1
|
Hammarström A, Westerlund H, Janlert U, Virtanen P, Ziaei S, Östergren PO. How do labour market conditions explain the development of mental health over the life-course? a conceptual integration of the ecological model with life-course epidemiology in an integrative review of results from the Northern Swedish Cohort. BMC Public Health 2024; 24:1315. [PMID: 38750531 PMCID: PMC11094982 DOI: 10.1186/s12889-024-18461-6] [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: 10/05/2023] [Accepted: 03/27/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND The aim of this study was to contribute to the theoretical development within the field of labour market effects on mental health during life by integrating Bronfenbrenner's ecological model with mainly earlier theoretical work on life-course theory. METHODS An integrative review was performed of all 52 publications about labour market conditions in relation to mental health from the longitudinal Northern Swedish Cohort study. Inductive and deductive qualitative content analysis were performed in relation to Bronfenbrenner's ecological framework combined with life-course theories. RESULTS The following nine themes were identified: 1. Macroeconomic recession impairs mental health among young people. 2. The mental health effects on individuals of youth unemployment seem rather insensitive to recession. 3. Small but consistent negative effect of neighbourhood unemployment and other work-related disadvantaged on individuals' mental health over life. 4. Youth unemployment becomes embodied as scars of mental ill-health over life. 5. Weak labour market attachment impairs mental health over life. 6. Bidirectional relations between health and weak labour market attachment over life. 7. Macrolevel structures are of importance for how labour market position cause poor health. 8. Unequal gender relations at work impacts negatively on mental health. 9. The agency to improve health over life in dyadic relations. Unemployment in society permeates from the macrolevel into the exolevel, defined by Bronfenbrenner as for example the labour market of parents or partners or the neighbourhood into the settings closest to the individual (the micro- and mesolevel) and affects the relations between the work, family, and leisure spheres of the individual. Neighbourhood unemployment leads to poor health among those who live there, independent of their employment status. Individuals' exposure to unemployment and temporary employment leads to poorer mental health over the life-course. Temporal dimensions were identified and combined with Bronfenbrenner levels into a contextual life-course model CONCLUSION: Combining the ecosocial theory with life-course theories provides a framework for understanding the embodiment of work-related mental health over life. The labour market conditions surrounding the individual are of crucial importance for the embodiment of mental health over life, at the same time as individual agency can be health promoting. Mental health can be improved by societal efforts in regulations of the labour market.
Collapse
Affiliation(s)
- Anne Hammarström
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, Stockholm, 113 65, Sweden.
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Urban Janlert
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Pekka Virtanen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Shirin Ziaei
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, Stockholm, 113 65, Sweden
| | - Per-Olof Östergren
- Social Medicine and Global Health, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| |
Collapse
|
2
|
Omorou AY, Langlois J, Böhme P, Legrand K, Muller L, Saez L, Pourcher-Lambolez C, Spitz E, Briançon S, Lecomte E. Proportionate universalism intervention is effective for tackling nutritional social gradient in adolescents: the PRALIMAP-INÈS mixed randomised trial. Public Health 2023; 221:79-86. [PMID: 37423032 DOI: 10.1016/j.puhe.2023.06.006] [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: 01/23/2023] [Revised: 05/15/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE This study aimed to investigate the effectiveness of proportionate universalism intervention to reduce the slope of the nutritional social gradient in adolescents. STUDY DESIGN A mixed (experimental and quasi-experimental) multicentre trial. METHODS Data from 985 adolescents of the PRALIMAP-INÈS trial (North-eastern France, 2012-2015) were analysed. For this, adolescents were split into five social classes according to the Family Affluence Scale: Highly Less Advantaged (H.L.Ad; n = 33), Less Advantaged (L.Ad; n = 155), Intermediate (Int; n = 404), Advantaged (Ad; n = 324) and Highly Advantaged (H.Ad; n = 69). The overweight care management was a standard care for all and a strengthened one adapted to the social class of adolescents. The main outcome was the 1-year change of the body mass index z-score (BMIz) slope. Other nutritional outcomes were BMI, ΔBMIp95 (BMI minus 95th percentile of the WHO reference), %BMIp95 (percent of 95th percentile of the WHO reference), leisure-time sport, consumption of fruits and vegetables and consumption of sugary foods and drinks. RESULTS The inclusion data confirmed a weight social gradient expressed by a significant BMIz linear regression coefficient (β = -0.09 [-0.14 to -0.04], P < 0.0001). The higher the social class, the lower the BMIz. The 1-year BMIz linear regression coefficient was -0.07 [-0.12 to -0.02], corresponding to a significant weight social gradient reduction of 23.3% (β = 0.021 [0.001 to 0.041]; P = 0.04). Consistent results were found for other nutritional outcomes. CONCLUSIONS PRALIMAP-INÈS shows that proportionate universalism intervention is effective to reduce the adolescents' nutritional social gradient and suggests that equitable health programmes and policies are a realistic goal.
Collapse
Affiliation(s)
- A Y Omorou
- University of Lorraine, APEMAC, Nancy, Metz, France; CHRU-Nancy, INSERM, University of Lorraine, CIC-1433 Clinical Epidemiology, Nancy, France.
| | - J Langlois
- National Conservatory of Arts and Crafts, Nancy, France
| | - P Böhme
- CHRU-Nancy, Department of Diabetology, Metabolic Diseases and Nutrition, Nancy, France
| | - K Legrand
- University of Lorraine, APEMAC, Nancy, Metz, France; CHRU-Nancy, INSERM, University of Lorraine, CIC-1433 Clinical Epidemiology, Nancy, France
| | - L Muller
- University of Lorraine, APEMAC, Nancy, Metz, France
| | - L Saez
- University of Lorraine, APEMAC, Nancy, Metz, France
| | | | - E Spitz
- University of Lorraine, APEMAC, Nancy, Metz, France
| | - S Briançon
- University of Lorraine, APEMAC, Nancy, Metz, France
| | - E Lecomte
- National Conservatory of Arts and Crafts, Nancy, France
| |
Collapse
|
3
|
Jayawardana D, Gannon B, Doust J, Mishra GD. Excess healthcare costs of psychological distress in young women: Evidence from linked national Medicare claims data. HEALTH ECONOMICS 2023; 32:715-734. [PMID: 36495290 PMCID: PMC10947058 DOI: 10.1002/hec.4641] [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: 06/08/2021] [Revised: 10/14/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
The prevalence of mental health disorders in young adults is increasing, yet there is limited empirical evidence on its economic consequences. We contribute to the literature by estimating the healthcare costs of psychological distress using panel data of young women (aged 18-23 years with a 5-year follow-up) from the Australian Longitudinal Study on Women's Health and linked administrative data from Medicare Australia. Our empirical strategy is based on the classical two-part model of healthcare costs with individual specific fixed-effects. We complement our analysis with a test for selection on unobservables to address potential concerns of endogeneity. We find that young women with psychological distress have 15% higher annual healthcare costs (excluding hospital costs) than women with no psychological distress. A large proportion of these costs is driven by the use of antidepressants and the services of psychiatrists and psychologists. We further find that women with psychological distress have higher out-of-pocket costs on these mental health related services compared to non-mental health specific services. Additionally, we show that the effect of psychological distress on healthcare costs is highest during the first 6 months of onset, which gradually decreases afterwards. The findings justify the importance of policy initiatives towards early prevention and treatment of psychological distress, especially among young women.
Collapse
Affiliation(s)
- Danusha Jayawardana
- Centre for Health EconomicsMonash Business SchoolMonash UniversityCaulfield EastVictoriaAustralia
| | - Brenda Gannon
- School of Economics and Centre for the Business and Economics of HealthUniversity of QueenslandSt LuciaQueenslandAustralia
- NHMRC Centre for Research Excellence on Women and Non‐Communicable Diseases (CRE WaND)School of Public HealthThe University of QueenslandHerstonQueenslandAustralia
| | - Jenny Doust
- NHMRC Centre for Research Excellence on Women and Non‐Communicable Diseases (CRE WaND)School of Public HealthThe University of QueenslandHerstonQueenslandAustralia
| | - Gita D. Mishra
- NHMRC Centre for Research Excellence on Women and Non‐Communicable Diseases (CRE WaND)School of Public HealthThe University of QueenslandHerstonQueenslandAustralia
| |
Collapse
|
4
|
Matos Fialho PM, Dragano N, Reuter M, Deindl C, Schleberger S, Metzendorf MI, Hoffmann S, Diehl K, Wachtler B, Schüttig W, Herke M, Richter M, Pischke CR. School-to-work and school-to-university transition and health inequalities among young adults: a scoping review. BMJ Open 2022; 12:e058273. [PMID: 35820759 PMCID: PMC9274510 DOI: 10.1136/bmjopen-2021-058273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The main objective was to systematically map evidence regarding the emergence of health inequalities in individuals aged 16-24 years during school-to-work and school-to-university transition (STWT). Second, we aimed to summarise the evidence on potential effects of contextual and compositional characteristics of specific institutional contexts entered during STWT on health and health behaviours. DESIGN Scoping review. STUDY SELECTION Relevant literature was systematically searched following the methodological framework proposed by Arksey and O'Malley. Ovid MEDLINE and Web of Science, and websites of the International Labour Organization and National Institute for Occupational Safety and Health were searched, using a predetermined search strategy. Articles in English or German published between 1 January 2000 and 3 February 2020 were considered. DATA EXTRACTION To collect the main information from the selected studies, a data extraction spreadsheet was created. Data were summarised and grouped into five health outcomes and five institutional contexts (school, vocational training, university, work, unemployment). RESULTS A total of 678 articles were screened for inclusion. To be able to draw a picture of the development of various health outcomes over time, we focused on longitudinal studies. Forty-six prospective studies mapping health-related outcomes during STWT were identified. Higher family socioeconomic position (SEP) was associated with higher levels of health behaviour and lower levels of health-damaging behaviour, but there was also some evidence pointing in the opposite direction. Disadvantaged family SEP negatively impacted on mental health and predicted an adverse weight development. There was limited evidence for the outcomes physical/somatic symptoms and self-rated health. Meso-level characteristics of the institutional contexts identified were not systematically assessed, only individual-level factors resulting from an exposure to these contexts, rendering an analysis of effects of contextual and compositional characteristics on health and health behaviours impossible. CONCLUSIONS This scoping review demonstrated a wide range of health inequalities during STWT for various health outcomes. However, knowledge on the role of the core institutional contexts regarding the development of health inequalities is limited.
Collapse
Affiliation(s)
- Paula Mayara Matos Fialho
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine University, Medical Faculty, Duesseldorf, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine University, Medical Faculty, Duesseldorf, Germany
| | - Marvin Reuter
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine University, Medical Faculty, Duesseldorf, Germany
| | - Christian Deindl
- Department of Social Sciences, TU Dortmund University, Dortmund, Germany
| | - Sarah Schleberger
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine University, Medical Faculty, Duesseldorf, Germany
| | - Maria-Inti Metzendorf
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice (ifam), Centre for Health and Society, Medical Faculty, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | - Stephanie Hoffmann
- Department of Public Health, Faculty for Social Work, Health, and Music, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Katharina Diehl
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Wiebke Schüttig
- Department of Health Economics, Technical University Munich, Munich, Germany
| | - Max Herke
- 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
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich-Heine University, Medical Faculty, Duesseldorf, Germany
| |
Collapse
|
5
|
Ziaei S, Hammarström A. What social determinants outside paid work are related to development of mental health during life? An integrative review of results from the Northern Swedish Cohort. BMC Public Health 2021; 21:2190. [PMID: 34847924 PMCID: PMC8638423 DOI: 10.1186/s12889-021-12143-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite global increase in burden of mental health conditions, longitudinal studies on factors related to development of mental health are scarce. Particularly integrated understanding of how factors at each level of ecological system interact to influence mental health of individuals during their life is missing. Both work and outside work (life beyond work) spheres are two important areas in human life which can have independent effects on mental health of individuals. In this integrative review, we aimed to synthesis findings about social determinants outside paid work that are related to development of mental health during life in a 27-year prospective Swedish Cohort study by using Bronfenbrenner's Ecological Systems Theory. METHODS The material for this paper consists of all mental health related papers within Northern Swedish Cohort. Papers related to outside paid work exposures of life circumstances were selected. An integrative review was conducted on 27 papers and deductive qualitative content analysis in relation to Bronfenbrenner ecological framework was performed to identify the main themes. RESULTS The results of this review showed that class structures and gender order at macro-level permeated into all other levels and finally became embodied in the individuals as symptoms of mental health during life. At the "exo-level" neighbourhood disadvantage was related to mental ill-health of individuals. The importance of parental interaction with other settings, like school, for mental health of individuals was highlighted at "meso-level". At "micro-level" poor social relationships; social and material adversities and inequality in gender relations during adult life were related to mental ill-health. CONCLUSION We found mental health of individuals to be related to both unique and common factors manifesting at different socio-ecological levels. Social structures at the macro-level namely class structures and gender order permeate all other levels and eventually become embodied in the individuals as symptoms of mental health during life. Interventions addressing gender and class related inequalities might be of importance for improving mental health of individuals during their life.
Collapse
Affiliation(s)
- Shirin Ziaei
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65, Stockholm, Stockholm, Sweden.
| | - Anne Hammarström
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65, Stockholm, Stockholm, Sweden.,Department of Epidemiology and Global Health, Umea University, 901 87, Umea, Sweden
| |
Collapse
|
6
|
Rivera-Navarro J, Conde P, Díez J, Gutiérrez-Sastre M, González-Salgado I, Sandín M, Gittelsohn J, Franco M. Urban environment and dietary behaviours as perceived by residents living in socioeconomically diverse neighbourhoods: A qualitative study in a Mediterranean context. Appetite 2020; 157:104983. [PMID: 33045303 DOI: 10.1016/j.appet.2020.104983] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 10/23/2022]
Abstract
Scholars have determined that low socioeconomic status (SES) is associated with unhealthy dietary behaviours and that local food environments shape food inequality. Less is known about how residents' perceptions of their food environment affect their dietary behaviours. We conducted 37 semistructured interviews and 29 focus groups in three socioeconomically distinct neighbourhoods in Madrid. We identified the following main categories related to social and physical food environments: (a) perceptions of healthy and unhealthy dietary behaviours, (b) children's relationships with food, (c) precariousness and (d) residential food retailer types. Older adults were perceived as healthier consumers, whereas younger people were identified as fast-food consumers. In the low- and middle-SES neighbourhoods, residents saw home-cooked legume-based stews as healthy food. In the high-SES neighbourhood, television cooking programs were highlighted as a positive influence. In the low- and middle-SES neighbourhoods, grandparents played an essential role in the transmission of healthy eating habits to their grandchildren. In the high-SES neighbourhood, children's diets at home were determined by school menus. In the low- and middle-SES neighbourhoods, participants talked about a black market where food could be purchased. Food retailers with low-quality foods were also highlighted. In all neighbourhoods, residents missed traditional food stores, and in the low- and middle-SES neighbourhoods, immigrant-run food stores were not well accepted. Our study presents the concepts shaping how neighbourhood SES differences affect dietary behaviours according to residents of a large Mediterranean city.
Collapse
Affiliation(s)
- Jesús Rivera-Navarro
- Sociology and Communication Department, Social Sciences Faculty, Universidad de Salamanca, Salamanca, Spain.
| | - Paloma Conde
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Marta Gutiérrez-Sastre
- Sociology and Communication Department, Social Sciences Faculty, Universidad de Salamanca, Salamanca, Spain
| | - Ignacio González-Salgado
- Sociology and Communication Department, Social Sciences Faculty, Universidad de Salamanca, Salamanca, Spain
| | - María Sandín
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Surgery and Medical and Social Sciences Department, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Joel Gittelsohn
- Global Obesity Prevention Center, Department of International Health, Johns Hopkins Bloomberg School of Publica Health, Baltimore, MD, United States
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Surgery and Medical and Social Sciences Department, School of Medicine and Health Sciences, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| |
Collapse
|
7
|
Briody J, Doyle O, Kelleher C. The effect of local unemployment on health: A longitudinal study of Irish mothers 2001-2011. ECONOMICS AND HUMAN BIOLOGY 2020; 37:100859. [PMID: 32114328 DOI: 10.1016/j.ehb.2020.100859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/19/2019] [Accepted: 01/29/2020] [Indexed: 06/10/2023]
Abstract
The relationship between economic conditions and health is mixed, with some evidence from the most recent financial crisis finding a positive effect of periods of unemployment on heath behaviours. This study uses longitudinal data spanning the periods before, during and after the Irish crisis of 2007, to test the impact of economic expansion and contraction on mothers physical and mental health and health behaviours. Three waves of data from the Irish Lifeways Cohort Study for the period 2001-2011, and local area employment rates from the Irish Census, are used to capture the impact of a period of increased unemployment on health before, during and after the Irish recession, independent of individual employment status. The results from fixed effect linear probability models demonstrate that an additional unit of local area unemployment increases the probability of reporting poor self-rated health by 1-1.8 percentage points and of reporting poor mental well-being by 1.4 and 2.7 percentage points depending on the instrument used. There are decreases in the probability of consuming cigarettes by 3.3 percentage points, self-describing as a regular smoker by 2.9 percentage points and obesity by 0.9 percentage points. The probability of engaging in at least 20 minutes of strenuous or moderate exercise per week declines by 7.8 and 8.7 percentage points respectively, while the probability of engaging in at least 20 minutes of mild exercise rises by 10 percentage points. These results are largely consistent with the US literature, which is predominantly based on working men, thus demonstrating the universal impact of economic vulnerability on health.
Collapse
Affiliation(s)
- Jonathan Briody
- School Of Economics, Geary Institute for Public Policy, University College Dublin Belfield, Dublin 4, Ireland.
| | - Orla Doyle
- School Of Economics, Geary Institute for Public Policy, University College Dublin Belfield, Dublin 4, Ireland
| | - Cecily Kelleher
- School of Public Health, Physiotherapy and Sports Science, Woodview House, University College Dublin Belfield, Dublin 4, Ireland
| |
Collapse
|
8
|
Assessment of the Health Status of the Oldest Olds Living on the Greek Island of Ikaria: A Population Based-Study in a Blue Zone. Curr Gerontol Geriatr Res 2019; 2019:8194310. [PMID: 31885554 PMCID: PMC6914977 DOI: 10.1155/2019/8194310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 10/11/2019] [Indexed: 12/02/2022] Open
Abstract
Objective To describe the demographic characteristics, socio-economic status, functional status (autonomy, strength), and health status (cognitive and thymic functions, cardiovascular risk factors, and nutritional status) of the oldest olds living on the Greek island of Ikaria. We also try to explain the longevity observed in this population. Methods A cross-sectional observational study of people aged 90 and over living in both municipalities of north-western Ikaria (Evdilos and Raches) was conducted over one year, from October 21, 2012 to October 21, 2013. The participants were interviewed (medical history), had a brief clinical examination, and underwent standardized geriatric assessments including the Geriatric Depression Scale (GDS-15), the Mini-Mental-State Examination (MMSE), the Activities of Daily Living (ADL), the Instrumental ADL (IADL), and an assessment of grip strength. Results Seventy-one persons (37 females, 34 males), aged 94.1 years on average, were interviewed at their homes. Seven percent were current smokers (females 5.4%, males 8.8%). Hypertension was diagnosed in 70.4% of participants, diabetes in 19.7%, hypercholesterolemia in 12.7%, and obesity in 17.2%; 66.0% of the population had one chronic disease or more. The mean score for the GDS-15 scale was 3.7/15.0, 23.7/30.0 for the MMSE, 4.0/6.0 for the ADL, and 4.2/8.0 in females and 3.6/5.0 in males for the IADL. Grip strength was 17.0 kg in females and 26.5 kg in males. Conclusions This study provides an overview of the socio-demographic and medical characteristics of the oldest olds living in a longevity Blue Zone.
Collapse
|
9
|
Wilkinson LR, Ferraro KF, Mustillo SA. Wealth in Middle and Later Life: Examining the Life Course Timing of Women's Health Limitations. THE GERONTOLOGIST 2019; 59:902-911. [PMID: 29868906 DOI: 10.1093/geront/gny048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Guided by cumulative inequality theory, this study poses two main questions: (a) Does women's poor health compromise household financial assets? (b) If yes, is wealth sensitive to the timing of women's health limitations? In addressing these questions, we consider the effect of health limitations on wealth at older ages, as well as examine how health limitations influence wealth over particular segments of the life course, giving attention to both the onset and duration of health limitations. RESEARCH DESIGN AND METHODS Using 36 years of data from the National Longitudinal Survey of Mature Women, piecewise growth curve and linear regression models were used to estimate the effects of life course timing and duration of health limitations on household wealth. RESULTS The findings reveal that women who experienced health limitations accumulated substantially less wealth over time, especially if the health limitations were manifest during childhood or early adulthood. DISCUSSION AND IMPLICATIONS This study identifies how early-life health problems lead to less wealth in later life.
Collapse
Affiliation(s)
| | - Kenneth F Ferraro
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana.,Department of Sociology, Purdue University, West Lafayette, Indiana
| | | |
Collapse
|
10
|
Elser H, Falconi AM, Bass M, Cullen MR. Blue-collar work and women's health: A systematic review of the evidence from 1990 to 2015. SSM Popul Health 2018; 6:195-244. [PMID: 30417066 PMCID: PMC6215057 DOI: 10.1016/j.ssmph.2018.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 08/06/2018] [Accepted: 08/13/2018] [Indexed: 01/09/2023] Open
Abstract
Despite the implications of gender and sex differences for health risks associated with blue-collar work, adverse health outcomes among blue-collar workers has been most frequently studied among men. The present study provides a "state-of-the-field" systematic review of the empiric evidence published on blue-collar women's health. We systematically reviewed literature related to the health of blue-collar women published between January 1, 1990 and December 31, 2015. We limited our review to peer-reviewed studies published in the English language on the health or health behaviors of women who were presently working or had previously worked in a blue-collar job. Studies were eligible for inclusion regardless of the number, age, or geographic region of blue-collar women in the study sample. We retained 177 studies that considered a wide range of health outcomes in study populations from 40 different countries. Overall, these studies suggested inferior health among female blue-collar workers as compared with either blue-collar males or other women. However, we noted several methodological limitations in addition to heterogeneity in study context and design, which inhibited comparison of results across publications. Methodological limitations of the extant literature, alongside the rapidly changing nature of women in the workplace, motivate further study on the health of blue-collar women. Efforts to identify specific mechanisms by which blue-collar work predisposes women to adverse health may be particularly valuable in informing future workplace-based and policy-level interventions.
Collapse
Affiliation(s)
- Holly Elser
- School of Public Health, Division of Epidemiology, University of California, Berkeley, 50 University Hall, Berkeley, CA 94720, United States
| | - April M. Falconi
- Stanford Center for Population Health Sciences, Stanford University, 1070 Arastradero Road, Palo Alto, CA 94304, United States
| | - Michelle Bass
- Population Research Librarian, Lane Medical Library & Knowledge Management Center, Stanford University School of Medicine, 300 Pasteur Dr L109, Stanford, CA 94305, United States
| | - Mark R. Cullen
- Stanford Center for Population Health Sciences, Stanford University, 1070 Arastradero Road, Palo Alto, CA 94304, United States
| |
Collapse
|
11
|
Landstedt E, Brydsten A, Hammarström A, Virtanen P, Almquist YB. The role of social position and depressive symptoms in adolescence for life-course trajectories of education and work: a cohort study. BMC Public Health 2016; 16:1169. [PMID: 27863527 PMCID: PMC5116205 DOI: 10.1186/s12889-016-3820-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 11/04/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND While a vast amount of studies confirm the social reproduction of class and status from one generation to the next, less is known about the role of health in the child generation for these processes. Research has shown that particularly mental distress in adolescence is important for future life chances. This study aimed to examine the importance of parental socioeconomic position and depressive symptoms in youth for life-course trajectories of education and labour market attachment among men and women. METHODS Based on four waves of questionnaire data from the Northern Swedish Cohort (n = 1,001), consisting of individuals born in 1965, three steps of gender-separate analyses were undertaken. First, the individual trajectories of education and labour market attachment from age 18 to 42 were mapped through sequence analysis. Second, cluster analysis was used to identify typical trajectories. Third, two indicators of parental socioeconomic position - occupational class and employment status - and depressive symptoms at age 16 were used in multinomial regression analyses to predict adult life-course trajectories. RESULTS Four typical trajectories were identified for men, of which three were characterised by stable employment and various lengths of education, and the fourth reflected a more unstable situation. Among women, five trajectories emerged, characterised by more instability compared to men. Low parental occupational class and unemployment were significantly associated with a higher risk of ending up in less advantaged trajectories for men while, for women, this was only the case for occupational class. Youth levels of depressive symptoms did not significantly differ across the trajectories. CONCLUSIONS This study found support for the intergenerational reproduction of social position, particularly when measured in terms of parental occupational class. Youth depressive symptoms did not show clear differences across types of trajectories, subsequently impeding such symptoms to trigger any selection processes. While this could be a consequence of the specific framework of the current study, it may also suggest that depressive symptoms in youth are not a root cause for the more complex processes through which how social position develops across life. The possible impact of welfare and labour market policies is discussed.
Collapse
Affiliation(s)
- Evelina Landstedt
- Department of Public Health and Clincial Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Anna Brydsten
- Department of Public Health and Clincial Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Anne Hammarström
- Department of Public Health and Clincial Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Pekka Virtanen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Ylva B. Almquist
- Centre for Health Equity Studies (CHESS) Stockholm University/Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
12
|
Sweeting H, Green M, Benzeval M, West P. The emergence of health inequalities in early adulthood: evidence on timing and mechanisms from a West of Scotland cohort. BMC Public Health 2016; 16:41. [PMID: 26792614 PMCID: PMC4721047 DOI: 10.1186/s12889-015-2674-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 12/23/2015] [Indexed: 11/22/2022] Open
Abstract
Background Evidence is inconsistent as to whether or not there are health inequalities in adolescence according to socio-economic position (SEP) and whether or when they emerge in early adulthood. Despite the large health inequalities literature, few studies have simultaneously compared the relative importance of ‘health selection’ versus ‘social causation’ at this life-stage. This study followed a cohort through the youth-adult transition to: (1) determine whether, and if so, when, health inequalities became evident according to both class of origin and current SEP; (2) compare the importance of health selection and social causation mechanisms; and (3) investigate whether these phenomena vary by gender. Methods Data are from a West-of-Scotland cohort, surveyed five times between age 15 (in 1987, N=1,515, response=85%) and 36. Self-reported physical and mental health were obtained at each survey. SEP was based on parental occupational class at 15, a combination of own education or occupational status at 18 and own occupational class (with an additional non-employment category) at older ages. In respect of when inequalities emerged, we used the relative index of inequality to examine associations between both parental and own current SEP and health at each age. In respect of mechanisms, path models, including SEP and health at each age, investigated both inter and intra-generational paths from SEP to health (‘causation’) and from health to SEP (‘selection’). Analyses were conducted separately for physical and mental health, and stratified by gender. Results Associations between both physical and mental health and parental SEP were non-significant at every age. Inequalities according to own SEP emerged for physical health at 24 and for mental health at 30. There was no evidence of selection based on physical health, but some evidence of associations between mental health in early adulthood and later SEP (intra-generational selection). Paths indicated intra-generational (males) and inter-generational (females) social causation of physical health inequalities, and intra-generational (males and females) and inter-generational (females) social causation of mental health inequalities. Conclusions The results suggest complex and reciprocal relationships between SEP and health and highlight adolescence and early adulthood as a sensitive period for this process, impacting on future life-chances and health. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2674-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Helen Sweeting
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK.
| | - Michael Green
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK.
| | - Michaela Benzeval
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK. .,Institute for Social and Economic Research, University of Essex, Colchester, CO4 3SQ, UK.
| | - Patrick West
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, UK.
| |
Collapse
|
13
|
Gustafsson PE, Hammarström A, San Sebastian M. Cumulative contextual and individual disadvantages over the life course and adult functional somatic symptoms in Sweden. Eur J Public Health 2014; 25:592-7. [PMID: 25527526 DOI: 10.1093/eurpub/cku213] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Disadvantage, originating in one's residential context or in one's past life course, has been shown to impact on health in adulthood. There is however little research on the accumulated health impact of both neighbourhood and individual conditions over the life course. This study aims to examine whether the accumulation of contextual and individual disadvantages from adolescence to middle-age predicts functional somatic symptoms (FSS) in middle-age, taking baseline health into account. METHODS The sample is the age 16, 21, 30 and 42 surveys of the prospective Northern Swedish Cohort, with analytical sample size n = 910 (85% of the original cohort). FSS at age 16 and 42, and cumulative socioeconomic disadvantage, social adversity and material adversity between 16 and 42 years were operationalized from questionnaires, and cumulative neighbourhood disadvantage between 16 and 42 years from register data. RESULTS Results showed accumulation of disadvantages jointly explained 9-12% of FSS variance. In the total sample, cumulative neighbourhood and socioeconomic disadvantage significantly predicted FSS at age 42 in the total sample. In women, neighbourhood disadvantage but not socioeconomic disadvantage contributed significantly, whereas in men, socioeconomic but not neighbourhood disadvantage contributed significantly. In all analyses, associations were largely explained by the parallel accumulation of social and material adversities, but not by symptoms at baseline. CONCLUSION In conclusion, the accumulation of diverse forms of disadvantages together plays an important role for somatic complaints in adulthood, independently of baseline health.
Collapse
Affiliation(s)
- Per E Gustafsson
- 1 Division of Social Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anne Hammarström
- 1 Division of Social Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Miguel San Sebastian
- 2 Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| |
Collapse
|
14
|
La Compleja Relación Entre Posición Socioeconómica, Estatus Migratorio y Resultados de Salud. Value Health Reg Issues 2014; 5:1-6. [PMID: 29702780 DOI: 10.1016/j.vhri.2013.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The relationship between socioeconomic position (SEP), migration and health is dynamic, difficult to predict, multifactorial and poorly studied in the Latin American region. Moreover, there are high levels of uncertainty about reasons, types, and consequences of migration to an individual, family, community, country of origin and the receiving country. OBJECTIVE To discuss the evidence about the complex relationship between SEP, migration and health outcomes. RESULTS According to international evidence available, migration has a direct impact on health outcomes in a population and, in turn, on public health policy decisions in each locality. The available evidence on this issue affects multiple parts of the social sciences. The "healthy migrant" effect is not consistently observed among immigrant populations, particularly after adjusting for PSE. Moreover, the immigrant population tends to assimilate in terms of risk factors and morbidity to the local population after about 10 years of stay in the foreign country. Migration has consequences for international relations, economic productive capacity of a country, inequality, demographic changes and health outcomes, to mention a few. CONCLUSION There is now the opportunity to generate better and more evidence longitudinal population-based around the relationship between SEP, migration status and health. This will contribute to reduce uncertainty about the health status of immigrants that is required for decision- making in public health in Chile and the region.
Collapse
|