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Colón-López A, García C. 20th Century Puerto Rico and Later-Life Health: The Association Between Multigenerational Education and Chronic Conditions in Island-Dwelling Older Adults. J Aging Health 2023; 35:3-22. [PMID: 35536114 PMCID: PMC10081163 DOI: 10.1177/08982643221097532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Previous research on the association between education and older adult health in the U.S. has not included Puerto Rico. We investigated the effects of multigenerational educational attainment and chronic conditions among older Puerto Ricans residing on the archipelago's main island. METHODS Data were from the longitudinal Puerto Rican Elderly Health Conditions Project. Generalized Poisson regression models were used to examine if multigenerational educational attainment was associated with chronic disease. RESULTS Findings show that parental educational attainment was associated with fewer chronic conditions among females at baseline but not at follow-up, suggesting that the effects of parental education on health over time are less pronounced. For males, educational attainment across the three generations was not significantly associated with chronic disease at baseline or follow-up. DISCUSSION Multigenerational education is an important determinant of older adult health that continues to be relevant in Puerto Rico and the Latin American and Hispanic-Caribbean region.
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Affiliation(s)
- Alejandra Colón-López
- Department of Sociology, 9968University of Alabama - Birmingham, Birmingham, AL, USA
| | - Catherine García
- Department of Human Development and Family Science, Aging Studies Institute, Center for Aging and Policy Studies, Lerner Center for Public Health Promotion, 2029Syracuse University, Syracuse, NY, USA
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Liu MM, Crowe M, Telles EE, Jiménez-Velázquez IZ, Dow WH. Color disparities in cognitive aging among Puerto Ricans on the archipelago. SSM Popul Health 2022; 17:100998. [PMID: 35967472 PMCID: PMC9366965 DOI: 10.1016/j.ssmph.2021.100998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/24/2021] [Accepted: 12/08/2021] [Indexed: 01/19/2023] Open
Abstract
This research seeks to contribute new understanding of color disparities and gender in cognitive aging among older adults residing in Puerto Rico. We use the island-representative Puerto Rican Elderly Health Conditions (PREHCO) longitudinal study that measures cognitive health at baseline and cognitive decline between waves. In pooled models, we discern little or no color disparities in cognition at baseline. Sex-stratified models of baseline cognition indicate that Trigueño men slightly outperform white men. In contrast, color disparities in cognitive decline are apparent. In just four years between the two waves of PREHCO, on a 20-point cognitive test scale, Black men experienced 0.78 more points of cognitive decline, while Trigueño men experienced 0.44 more points of cognitive decline than white men in Puerto Rico. Mestiza women experience 0.80 less points of cognitive decline relative to white women. Nearly all of the color/race association with cognitive decline appears to be independent from health behaviors and conditions, individual human capital attainment, and family background. While lower-status color groups more frequently report discrimination, discrimination does not mediate the impact of color/skin tone and cognitive performance, suggesting the importance of further research on the role of broader dimensions of life course structural racism.
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Affiliation(s)
- Mao-Mei Liu
- Department of Demography, University of California Berkeley, 2232 Piedmont Avenue, Berkeley, CA, 94720, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama, Birmingham, Campbell Hall, Rm 334, 1300 University Blvd., Birmingham, AL, 35233, USA
| | - Edward E. Telles
- Department of Sociology, University of California Irvine, 4171 Social Science Plaza A, Irvine, CA, 92697-5100, USA
| | - Ivonne Z. Jiménez-Velázquez
- School of Medicine & Department of Medicine, University of Puerto Rico, Medical Sciences Campus PO Box 365067, San Juan, PR, 00936-5067, USA
| | - William H. Dow
- Department of Demography, University of California Berkeley, 2232 Piedmont Avenue, Berkeley, CA, 94720, USA
- School of Public Health, University of California Berkeley, 2121 Berkeley Way #5324, Berkeley, CA, 94720, USA
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Life-course pathways from childhood socioeconomic status to type 2 diabetes in mid-late Chinese adulthood. Sci Rep 2021; 11:13051. [PMID: 34158532 PMCID: PMC8219676 DOI: 10.1038/s41598-021-91768-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
The relationship between childhood socioeconomic status (SES) and type 2 diabetes (T2D) remains inconclusive, and the pathways and mechanisms driving this relationship have yet to be clarified. This study aimed to examine the pathways linking childhood SES to T2D prevalence in mid-late adulthood in a low- and middle-income country. The incidence of T2D diagnosed in mid-late Chinese adulthood was assessed using self-reports from the Health and Retirement Longitudinal Study (CHARLS). Childhood SES was assessed by the education, occupation, survivorship of the parents and the financial situation of the family, whereas adulthood SES was assessed by education and wage. This study performed structural equation modeling to clarify the direct and indirect pathways from childhood SES to T2D via childhood health, childhood food shortage, adulthood SES and physical activity. A total of 15,132 participants were included, and the prevalence of T2D was 5.24%. This study found that childhood SES was directly associated with T2D in mid-late adulthood, the probability of developing T2D increased by 9.20% of the standard deviation for each decrease in standard deviation in childhood SES. Childhood SES was indirectly associated with T2D via adulthood SES, physical activity, childhood health and food shortage. Adulthood SES and physical activity mainly mediated the indirect pathway from childhood SES and T2D. This study showed direct and indirect pathways from disadvantaged childhood SES to increased risk of T2D in mid-late Chinese adulthood. Childhood SES, adulthood SES, physical activity, childhood health and food shortage were identified as life-course interventional targets that should be considered in the development of effective strategies to reduce the burden of T2D and SES-related health inequities in childhood.
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Karlsson L, Lundevaller EH, Schumann B. Season of birth, stillbirths, and neonatal mortality in Sweden: the Sami and non-Sami population, 1800-1899. Int J Circumpolar Health 2020; 78:1629784. [PMID: 31221048 PMCID: PMC6598521 DOI: 10.1080/22423982.2019.1629784] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Seasonal patterns of neonatal mortality and stillbirths have been found around the world. However, little is known about the association between season of birth and infant mortality of pre-industrial societies in a subarctic environment. In this study, we compared how season of birth affected the neonatal and stillbirth risk among the Sami and non-Sami in Swedish Sápmi during the nineteenth century. Using digitised parish records from the Demographic Data Base at Umeå University, we applied logistic regression models for estimating the association of season of birth with stillbirths and neonatal mortality, respectively. Higher neonatal mortality was found among the winter- and autumn-born Sami, compared to summer-born infants. Stillbirth risk was higher during autumn compared to summer among the Sami, whereas we found no seasonal differences in mortality among the non-Sami population. We relate the higher neonatal mortality risk among winter-born Sami to differences in seasonality of living conditions associated with reindeer herding.
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Affiliation(s)
- Lena Karlsson
- a Centre for Demographic and Ageing Research (CEDAR) , Umeå University , Umeå , Sweden.,b Department of Sociology , Umeå University , Umeå , Sweden
| | | | - Barbara Schumann
- a Centre for Demographic and Ageing Research (CEDAR) , Umeå University , Umeå , Sweden.,c Department of Epidemiology and Global Health , Umeå University , Umeå , Sweden
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Karlsson L, Lundevaller E, Schumann B. The association between cold extremes and neonatal mortality in Swedish Sápmi from 1800 to 1895. Glob Health Action 2019; 12:1623609. [PMID: 31232229 PMCID: PMC6598478 DOI: 10.1080/16549716.2019.1623609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 05/20/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Studies in which the association between temperature and neonatal mortality (deaths during the first 28 days of life) is tracked over extended periods that cover demographic, economic and epidemiological transitions are quite limited. From previous research about the demographic transition in Swedish Sápmi, we know that infant and child mortality was generally higher among the indigenous (Sami) population compared to non-indigenous populations. Objective: The aim of this study was to analyse the association between extreme temperatures and neonatal mortality among the Sami and non-Sami population in Swedish Sápmi (Lapland) during the nineteenth century. Methods: Data from the Demographic Data Base, Umeå University, were used to identify neonatal deaths. We used monthly mean temperature in Tornedalen and identified cold and warm month (5th and 95th) percentiles. Monthly death counts from extreme temperatures were modelled using negative binomial regression. We computed relative risks (RR) with 95% confidence intervals (CI), adjusting for time trends and seasonality. Results: Overall, the neonatal mortality rate was higher among Sami compared to non-Sami infants (62/1,000 vs 35/1,000 live births), although the differences between the two populations decreased after 1860. For the Sami population prior 1860, the results revealed a higher neonatal incidence rate during cold winter months (<-15.4°C, RR = 1.60, CI 1.14-2.23) compared to infants born during months of medium temperature. No association was found between extreme cold months and neonatal mortality for non-Sami populations. Warm months (+15.1°C) had no impact on Sami or non-Sami populations. Conclusions: This study revealed the role of environmental factors (temperature extremes) on infant health during the demographic transition where cold extremes mainly affected the Sami population. Ethnicity and living conditions contributed to differential weather vulnerability.
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Affiliation(s)
- Lena Karlsson
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
- Department of Sociology, Umeå University, Umeå, Sweden
| | - Erling Lundevaller
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
| | - Barbara Schumann
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Wang Q, Zhang H, Rizzo JA, Fang H. The Effect of Childhood Health Status on Adult Health in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020212. [PMID: 29373554 PMCID: PMC5858281 DOI: 10.3390/ijerph15020212] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/20/2018] [Accepted: 01/22/2018] [Indexed: 01/08/2023]
Abstract
Childhood health in China was poor in the 1950s and 1960s because of limited nutrition. In the last three decades, China has distinguished itself through its tremendous economic growth and improvements in health and nutrition. However, prior to such growth, access to good nutrition was more variable, with potentially important implications, not only for childhood health, but also for adult health, because of its long-term effects lasting into adulthood. To shed light on these issues, this study examined the long-run association between childhood health and adult health outcomes among a middle-aged Chinese population and addresses the endogeneity of childhood health. A nationwide database from the 2011 China Health and Retirement Longitudinal Study (CHARLS) was employed. Three adult health outcomes variables were used: self-reported health status, cognition, and physical function. The local variation in grain production in the subjects’ fetal period and the first 24 months following birth was employed as an instrument for childhood health in order to correct for its endogeneity. Childhood health recalled by the respondents was positively and significantly associated with their adult health outcomes in terms of self-reported health status, cognition, and physical function in single-equation estimates that did not correct for the endogeneity of childhood health. A good childhood health status increased the probabilities of good adult health, good adult cognitive function, and good adult physical function by 16% (95% CI: 13–18%), 13% (95% CI: 10–15%), and 14% (95% CI: 12–17%), respectively. After correcting for endogeneity, the estimated effects of good childhood health were consistent but stronger. We also studied the male and female populations separately, finding that the positive effects of childhood health on adult health were larger for males. In China, childhood health significantly affects adult health. This suggests that early interventions to promote childhood health will have long-term benefits in China and that health-care policies should consider their long-term impacts over the life cycle in addition to their effects on specific age groups.
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Affiliation(s)
- Qing Wang
- School of Business, Dalian University of Technology, Panjin 124221, China.
| | - Huyang Zhang
- China Center for Health Development Studies, Peking University, Beijing 100083, China.
- Department of Health Policy and Administration, Peking University, Beijing 100083, China.
| | - John A Rizzo
- Department of Family, Population & Preventive Medicine, State University of New York at Stony Brook, Stony Brook, NY 11790, USA.
| | - Hai Fang
- China Center for Health Development Studies, Peking University, Beijing 100083, China.
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Wang Q, Shen JJ. Childhood Health Status and Adulthood Cardiovascular Disease Morbidity in Rural China: Are They Related? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E565. [PMID: 27275829 PMCID: PMC4924022 DOI: 10.3390/ijerph13060565] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 05/14/2016] [Accepted: 06/02/2016] [Indexed: 11/17/2022]
Abstract
Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on adulthood health later on, health policy and programs to improve the health status and well-being of Chinese populations over the entire life cycle, especially in persons' early life, are expected to be effective and successful.
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Affiliation(s)
- Qing Wang
- School of Business, Dalian University of Technology, Panjin 124221, China.
| | - Jay J Shen
- Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89103, USA.
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Dorélien AM. Effects of Birth Month on Child Health and Survival in Sub-Saharan Africa. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2015; 61:209-30. [PMID: 26266973 PMCID: PMC4700555 DOI: 10.1080/19485565.2015.1032399] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Birth month is broadly predictive of both under-5 mortality rates and stunting throughout most of sub-Saharan Africa (SSA). Observed factors, such as mother's age at birth and educational status, are correlated with birth month but are not the main factors underlying the relationship between birth month and child health. Accounting for maternal selection via a fixed-effects model attenuates the relationship between birth month and health in many SSA countries. In the remaining countries, the effect of birth month may be mediated by environmental factors. This study found that birth month effects on mortality typically do not vary across age intervals; the differential mortality rates by birth month are evident in the neonatal period and continue across age intervals. The male-to-female sex ratio at birth did not vary by birth month, which suggests that in utero exposures are not influencing fetal loss, and that therefore the birth month effects are not likely a result of selective survival during the in utero period. In one-third of the sample, the birth month effects on stunting diminished after the age of 2 years; therefore, some children were able to catch up. Policies to improve child health should target pregnant women and infants and must take seasonality into account.
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Affiliation(s)
- Audrey M Dorélien
- a Humphrey School of Public Affairs , University of Minnesota , Minneapolis , Minnesota , USA
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Aguilar ML, Psoter WJ, Montero M, Milord F, Joshipura KJ. The quality of removable prostheses in dentate, community-dwelling elderly residing in Puerto Rico. J Prosthodont 2013; 22:556-560. [PMID: 23387934 DOI: 10.1111/jopr.12025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2012] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Edentulism has been decreasing in the US elderly population; however, due to the increasing number of elderly, the need for prostheses has been projected to rise over the next several decades. One of the aims of the Puerto Rican Elderly Dental Health Study (PREDHS) was to assess the quality of removable prostheses (RP) in the Puerto Rican (PR) elderly (>69 years of age) population. METHODS A cross-sectional design, using a subgroup from the Puerto Rican Elderly: Health Conditions (PREHCO) study of dentate, community-dwelling older adults from the greater San Juan area was employed. Eligible participants were administered structured questionnaires and examined in their homes by three trained and calibrated dentists using National Institute of Dental and Craniofacial Research (NIDCR) criteria. RESULTS One hundred and eighty three (183) participants were examined (61 males, 122 females) (p < 0.001). Overall, 64% were found to have a prosthetic problem with no statistical difference between genders. Unadjusted and age-adjusted logistic models were employed. Increasing age was associated with both upper and lower clinically defined abraded prostheses, (p = 0.007; p = 0.041, respectively). Maxillary (23%) and mandibular (27%) prostheses needed replacement due to deficiencies. CONCLUSION RP deficiencies were found in almost two-thirds of a representative sample of dentate 70+ year-old people residing in PR. There was no difference in the proportion of deficiencies between elderly who reported a dental visit in the preceding year or not having seen a dentist. A quarter of the prostheses required replacement. The findings from this and the NHANES studies demonstrate that an engaged and recognized prosthodontic dental school faculty continues to be as important now as it was a generation ago.
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Affiliation(s)
- Maria L Aguilar
- Restorative Dental Science Department, University of Florida, College of Dentistry, Gainesville, FL
| | - Walter J Psoter
- Department of Epidemiology, New York University College of Dentistry, New York, NY
| | - Mauricio Montero
- Graduate Program, University of Costa Rica School of Dentistry, San José, Costa Rica
| | - Fabiola Milord
- Global Health Leadership Program, New York University, New York, NY
| | - Kaumudi J Joshipura
- Center for Clinical Research and Health Promotion, School of Dental Medicine, University of Puerto Rico, San Juan, PR
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McEniry M. Early-life conditions and older adult health in low- and middle-income countries: a review. J Dev Orig Health Dis 2013; 4:10-29. [PMID: 23316272 PMCID: PMC3540412 DOI: 10.1017/s2040174412000499] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Population aging and subsequent projected large increases in chronic conditions will be important health concerns in low- and middle-income countries. Although evidence is accumulating, little is known regarding the impact of poor early-life conditions on older adult (50 years and older) health in these settings. A systematic review of 1141 empirical studies was conducted to identify population-based and community studies in low- and middle-income countries, which examined associations between early-life conditions and older adult health. The resulting review of 20 studies revealed strong associations between (1) in utero/early infancy exposures (independent of other early life and adult conditions) and adult heart disease and diabetes; (2) poor nutrition during childhood and difficulties in adult cognition and diabetes; (3) specific childhood illnesses such as rheumatic fever and malaria and adult heart disease and mortality; (4) poor childhood health and adult functionality/disability and chronic diseases; (5) poor childhood socioeconomic status (SES) and adult mortality, functionality/disability and cognition; and (6) parental survival during childhood and adult functionality/disability and cognition. In several instances, associations remained strong even after controlling for adult SES and lifestyle. Although exact mechanisms cannot be identified, these studies reinforce to some extent the importance of early-life environment on health at older ages. Given the paucity of cohort data from the developing world to examine hypotheses of early-life conditions and older adult health, population-based studies are relevant in providing a broad perspective on the origins of adult health.
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Affiliation(s)
- M. McEniry
- Institute for Social Research, ICPSR, Population Studies Center, University of Michigan, Ann Arbor, USA
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McEniry MC. In utero exposures, season of birth and population studies of older adults: Author's reply. Soc Sci Med 2011. [DOI: 10.1016/j.socscimed.2010.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Reconstructing dose: a commentary on McEniry. Soc Sci Med 2011; 72:1016-7; discussion 1018-20. [PMID: 21324412 DOI: 10.1016/j.socscimed.2010.12.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 12/03/2010] [Indexed: 11/23/2022]
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