in households' socioeconomic characteristics, changes in other welfare expenditures, and selective fertility. A back-of-an-envelope calculation points to a minimum of 3.9% social externality of Medicaid through income rises due to next generations' improvements in birth outcomes.
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Affiliation(s)
- Hamid Noghanibehambari
- Center for Demography of Health and Aging, University of Wisconsin-Madison, 1180 Observatory Drive, Madison 53706, WI, USA.
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Barbieri PN, Nguyen HM. When in America, do as the Americans? The evolution of health behaviors and outcomes across immigrant cohorts. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101063. [PMID: 34547713 DOI: 10.1016/j.ehb.2021.101063] [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: 01/25/2021] [Revised: 06/13/2021] [Accepted: 09/07/2021] [Indexed: 06/13/2023]
Abstract
This study seeks to understand US immigrants' health-related behaviors and outcomes across arrival cohorts. We simultaneously examine risky consumption choices (smoking and drinking) and physical health conditions (asthma, diabetes, vision problems, and coronary heart diseases) using data from the National Health Interview Surveys (1989-2018). We incorporate cohort fixed-effects and the interactions between cohort effects and years since immigration into our empirical framework to capture the dynamics of immigrant health over time. For all health indicators, we find that there are important differences between arriving immigrants and natives. Despite some heterogeneity in the dynamics of unhealthy behaviors, this heterogeneity seems to dissipate as we explore longer-term health outcomes. Overall, our findings provide an interesting outlook on how the integration into the host society affects American immigrants' health. We contribute new results to the immigrant assimilation literature, which has primarily focused on obesity and wages.
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Affiliation(s)
- Paolo Nicola Barbieri
- Centre for Health Economics, University of Gothenburg, Sweden & Department of Economic Research and Analysis, Prometeia, Italy
| | - Hieu M Nguyen
- Department of Economics, Illinois Wesleyan University, 1402 Park Street, SFH 320, Bloomington, IL 61702, USA.
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Blumenberg C, Martins RC, da Silva SG, da Silva BGC, Wehrmeister FC, Gonçalves H, Hallal PC, Crochemore-Silva I, Menezes AMB. Influence of parental physical activity on offspring's nutritional status: an intergenerational study in the 1993 Pelotas birth cohort. Public Health Nutr 2021; 25:1-8. [PMID: 34569464 PMCID: PMC9991797 DOI: 10.1017/s1368980021004079] [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: 11/01/2020] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the influence of parental physical activity on offspring's nutritional status in the 1993 Pelotas (Brazil) birth cohort. DESIGN Birth cohort study. SETTING The main outcomes were overweight and obesity status of children. The main exposure was parental physical activity over time, measured during the 11, 15 and 18 years of age follow-ups. The exposure was operationalised as cumulative, and the most recent measure before the birth of child. We adjusted Poisson regression models with robust variance to evaluate crude and adjusted associations between parental physical activity and offspring's nutritional status. All analyses were stratified according to the sex of the parent. PARTICIPANTS A total of 874 members from the 1993 Pelotas (Brazil) birth cohort followed-up at 22 years of age with their first-born child were analysed. RESULTS Children were, on average, 3·1 years old. Crude analyses showed that the mother's cumulative physical activity measure had an indirect association with the prevalence of children's obesity. The most recent maternal physical activity measure before the birth of the child was associated with 41 % lower prevalence of obesity in children, even after adjustment for confounders. CONCLUSIONS The most recent maternal physical activity measure was indirectly associated with the prevalence of obesity in children. No associations were found for fathers, reinforcing the hypothesis of a biological effect of maternal physical activity on offspring's nutritional status.
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Affiliation(s)
- Cauane Blumenberg
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
| | - Rafaela Costa Martins
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
| | - Shana Ginar da Silva
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
- Medical School, Federal University of Fronteira Sul (UFFS), Passo Fundo, Brazil
| | - Bruna Gonçalves Cordeiro da Silva
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
| | - Fernando C Wehrmeister
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
| | - Helen Gonçalves
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
| | - Pedro C Hallal
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
- Post-graduate Program in Physical Education, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Inácio Crochemore-Silva
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
- Grupo de Estudos e Pesquisa em Acelerometria (GEPEA), Pelotas, Brazil
- Post-graduate Program in Physical Education, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Ana MB Menezes
- Post-graduate Program in Epidemiology, Federal University of Pelotas (UFPel), 1160 Marechal Deodoro St., 3rd Floor, Centro, Pelotas, RS96020-220, Brazil
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Nationwide evidence that education disrupts the intergenerational transmission of disadvantage. Proc Natl Acad Sci U S A 2021; 118:2103896118. [PMID: 34312230 PMCID: PMC8346897 DOI: 10.1073/pnas.2103896118] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We leveraged a three-generation approach in 2.1 million Danes to measure the transmission and disruption of multiple health and social disadvantages: poor physical health, poor mental health, social welfare dependency, criminal offending, and protective services involvement. Health and social disadvantages clustered within a small segment of families: Adults who relied disproportionately on multiple, different health and social services tended to have parents who relied disproportionately on multiple, different health and social services and tended to have children who appeared in protective services records. Education disrupted these statistical associations between and within generations and between and within families. If associations are causal, investing in young people’s education potential could interrupt the multigenerational cycle of disadvantage and reduce health and social inequalities. Despite overall improvements in health and living standards in the Western world, health and social disadvantages persist across generations. Using nationwide administrative databases linked for 2.1 million Danish citizens, we leveraged a three-generation approach to test whether multiple, different health and social disadvantages—poor physical health, poor mental health, social welfare dependency, criminal offending, and Child Protective Services involvement—were transmitted within families and whether education disrupted these statistical associations. Health and social disadvantages concentrated, aggregated, and accumulated within a small, high-need segment of families: Adults who relied disproportionately on multiple, different health and social services tended to have parents who relied disproportionately on multiple, different health and social services and tended to have children who evidenced risk for disadvantage at an early age, through appearance in protective services records. Intra- and intergenerational comparisons were consistent with the possibility that education disrupted this transmission. Within families, siblings who obtained more education were at a reduced risk for later-life disadvantage compared with their cosiblings who obtained less education, despite shared family background. Supporting the education potential of the most vulnerable citizens might mitigate the multigenerational transmission of multiple disadvantages and reduce health and social disparities.
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Fletcher J, Jajtner KM. Intergenerational health mobility: Magnitudes and Importance of Schools and Place. HEALTH ECONOMICS 2021; 30:1648-1667. [PMID: 33896073 PMCID: PMC8195209 DOI: 10.1002/hec.4273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 01/11/2021] [Accepted: 03/29/2021] [Indexed: 06/01/2023]
Abstract
This paper broadens the literature on intergenerational persistence of socioeconomic status to consider individual, family, and spatial variation in intergenerational health mobility in the United States. Using a school-based representative panel (Add Health), we report overall health persistence of 0.17 with higher mobility in Hispanic families. We find large variation by place; intergenerational health persistence estimates range between 0 and 0.5, with similarly large ranges for absolute upward and downward health mobility. School- and contextual-level correlates indicate local race/ethnicity composition, proportion of single parents, and average mother's education may be related to observed variation in intergenerational health mobility.
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Jensen TM, Duke NN, Harris KM, Hotz VJ, Perreira KM. Like Parent, Like Child: Intergenerational Patterns of Cardiovascular Risk Factors at Midlife. J Adolesc Health 2021; 68:596-603. [PMID: 32753345 PMCID: PMC7854782 DOI: 10.1016/j.jadohealth.2020.06.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 06/04/2020] [Accepted: 06/25/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE We aimed to assess the prevalence of four cardiovascular risk factors (obesity, diabetes, excessive alcohol intake, and cigarette smoking) for parents and their adult children at the same approximate midlife age. We also evaluated associations of parents' cardiovascular risk factors, childhood health exposures, and social contexts (i.e., family, school, and neighborhood) during adolescence with adult children's cardiovascular health at midlife. METHODS We used data from respondents at Wave V of the National Longitudinal Study of Adolescent to Adult Health who had corresponding parent (mostly mothers) data from Wave I. The final sample included 10,466 adult children with a mean age of 37.8 years. Descriptive statistics and logistic regression models were estimated, accounting for the National Longitudinal Study of Adolescent to Adult Health sampling design. RESULTS At similar ages (i.e., 35-45 years) to their parents, adult children had higher rates of excessive drinking and obesity than their parents, lower rates of diabetes, and similar rates of smoking. Adult children's health largely converged and correlated with their parents' health at similar ages. Cardiovascular risks for adult children were also significantly associated with their childhood health exposures and social contexts during adolescence. Some associations varied with respect to the health status of parents at Wave I. CONCLUSIONS The cardiovascular risk of parents at midlife is strongly associated with the cardiovascular risk of their adult children at midlife. The status of parents' health during adolescence can also modify the significance and magnitude of associations between childhood health exposures or adolescent social contexts and adult children's cardiovascular risk factors.
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Affiliation(s)
- Todd M Jensen
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Naomi N Duke
- Department of Pediatrics, Duke University, Durham, North Carolina
| | - Kathleen Mullan Harris
- Department of Sociology & Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - V Joseph Hotz
- Department of Economics, Duke University, Durham, North Carolina
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Finaret AB, Masters WA. Can shorter mothers have taller children? Nutritional mobility, health equity and the intergenerational transmission of relative height. ECONOMICS AND HUMAN BIOLOGY 2020; 39:100928. [PMID: 33068874 DOI: 10.1016/j.ehb.2020.100928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/11/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
This study develops the concept of nutritional mobility, defined here as the probability that a mother ranked low in her cohort's height distribution will have a child who attains a higher rank order. We demonstrate that rank-order regression provides a robust metric of health equity, revealing differences in opportunities for each child to reach their own growth potential. We estimate four indicators of nutritional mobility and test for associations between nutritional mobility and various local economic and environmental factors. Nutritional mobility has improved over time, and the nutrition environment contributes about 2.86 times as much as a mother's height to her child's expected rank in height-for-age. Populations with the least mobility are in Latin America, and the most mobility is in more urbanized areas of Africa and Asia. Rank-order mobility is an important aspect of health equity, offering valuable insight into the role of socioecological factors in nutrition improvement across generations.
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Affiliation(s)
- Amelia B Finaret
- Department of Global Health Studies, Allegheny College, 520 N. Main Street, Meadville, PA, 16335, United States.
| | - William A Masters
- Friedman School of Nutrition Science and Policy and Department of Economics, Tufts University, United States
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15
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Branje S, Geeraerts S, de Zeeuw EL, Oerlemans AM, Koopman-Verhoeff ME, Schulz S, Nelemans S, Meeus W, Hartman CA, Hillegers MHJ, Oldehinkel AJ, Boomsma DI. Intergenerational transmission: Theoretical and methodological issues and an introduction to four Dutch cohorts. Dev Cogn Neurosci 2020; 45:100835. [PMID: 32823179 PMCID: PMC7451818 DOI: 10.1016/j.dcn.2020.100835] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/27/2020] [Accepted: 08/04/2020] [Indexed: 01/09/2023] Open
Abstract
Behaviors, traits and characteristics are transmitted from parents to offspring because of complex genetic and non-genetic processes. We review genetic and non-genetic mechanisms of intergenerational transmission of psychopathology and parenting and focus on recent methodological advances in disentangling genetic and non-genetic factors. In light of this review, we propose that future studies on intergenerational transmission should aim to disentangle genetic and non-genetic transmission, take a long-term longitudinal perspective, and focus on paternal and maternal intergenerational transmission. We present four large longitudinal cohort studies within the Consortium on Individual Development, which together address many of these methodological challenges. These four cohort studies aim to examine the extent to which genetic and non-genetic transmission from the parental generation shapes parenting behavior and psychopathology in the next generation, as well as the extent to which self-regulation and social competence mediate this transmission. Conjointly, these four cohorts provide a comprehensive approach to the study of intergenerational transmission.
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Affiliation(s)
- Susan Branje
- Youth and Family, Department of Educational and Pedagogical Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Sanne Geeraerts
- Youth and Family, Department of Educational and Pedagogical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Eveline L de Zeeuw
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Anoek M Oerlemans
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - M Elisabeth Koopman-Verhoeff
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Susanne Schulz
- Youth and Family, Department of Educational and Pedagogical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Stefanie Nelemans
- Youth and Family, Department of Educational and Pedagogical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Wim Meeus
- Youth and Family, Department of Educational and Pedagogical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Albertine J Oldehinkel
- Department of Psychiatry, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Dorret I Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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16
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Bricard D, Jusot F, Trannoy A, Tubeuf S. Inequality of opportunities in health and death: an investigation from birth to middle age in Great Britain. Int J Epidemiol 2020; 49:1739-1748. [PMID: 33011793 PMCID: PMC7746403 DOI: 10.1093/ije/dyaa130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2020] [Indexed: 11/23/2022] Open
Abstract
Objective We assess the existence of unfair inequalities in health and death using the normative framework of inequality of opportunities, from birth to middle age in Great Britain. Methods We use data from the 1958 National Child Development Study, which provides a unique opportunity to observe individual health from birth to the age of 54, including the occurrence of mortality. We measure health status combining self-assessed health and mortality. We compare and statistically test the differences between the cumulative distribution functions of health status at each age according to one childhood circumstance beyond people’s control: the father’s occupation. Results At all ages, individuals born to a ‘professional’, ‘senior manager or technician’ father report a better health status and have a lower mortality rate than individuals born to ‘skilled’, ‘partly skilled’ or ‘unskilled’ manual workers and individuals without a father at birth. The gap in the probability to report good health between individuals born into high social backgrounds compared with low, increases from 12 percentage points at age 23 to 26 at age 54. Health gaps are even more marked in health states at the bottom of the health distribution when mortality is combined with self-assessed health. Conclusions There is increasing inequality of opportunities in health over the lifespan in Great Britain. The tag of social background intensifies as individuals get older. Finally, there is added analytical value to combining mortality with self-assessed health when measuring health inequalities.
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Affiliation(s)
| | - Florence Jusot
- PSL, Université Paris-Dauphine, LEDA-LEGOS, Paris, France
| | - Alain Trannoy
- CNRS, EHESS, Centrale Marseille, AMSE, Aix-Marseille University, Marseille, France
| | - Sandy Tubeuf
- Institute of Health and Society (IRSS) and Institute of Economic and Social Research (IRES), Université catholique de Louvain, Brussels, Belgium
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17
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Fletcher J, Jajtner K. Childhood Origins Of Intergenerational Health Mobility In The United States. Health Aff (Millwood) 2020; 39:1710-1718. [PMID: 33017243 PMCID: PMC7641035 DOI: 10.1377/hlthaff.2020.00737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Policy makers and parents should share a goal that all children have opportunities to thrive, regardless of their circumstances at birth. Studies that focus on socioeconomic measures of opportunities for thriving measure intergenerational mobility, or the extent to which children's outcomes can diverge from those of their parents. We bring this focus to the study of children's health by estimating intergenerational health mobility during early childhood in a national sample. We find that children in families characterized as minorities, those without health insurance, or those with low socioeconomic status experience less upward health mobility and greater downward health mobility. We also show that community characteristics may shape health mobility. For example, children growing up in places with high proportions of uninsured residents are less likely to experience upward health mobility and more likely to experience downward health mobility. These descriptive findings may allow new insights into ways in which children's health can be decoupled from their circumstances at birth.
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Affiliation(s)
- Jason Fletcher
- Jason Fletcher is a professor in the La Follette School of Public Affairs, Departments of Sociology, Agricultural and Applied Economics, and Population Health Sciences, University of Wisconsin-Madison, in Madison, Wisconsin
| | - Katie Jajtner
- Katie Jajtner is a postdoctoral associate in the Center for Demography of Health and Aging, University of Wisconsin-Madison
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18
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Jajtner KM. Work-Limiting Disability and Intergenerational Economic Mobility. SOCIAL SCIENCE QUARTERLY 2020; 101:2001-2016. [PMID: 33223571 PMCID: PMC7676749 DOI: 10.1111/ssqu.12836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/24/2020] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To examine whether work-limiting disability may modify intergenerational economic mobility in the United States. METHODS Using the Panel Study of Income Dynamics, common metrics of intergenerational mobility are estimated by parent work-limiting disability. These include rank slope coefficients capturing persistence of socioeconomic status and absolute upward economic mobility capturing expected child outcomes. RESULTS Parent-child pairs with work-limiting disability experience five to twelve percentiles lower absolute economic mobility at the 25th percentile of parent income. More severe and/or chronic conditions have larger disparities and higher parent income is associated with smaller disparities. Women may experience larger mobility differences, while non-Hispanic black children may face a higher likelihood of parents experiencing work limitations. CONCLUSIONS Work-limiting disability appears to modify children's economic opportunity. This contributes to the understanding of disparate access to opportunity in the United States while also identifying economic disadvantages associated with disability for subsequent generations.
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Affiliation(s)
- Katie M Jajtner
- Center for Demography of Health and Aging, University of Wisconsin - Madison
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19
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Bharti S, Bharti B. Modeling Life-Course Socioeconomic Changes and Blood Pressure in Adults: Time for Transdisciplinary Approach. Am J Hypertens 2020; 33:23-25. [PMID: 31586444 DOI: 10.1093/ajh/hpz156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 08/29/2019] [Accepted: 09/13/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sahul Bharti
- Build Healthy India Movement (Research based NGO), Chandigarh, India
| | - Bhavneet Bharti
- Build Healthy India Movement (Research based NGO), Chandigarh, India
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20
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Remes H, Moustgaard H, Kestilä LM, Martikainen P. Parental education and adolescent health problems due to violence, self-harm and substance use: what is the role of parental health problems? J Epidemiol Community Health 2019; 73:225-231. [PMID: 30635438 DOI: 10.1136/jech-2018-211316] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/27/2018] [Accepted: 11/30/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Adolescent health problems are more prevalent in families with low socioeconomic position, but few studies have assessed the role of parental health in this association. This study examines the extent to which parental health problems, particularly those related to high-risk health behaviour, might explain the association between parental education and adolescent health problems due to violence, self-harm and substance use. METHODS We used longitudinal register data on a 20% representative sample of all families with children aged 0-14 years in 2000 in Finland with information on parental social background and parental and offspring health problems based on hospital discharge data. We estimated discrete-time survival models with the Karlson-Holm-Breen method on hospital admissions due to violence, self-harm and substance use among adolescents aged 13-19 years in 2001-2011 (n=145 404). RESULTS Hospital admissions were 2-3 times more common among offspring of basic educated parents than tertiary educated parents. Similar excess risks were observed among those with parental mental health problems and parental health problems due to violence, self-harm and substance use. The OR for offspring of basic educated parents was attenuated from OR 2.73 (95% CI 2.34 to 3.18) to OR 2.38 (2.04 to2.77) with adjustment for parental health problems, particularly those due to violence, self-harm and substance use. Having both low parental education and parental health problems showed simple cumulative effects. CONCLUSIONS The excess risks of hospital admissions due to violence, self-harm and substance use among adolescents with lower educated parents are largely independent of severe parental health problems.
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Affiliation(s)
- Hanna Remes
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Heta Moustgaard
- Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Laura M Kestilä
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Pekka Martikainen
- Department of Social Research, University of Helsinki, Helsinki, Finland.,CHESS, University of Stockholm, Stockholm, Sweden.,Max Planck Institute of Demographic Research, Rostock, Germany
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21
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Čvorović J. Influence of maternal height on children's health status and mortality: A cross-sectional study in poor Roma communities in rural Serbia. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2018; 69:357-363. [PMID: 30514571 DOI: 10.1016/j.jchb.2018.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 11/24/2018] [Indexed: 12/16/2022]
Abstract
To determine possible variations in children's health status and mortality associated with variations in maternal stature, an anthropometric and demographic study was conducted in a Roma population of poor socio-economic status in rural Serbia. Data were collected during several years of anthropological fieldwork. The sample consisted of 691 women, ranging from 16 to 80 years of age. In addition to stature, Roma women's demographics, reproductive history, reproductive outcomes and health status of their children were collected. The results provide evidence of a significant association between mother's stature and their children's health and mortality, with a shorter mother's stature predisposing children to poor health and survival outcomes. The findings could prompt development of a definition of short stature among Roma women to evaluate the risk based on height distribution among the general Roma population.
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Affiliation(s)
- Jelena Čvorović
- Institute of Ethnography, Serbian Academy of Sciences and Arts, Belgrade 11 000, Serbia.
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22
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Patton GC, Olsson CA, Skirbekk V, Saffery R, Wlodek ME, Azzopardi PS, Stonawski M, Rasmussen B, Spry E, Francis K, Bhutta ZA, Kassebaum NJ, Mokdad AH, Murray CJL, Prentice AM, Reavley N, Sheehan P, Sweeny K, Viner RM, Sawyer SM. Adolescence and the next generation. Nature 2018; 554:458-466. [PMID: 29469095 DOI: 10.1038/nature25759] [Citation(s) in RCA: 192] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/18/2018] [Indexed: 12/30/2022]
Abstract
Adolescent growth and social development shape the early development of offspring from preconception through to the post-partum period through distinct processes in males and females. At a time of great change in the forces shaping adolescence, including the timing of parenthood, investments in today's adolescents, the largest cohort in human history, will yield great dividends for future generations.
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Affiliation(s)
- George C Patton
- The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | - Craig A Olsson
- The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia.,Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria 3220, Australia
| | - Vegard Skirbekk
- Centre for Fertility and Health, Norwegian Institute of Public Health, Nydalen, Oslo 0403, Norway.,Columbia University, New York, New York 10032, USA
| | - Richard Saffery
- The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia
| | - Mary E Wlodek
- The University of Melbourne, Department of Physiology, Parkville, Victoria 3010, Australia
| | - Peter S Azzopardi
- The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Maternal and Child Health Program, International Development Discipline, Burnet Institute, Melbourne, Victoria 3004, Australia.,Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia 5000, Australia
| | - Marcin Stonawski
- Department of Demography, Cracow University of Economics, Cracow 31-510, Poland.,European Commission, Joint Research Centre, Centre for Advanced Studies, Ispra, Varese 21027, Italy
| | - Bruce Rasmussen
- Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne, Victoria 3000, Australia
| | - Elizabeth Spry
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia.,Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Victoria 3220, Australia
| | - Kate Francis
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | - Zulfiqar A Bhutta
- SickKids Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario M5G 0A4, Canada.,Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Nicholas J Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington 98121, USA.,Division of Pediatric Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, Washington 98105, USA
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington 98121, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington 98121, USA
| | - Andrew M Prentice
- MRC Unit The Gambia, Fajara, Gambia.,MRC International Nutrition Group, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Nicola Reavley
- The University of Melbourne, Melbourne School of Population and Global Health, Parkville, Victoria 3010, Australia
| | - Peter Sheehan
- Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne, Victoria 3000, Australia
| | - Kim Sweeny
- Victoria Institute of Strategic Economic Studies, Victoria University, Melbourne, Victoria 3000, Australia
| | - Russell M Viner
- UCL Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Susan M Sawyer
- The University of Melbourne, Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, Parkville, Victoria 3010, Australia.,Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria 3052, Australia
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23
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Thompson O. Gene-Environment Interaction in the Intergenerational Transmission of Asthma. HEALTH ECONOMICS 2017; 26:1337-1352. [PMID: 27633404 DOI: 10.1002/hec.3401] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 07/05/2016] [Accepted: 07/21/2016] [Indexed: 06/06/2023]
Abstract
Researchers have found strong linkages between parent and child health, but the mechanisms underlying intergenerational health transmission are not well understood. This paper investigates how the importance of genetic health transmission mechanisms varies by environmental conditions in the case of pediatric asthma, the single most common chronic health condition among American children. Using a sample that includes approximately 2000 adoptees and a large number of similar biological families, I find that the relative importance of genetic transmission differs strongly by socioeconomic status (SES). In high SES families, parent-child asthma associations are approximately 75% weaker among adoptees than biological children, suggesting a dominant role for genetic transmission. In lower SES families, parent-child asthma associations are virtually identical across biological and adoptive children, suggesting a negligible role for genetic transmission. A potential interpretation of this difference is that as environmental conditions affecting asthma improve among higher SES children, an increasingly large share of asthma variation is due to genetics. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Owen Thompson
- University of Wisconsin Milwaukee, Milwaukee, WI, USA
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24
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Pan J, Han W. Exploring the intergenerational persistence of health behaviour: an empirical study of smoking from China. BMC Public Health 2017; 17:557. [PMID: 28595640 PMCID: PMC5465591 DOI: 10.1186/s12889-017-4480-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/31/2017] [Indexed: 11/30/2022] Open
Abstract
Background It is of significance to look into the intergenerational transmission of risk behaviour to explain the disparity of health. Our paper contributes to the literature by providing evidence in the context of China, focusing on smoking behaviour. Methods This paper studies the intergenerational transmission of smoking in the context of China using a nationally representative dataset – the China Health and Nutrition Survey (CHNS). The two-part model, the Tobit model, and the fixed effects model are utilized for the empirical analysis, respectively. Results We found a strong intergenerational persistence of health behaviour. That is, parents’ smoking behaviour is positively correlated with their children’s smoking initiation. Conclusions Our study provides evidence of the intergenerational persistence of health behaviour in the case of smoking, in the world’s most populous country. This has policy implications for the issue of intergenerational mobility and health education, as well as for tobacco control in China.
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Affiliation(s)
- Jay Pan
- West China School of Public Health, Sichuan University, No. 17, Section 3, Ren Min Nan Road, Chengdu, China.,West China Research Center for Rural Health Development Sichuan University, Chengdu, China
| | - Wei Han
- Health, Nutrition and Population Global Practice, World Bank, 16F China World Office 2, No. 1 Jian Guo Men, Wai Avenue, Beijing, China.
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25
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Bor J, Cohen GH, Galea S. Population health in an era of rising income inequality: USA, 1980-2015. Lancet 2017; 389:1475-1490. [PMID: 28402829 DOI: 10.1016/s0140-6736(17)30571-8] [Citation(s) in RCA: 289] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 12/28/2016] [Accepted: 01/06/2017] [Indexed: 12/31/2022]
Abstract
Income inequality in the USA has increased over the past four decades. Socioeconomic gaps in survival have also increased. Life expectancy has risen among middle-income and high-income Americans whereas it has stagnated among poor Americans and even declined in some demographic groups. Although the increase in income inequality since 1980 has been driven largely by soaring top incomes, the widening of survival inequalities has occurred lower in the distribution-ie, between the poor and upper-middle class. Growing survival gaps across income percentiles since 2001 reflect falling real incomes among poor Americans as well as an increasingly strong association between low income and poor health. Changes in individual risk factors such as smoking, obesity, and substance abuse play a part but do not fully explain the steeper gradient. Distal factors correlated with rising inequality including unequal access to technological innovations, increased geographical segregation by income, reduced economic mobility, mass incarceration, and increased exposure to the costs of medical care might have reduced access to salutary determinants of health among low-income Americans. Having missed out on decades of income growth and longevity gains, low-income Americans are increasingly left behind. Without interventions to decouple income and health, or to reduce inequalities in income, we might see the emergence of a 21st century health-poverty trap and the further widening and hardening of socioeconomic inequalities in health.
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Affiliation(s)
- Jacob Bor
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Gregory H Cohen
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Sandro Galea
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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26
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Classen TJ, Thompson O. Genes and the intergenerational transmission of BMI and obesity. ECONOMICS AND HUMAN BIOLOGY 2016; 23:121-133. [PMID: 27599025 DOI: 10.1016/j.ehb.2016.08.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 08/05/2016] [Accepted: 08/15/2016] [Indexed: 06/06/2023]
Abstract
This paper compares the strength of intergenerational transmission of body mass index (BMI) and obesity in a sample of adoptees relative to a matched sample of biological children with similar observable characteristics. We find that BMI and obesity are strongly correlated among biological parent-child pairs, but there are no significant intergenerational associations in these health traits among adoptive parent-child pairs. The intergenerational elasticity of BMI for children to their parents is 0.2 in the matched biological sample, but indistinguishable from zero for adopted children with a standard error more than three times as large as the coefficient. Under reasonable assumptions, these findings indicate that the intergenerational transmission of BMI and obesity occurs primarily through genetic mechanisms. Additional analyses of transmission rates by parental gender and among step-parents and step-children support this conclusion. The role of determinants of BMI and obesity in the household environment in relation to our findings is discussed. Given the negative consequences of obesity on earnings and other economic measures, our results suggest that the genetic transmission of weight problems contributes substantially to intergenerational persistence in economic outcomes.
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Affiliation(s)
- Timothy J Classen
- Department of Economics, Quinlan School of Business, Loyola University Chicago, United States.
| | - Owen Thompson
- Department of Economics, University of Wisconsin-Milwaukee, United States
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27
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Darden M, Gilleskie D. The Effects of Parental Health Shocks on Adult Offspring Smoking Behavior and Self-Assessed Health. HEALTH ECONOMICS 2016; 25:939-54. [PMID: 25981179 PMCID: PMC6681448 DOI: 10.1002/hec.3194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 02/12/2015] [Accepted: 04/09/2015] [Indexed: 05/12/2023]
Abstract
An important avenue for smoking deterrence may be through familial ties if adult smokers respond to parental health shocks. In this paper, we merge the Original Cohort and the Offspring Cohort of the Framingham Heart Study to study how adult offspring smoking behavior and subjective health assessments vary with elder parent smoking behavior and health outcomes. These data allow us to model the smoking behavior of adult offspring over a 30-year period contemporaneously with parental behaviors and outcomes. We find strong 'like father, like son' and 'like mother, like daughter' correlations in smoking behavior. We find that adult offspring significantly curtail their own smoking following an own health shock; however, we find limited evidence that offspring smoking behavior is sensitive to parent health, with the notable exception that women significantly reduce both their smoking participation and intensity following a smoking-related cardiovascular event of a parent. We also model the subjective health assessment of adult offspring as a function of parent health, and we find that women report significantly worse health following the smoking-related death of a parent. Copyright © 2015 John Wiley & Sons, Ltd.
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28
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Cheng TL, Johnson SB, Goodman E. Breaking the Intergenerational Cycle of Disadvantage: The Three Generation Approach. Pediatrics 2016; 137:e20152467. [PMID: 27244844 PMCID: PMC4894258 DOI: 10.1542/peds.2015-2467] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/30/2015] [Indexed: 11/24/2022] Open
Abstract
Health disparities in the United States related to socioeconomic status are persistent and pervasive. This review highlights how social disadvantage, particularly low socioeconomic status and the health burden it brings, is passed from 1 generation to the next. First, we review current frameworks for understanding the intergenerational transmission of health disparities and provide 4 illustrative examples relevant to child health, development, and well-being. Second, the leading strategy to break the cycle of poverty in young families in the United States, the 2-generation approach, is reviewed. Finally, we propose a new 3-generation approach that must combine with the 2-generation approach to interrupt the intergenerational cycle of disadvantage and eliminate health disparities.
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Affiliation(s)
- Tina L Cheng
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Baltimore, Maryland;
| | - Sara B Johnson
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Baltimore, Maryland
| | - Elizabeth Goodman
- MassGeneral Hospital for Children, Boston, Massachusetts; and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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