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Salinas-Rodríguez A, Fernández-Niño JA, Rivera-Almaraz A, Manrique-Espinoza B. Intrinsic capacity trajectories and socioeconomic inequalities in health: the contributions of wealth, education, gender, and ethnicity. Int J Equity Health 2024; 23:48. [PMID: 38462637 PMCID: PMC10926672 DOI: 10.1186/s12939-024-02136-0] [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: 08/02/2023] [Accepted: 02/25/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Life-long health inequalities exert enduring impacts and are governed by social determinants crucial for achieving healthy aging. A fundamental aspect of healthy aging, intrinsic capacity, is the primary focus of this study. Our objective is to evaluate the social inequalities connected with the trajectories of intrinsic capacity, shedding light on the impacts of socioeconomic position, gender, and ethnicity. METHODS Our dynamic cohort study was rooted in three waves (2009, 2014, 2017) of the World Health Organization's Study on Global AGEing and Adult Health in Mexico. We incorporated a nationally representative sample comprising 2722 older Mexican adults aged 50 years and over. Baseline measurements of socioeconomic position, gender, and ethnicity acted as the exposure variables. We evaluated intrinsic capacity across five domains: cognition, psychological, sensory, vitality, and locomotion. The Relative Index of Inequality and Slope Index of Inequality were used to quantify socioeconomic disparities. RESULTS We discerned three distinct intrinsic capacity trajectories: steep decline, moderate decline, and slight increase. Significant disparities based on wealth, educational level, gender, and ethnicity were observed. Older adults with higher wealth and education typically exhibited a trajectory of moderate decrease or slight increase in intrinsic capacity. In stark contrast, women and indigenous individuals were more likely to experience a steeply declining trajectory. CONCLUSIONS These findings underscore the pressing need to address social determinants, minimize gender and ethnic discrimination to ensure equal access to resources and opportunities across the lifespan. It is imperative for policies and interventions to prioritize these social determinants in order to promote healthy aging and alleviate health disparities. This approach will ensure that specific demographic groups receive customized support to sustain their intrinsic capacity during their elder years.
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Affiliation(s)
- Aaron Salinas-Rodríguez
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Julián Alfredo Fernández-Niño
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E8532, Baltimore, MD, 21205, USA.
- Department of Public Health, Universidad del Norte, Barranquilla, Atlántico, Colombia.
| | - Ana Rivera-Almaraz
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Betty Manrique-Espinoza
- Center for Evaluation and Surveys Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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Dinh PC, Monahan PO, Fosså SD, Sesso HD, Feldman DR, Dolan ME, Nevel K, Kincaid J, Vaughn DJ, Martin NE, Sanchez VA, Einhorn LH, Frisina R, Fung C, Kroenke K, Travis LB. Impact of pain and adverse health outcomes on long-term US testicular cancer survivors. J Natl Cancer Inst 2024; 116:455-467. [PMID: 37966940 PMCID: PMC10919346 DOI: 10.1093/jnci/djad236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND No study has quantified the impact of pain and other adverse health outcomes on global physical and mental health in long-term US testicular cancer survivors or evaluated patient-reported functional impairment due to pain. METHODS Testicular cancer survivors given cisplatin-based chemotherapy completed validated surveys, including Patient-Reported Outcomes Measurement Information System v1.2 global physical and mental health, Patient-Reported Outcomes Measurement Information System pain questionnaires, and others. Multivariable linear regression examined relationships between 25 adverse health outcomes with global physical and mental health and pain-interference scores. Adverse health outcomes with a β^ of more than 2 are clinically important and reported below. RESULTS Among 358 testicular cancer survivors (median age = 46 years, interquartile range [IQR] = 38-53 years; median time since chemotherapy = 10.7 years, IQR = 7.2-16.0 years), median adverse health outcomes number was 5 (IQR = 3-7). A total of 12% testicular cancer survivors had 10 or more adverse health outcomes, and 19% reported chemotherapy-induced neuropathic pain. Increasing adverse health outcome numbers were associated with decreases in physical and mental health (P < .0001 each). In multivariable analyses, chemotherapy-induced neuropathic pain (β^ = -3.72; P = .001), diabetes (β^ = -4.41; P = .037), obesity (β^ = -2.01; P = .036), and fatigue (β^ = -8.58; P < .0001) were associated with worse global mental health, while being married or living as married benefited global mental health (β^ = 3.63; P = .0006). Risk factors for pain-related functional impairment included lower extremity location (β^ = 2.15; P = .04) and concomitant peripheral artery disease (β^ = 4.68; P < .001). Global physical health score reductions were associated with diabetes (β^ = -3.81; P = .012), balance or equilibrium problems (β^ = -3.82; P = .003), cognitive dysfunction (β^ = -4.43; P < .0001), obesity (β^ = -3.09; P < .0001), peripheral neuropathy score (β^ = -2.12; P < .0001), and depression (β^ = -3.17; P < .0001). CONCLUSIONS Testicular cancer survivors suffer adverse health outcomes that negatively impact long-term global mental health, global physical health, and pain-related functional status. Clinically important factors associated with worse physical and mental health identify testicular cancer survivors requiring closer monitoring, counseling, and interventions. Chemotherapy-induced neuropathic pain must be addressed, given its detrimental impact on patient-reported functional status and mental health 10 or more years after treatment.
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Affiliation(s)
- Paul C Dinh
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Patrick O Monahan
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
| | - Sophie D Fosså
- Department of Oncology, Oslo University Hospital, Radiumhospital, Oslo, Norway
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine Research, Brigham and Women’s Hospital, Boston, MA, USA
| | - Darren R Feldman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - M Eileen Dolan
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Kathryn Nevel
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - John Kincaid
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - David J Vaughn
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Neil E Martin
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Victoria A Sanchez
- Department of Medical Engineering, University of South Florida, Tampa, FL, USA
| | - Lawrence H Einhorn
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert Frisina
- Department of Medical Engineering, University of South Florida, Tampa, FL, USA
| | - Chunkit Fung
- Department of Medicine, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Kurt Kroenke
- Regenstrief Institute, Inc, Indiana University, Indianapolis, IN, USA
| | - Lois B Travis
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Beck KC, Røhr HL, Reme BA, Flatø M. Distressing testing: A propensity score analysis of high-stakes exam failure and mental health. Child Dev 2024; 95:242-260. [PMID: 37566438 DOI: 10.1111/cdev.13985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 06/07/2023] [Accepted: 06/15/2023] [Indexed: 08/12/2023]
Abstract
This study used rich individual-level registry data covering the entire Norwegian population to identify students aged 17-21 who either failed a high-stakes exit exam or who received the lowest passing grade from 2006 to 2018. Propensity score matching on high-quality observed characteristics was utilized to allow meaningful comparisons (N = 18,052, 64% boys). Results showed a 21% increase in odds of receiving a psychological diagnosis among students who failed the exam. Adolescents were at 57% reduced odds of graduating and 44% reduction in odds of enrolling in tertiary education 5 years following the exam. Results suggest that failing a high-stakes exam is associated with mental health issues and therefore may impact adolescents more broadly than captured in educational outcomes.
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Affiliation(s)
- Kathryn Christine Beck
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Sociology and Human Geography, University of Oslo, Oslo, Norway
| | | | - Bjørn-Atle Reme
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Martin Flatø
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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Hu XZ, Ursano RJ, Benedek D, Li X, Zhang L. Association of 5-HTTLPR With Post-Traumatic Stress Disorder in US Service Members. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2024; 8:24705470241245497. [PMID: 38682050 PMCID: PMC11055429 DOI: 10.1177/24705470241245497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/21/2024] [Indexed: 05/01/2024]
Abstract
Objective Post-traumatic stress disorder (PTSD) is a mental disorder that manifests after exposure to a stressful traumatic event, such as combat experience. Accumulated evidence indicates an important genetic influence in the development of PTSD. The serotonin transporter (5-HTT) gene has been identified as a candidate for PTSD and a polymorphism of the serotonin transporter-linked promoter region (5-HTTLPR) is associated with the disorder in the general population. However, whether it is associated with PTSD in active military service members has not been investigated. This study aimed to investigate the relationship between 5-HTTLPR and PTSD in service members. Methods Leucocyte genomic DNA was extracted from service members, including those with PTSD (n = 134) or without PTSD (n = 639). The 5-HTTLPR polymorphism was detected by means of 2 stages of TaqMan fluorescent PCR assay. PTSD symptoms and symptom severity were assessed using the PTSD Checklist (PCL), a 17-item, DSM-based, self-report questionnaire with well-established validity and reliability. PTSD was determined based on endorsement of DSM-IV criteria and a PCL total score ≥ 44. Results Significant differences in biallele distribution were observed between PTSD and controls (χ2 = 7.497, P = .024). The frequency of SS, SL, and LL genotypes in the PTSD group was 0.17, 0.56, and 0.27 respectively, compared to the frequencies of 0.27, 0.43, and 0.29 in non-PTSD controls. Carriers of the L allele had higher scores for reexperiencing and arousal symptoms on the PCL, compared to SS homozygote carriers (P < .05). The triallele genotypes showed no significant differences in distribution between the PTSD and control groups (P > .05) and no relationship with PTSD symptom severity. The interaction of triallelic genotypes of 5-HTTLPR and traumatic life events was associated with re-experiencing, avoidance, and arousal (P < .05 for all). Multiple regression analysis revealed significant correlations between both biallelic and triallelic genotypes of 5-HTTLPR, the interaction of the number of stressful lifetime events, and 5-HTTLPR genotypes with PCL total score (P < .001). Conclusion Our findings suggested that 5-HTT might play a minor role in PTSD, and the interaction between 5-HTTLPR and the environment had effects on PCL score, complementing and emphasizing 5-HTT for PTSD, especially in the military population.
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Affiliation(s)
- Xian-Zhang Hu
- Center for the Study of Traumatic Stress, Department of Psychiatry, USUHS, Bethesda, MD, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine
| | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, USUHS, Bethesda, MD, USA
| | - David Benedek
- Center for the Study of Traumatic Stress, Department of Psychiatry, USUHS, Bethesda, MD, USA
| | - Xiaoxia Li
- Center for the Study of Traumatic Stress, Department of Psychiatry, USUHS, Bethesda, MD, USA
- Henry M Jackson Foundation for the Advancement of Military Medicine
| | | | - Lei Zhang
- Center for the Study of Traumatic Stress, Department of Psychiatry, USUHS, Bethesda, MD, USA
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Choi Y, Uthirasamy N, Córdoba D, Morrow LM, Perez-Cortes S, Ramachandran U, Pai S, Lima D, Shelton PA, Jimenez ME. Feasibility and Acceptability of an Online Family Literacy Program in an Under-Resourced Community During the COVID-19 Pandemic. J Dev Behav Pediatr 2023; 44:e104-e110. [PMID: 36750983 PMCID: PMC9930163 DOI: 10.1097/dbp.0000000000001155] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/12/2022] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The objective of this study was to examine the feasibility and acceptability of an online family literacy program (FLP) among low-income Latino families during the COVID-19 pandemic. METHODS We conducted a mixed methods pilot study. Latino parent-child dyads participated in an 8-week online FLP conducted on video conferencing software, developed through a cross-sector health care-education partnership. We conducted surveys and structured observation to assess feasibility and acceptability and in-depth interviews to gain insight into the context of participants' experiences during the pandemic. RESULTS The 35 participating parent-child dyads all identified as Latino, 83% reported limited English proficiency, and 60% of parents did not achieve a high school diploma. Nearly two-thirds of families participated in at least half of the sessions. On average, parents welcomed, liked, approved, and found the program appealing. While 86% experienced a technology problem at least once during sessions, all were resolved with minimal assistance. During qualitative interviews, we identified 3 themes that provide insight into their experiences with the FLP within the broader context of the pandemic: (1) disruption in family routine and financial strain caused by COVID-19 intensified family stress, (2) the forced transition to remote learning highlighted the inequities experienced by Latino preschool children, and (3) the FLP empowered parents and enhanced health and education experiences. CONCLUSION Latino families had high participation levels in an online FLP and found it acceptable. Additional work is needed to understand how similar primary care programs can be leveraged to promote optimal development during a time of heightened need.
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Affiliation(s)
- Yewoon Choi
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Nila Uthirasamy
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - David Córdoba
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Lesley Mandel Morrow
- Graduate School of Education, Rutgers University-New Brunswick, 10 Seminary Place, New Brunswick, NJ 08901
| | - Silvia Perez-Cortes
- The Department of World Languages and Cultures, 405-407 Cooper Street Camden, NJ
| | - Usha Ramachandran
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Shilpa Pai
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Daniel Lima
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Patricia A. Shelton
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
| | - Manuel E. Jimenez
- The Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
- The Child Health Institute of New Jersey, 89 French St New Brunswick, NJ, 08901
- Children’s Specialized Hospital, 200 Somerset Street New Brunswick, NJ 08901
- The Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
- Boggs Center On Developmental Disabilities, Rutgers Robert Wood Johnson Medical School, 675 Hoes Lane Piscataway, NJ 08854
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Kuperberg A, Williams K, Mazelis JM. Student loans, physical and mental health, and health care use and delay in college. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-11. [PMID: 36595565 DOI: 10.1080/07448481.2022.2151840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/11/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
Objective: Determine relationships between college students' student loan presence and self-rated physical and mental health, major medical problems, mental health conditions, physical, dental, and mental health care visits and delays, and medication use and reductions. Participants: A total of 3,248 undergraduates at two regional public U.S. universities, surveyed Spring 2017. Methods: OLS and Logistic regression. Results: Loan presence was related to significantly worse self-rated physical and mental health and more major medical problems, but not to mental health conditions, or physical or mental health medication use. Respondents with loans were less likely to visit the dentist and more likely to report delaying medical, dental, and mental health care, and reducing medication use to save money. Conclusions: Results provide evidence of health and health care use divides among college students by loan presence.
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Affiliation(s)
- Arielle Kuperberg
- Department of Sociology, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Kenneshia Williams
- Department of Human Development and Family Studies, The University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Joan Maya Mazelis
- Department of Sociology, Anthropology and Criminal Justice, Rutgers University-Camden, Camden, New Jersey, USA
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Wallace J, Beidler E, Covassin T, Hibbler T, Schatz P. Understanding racial differences in computerized neurocognitive test performance and symptom-reporting to deliver culturally competent patient-centered care for sport-related concussion. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:91-100. [PMID: 33980084 DOI: 10.1080/23279095.2021.1912047] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This study examined neurocognitive performance and symptoms between concussed Black and White collegiate athletes at baseline, post-injury, and change from baseline to post-injury. METHOD The Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) was used to measure neurocognitive performance and four concussion symptom clusters for 235 concussed collegiate athletes. Between-groups differences were documented at baseline and post-injury, along with change in scores for sex/race, and sport/race groups, using ANOVAs. Baseline scores, and days-to-post-test were covariates in post-injury comparisons. Symptom endorsement by race was evaluated using chi-square analyses. RESULTS At baseline, group comparisons by race and sex showed that Black male/female athletes scored lower on reaction time (RT; p = .008), White females scored higher on verbal memory (VerbMem; p = .001), Black females scored lower on visual motor processing speed (VMS; p = .001), and Black football athletes scored slower/poorer on RT (p = .001) and VMS (p = .006). Post-injury, Black males scored lower on visual memory (VisMem; p = .005) and VMS (p = .002), and Black football athletes scored slower on VMS (p = .005), whereas White non-football athletes scored higher on VerbMem (p = .002) and reported fewer symptoms. Significant time-by-sport/race interactions were found for VerbMem (p < .001), VisMem (p < .001) and reported symptoms. With respect to post-injury symptom scores/endorsement, Black athletes scored significantly higher for physical (p = .01) and sleep (p = .01) symptoms. CONCLUSION These findings drive the conversation of how subjective measures of symptoms, and objective clinical concussion measures, may relate to the concussion recovery process and providing a culturally competent clinical management approach for diverse patients.
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Affiliation(s)
- Jessica Wallace
- Department of Health Science, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Erica Beidler
- Department of Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Tracey Covassin
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Tamaria Hibbler
- Department of Athletics, Michigan State University, East Lansing, Michigan, USA
| | - Philip Schatz
- Department of Psychology, Saint Joseph's University, Philadelphia, Pennsylvania, USA
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Azizabadi Z, Aminisani N, Emamian MH. Socioeconomic inequality in depression and anxiety and its determinants in Iranian older adults. BMC Psychiatry 2022; 22:761. [PMID: 36471352 PMCID: PMC9721087 DOI: 10.1186/s12888-022-04433-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 11/28/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Older adults with lower socioeconomic status are more vulnerable to stressful life events and at increased risk of common mental health disorders like anxiety and depression. This study investigates the socioeconomic inequality in depressive symptoms and anxiety. METHODS The data were from 7462 participants of the Neyshabur longitudinal study of ageing registered during 2016-2018. The outcome variables were anxiety and depressive symptoms. Anxiety was defined by the "Hospital Anxiety and Depression scale Questionnaire", and depressive symptoms was defined and measured by the "short-term form of the Epidemiological Center Questionnaire." The socioeconomic status was defined using principal component analysis of home assets. The Concentration Index (C) was used to measure socioeconomic inequality in anxiety and depressive symptoms. Concentration index was decomposed to its determinants to determine the role of the independent variables on inequality. RESULTS The prevalence of depressive symptoms and anxiety was 12.2% (95% CI: 11.4, 12.9) and 7.0% (95% CI: 6.4, 7.5), respectively. Moreover, the C for anxiety was -0.195 (95% CI: -0.254, -0.136) and for depressive symptoms was -0.206 (95% CI: -0.252, -0.159), which indicate a considerable inequality in favor of high socioeconomic group for anxiety and depressive symptoms. Decomposition of the concentration Index showed that education, unemployment and male sex were the most important positive contributors to the observed inequality in anxiety and depressive symptoms, while age and number of grandchildren were main negative contributors of this inequality. CONCLUSION Low socioeconomic groups were more affected by anxiety and depressive symptoms. Any intervention for alleviation of inequality in anxiety and depression should be focus on education and employment of people, especially in younger elderly.
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Affiliation(s)
- Zahra Azizabadi
- grid.444858.10000 0004 0384 8816Student Research Committee, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nayyereh Aminisani
- grid.502998.f0000 0004 0550 3395Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran.
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Horanicova S, Husarova D, Gecková AM, De Winter AF, Reijneveld SA. School Satisfaction and Its Associations with Health and Behavioural Outcomes among 15-Years Old Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11514. [PMID: 36141779 PMCID: PMC9516967 DOI: 10.3390/ijerph191811514] [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: 06/14/2022] [Revised: 09/08/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
Background: Health and behavioural outcomes of adolescents have been shown to be related to school pressure, demands or unfavourable relationships with classmates or teachers. These associations may relate to school satisfaction, but evidence on this is lacking. Therefore, our aim is to explore the associations of school satisfaction with hopelessness, health complaints, fighting and truancy. Methods: Data come from the cross-sectional Health Behaviour in School-aged Children study collected in 2018 from Slovak 15-year-old adolescents (N = 816; 50.9% boys). School satisfaction was measured by school engagement and attitudes towards education, grouped as: satisfied (both positive), inconsistent (one positive, one negative) and indifferent (both negative). Hopelessness, health complaints, fighting and truancy were measured using self-report questionnaires. Logistic regression models were used to explore the associations of school satisfaction with hopelessness, health complaints, fighting and truancy separately. Results: Indifferent adolescents were more likely to feel hopeless, to frequently experience two or more health complaints, to be involved in a fight and to skip school (odds ratios/95%-confidence interval: 2.57/1.49-4.45; 2.51/1.48-4.25; 1.92/1.02-3.60; and 2.34/1.25-4.40, respectively) than satisfied adolescents. Inconsistent adolescents were more likely to frequently experience two or more health complaints than satisfied adolescents (1.72/1.05-5.79). Conclusions: School satisfaction affects adolescents' health and social behaviour and may threaten their healthy development.
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Affiliation(s)
- Simona Horanicova
- Department of Health Psychology and Methodology Research, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, 040 01 Kosice, Slovakia
| | - Daniela Husarova
- Department of Health Psychology and Methodology Research, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Health, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Andrea Madarasová Gecková
- Department of Health Psychology and Methodology Research, Faculty of Medicine, P.J. Safarik University in Kosice, Tr. SNP 1, 040 01 Kosice, Slovakia
- Department of Community & Occupational Health, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University in Bratislava, Mlynské Luhy 4, 821 05 Bratislava, Slovakia
| | - Andrea F. De Winter
- Department of Community & Occupational Health, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Sijmen A. Reijneveld
- Department of Community & Occupational Health, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
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Jeon MJ, Kim JH, Bae SM. The Long-Term Associations of Objective and Subjective Health Status on Mortality. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:2089-2098. [PMID: 36743363 PMCID: PMC9884362 DOI: 10.18502/ijph.v51i9.10564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022]
Abstract
Background The aim of this study was to reveal the longitudinal associations of health status (HS) and Self-rated Health (SRH) on mortality. Methods Data from the Korea Longitudinal Study of Ageing were used in this study. The baseline data (2006) included 10,239 participants. The Cox proportional hazard model was used to verify the hypothesis. Results The mortality was high when the health status was Bad and higher when the SRH was Bad. The HS-Bad-SRH-Bad group had the highest mortality. Middle-aged people with diseases had higher mortality than older people who perceived themselves as in Bad health. For older people, mortality was high for SRH-Bad people of all health statuses. Conclusion The results predict a high rate of mortality for middle-aged and older people with a combination of HS-Bad and SRH-Bad, with SRH being relatively more influential in mortality.
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Affiliation(s)
- Moon-Ju Jeon
- Department of Psychology, Graduate School, Dankook University, Cheonan, Republic of Korea
| | - Jae-Hyun Kim
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea,Corresponding Authors: ;
| | - Sung-Man Bae
- Department of Psychology, Graduate School, Dankook University, Cheonan, Republic of Korea,Department of Psychology and Psychotherapy, College of Health Science, Dankook University, Cheonan, Republic of Korea,Corresponding Authors: ;
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Echevarria E, Lorch SA. Family Educational Attainment and Racial Disparities in Low Birth Weight. Pediatrics 2022; 150:188346. [PMID: 35757969 DOI: 10.1542/peds.2021-052369] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To evaluate the effect of grandmother and mother educational attainment on low birth weight (LBW) in children and grandchildren. METHODS The National Longitudinal Study of Adolescent to Adult Health is a multigenerational study that collected survey data from 1994 to 2018. Using this database, we constructed a cohort of 2867 non-Hispanic Black (NHB) and non-Hispanic White (NHW) grandmother-mother-grandchild triads to evaluate how education affects the likelihood of having LBW children and grandchildren, while adjusting for socioeconomic and maternal health factors using multivariable logistic regression. RESULTS Similar to previous studies, NHB women were more likely to have LBW descendants compared with NHW women in unadjusted and adjusted analyses. The prevalence of LBW descendants was lower in women with college education, regardless of race. Irrespective of race, mother and grandmother college education was associated with decreased odds of LBW children and grandchildren after adjusting for individual variables. When mother and grandmother education were examined together, and after adjusting for all individual, community, and health variables together, mother college education remained associated with lower odds of LBW (adjusted odds ratio, 0.58; 95% confidence interval, 0.44-0.77). There were no statistically significant differences in these effects between NHW and NHB populations. CONCLUSIONS Educational attainment in mothers is associated with decreased odds of LBW descendants after adjusting for multiple individual, community, and health covariates, regardless of race. Targeting improvements in education may ameliorate adverse pregnancy outcomes that disproportionately affect minority communities and cause significant lifelong consequences.
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Affiliation(s)
- Emily Echevarria
- Department of Pediatrics, New York-Presbyterian Hospital - Weill Cornell Medicine, New York, New York
| | - Scott A Lorch
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Perelman School of Medicine.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
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12
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Liu Y, Ma Y, Smith JP. Adult Children's Education and Older Parents' Chronic Illnesses in Aging China. Demography 2022; 59:535-562. [PMID: 35179200 DOI: 10.1215/00703370-9766973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Although intergenerational transmission from parents to children has been widely studied, less is known about human capital spillover from children to parents. Utilizing nationally representative data on both doctor diagnosis and biomarkers, as well as exploiting variations in the implementation of China's Compulsory Education Law, we examine the effects of adult children's education on the prevalence of chronic cardiovascular illnesses among older parents in China and explore potential mechanisms. Instrumental variable estimates indicate that additional years of schooling among adult children decrease the prevalence of hypertension among older parents, whereas no evidence indicates a significant impact on the prevalence of diabetes among the same group. Sons and daughters differentially impact their mothers and fathers. Compared with fathers, mothers benefit more from adult children's education. Although no significant differences are observed in the effects of sons' and daughters' education in urban China, sons' education is more beneficial for parents' health in rural China. Further analyses show that financial support and health support (e.g., diagnosis and management of chronic illnesses and maintenance of health behaviors) are critical pathways for older parents to benefit from their adult children's education.
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Affiliation(s)
- Yafei Liu
- Hubei University of Economics, Wuhan, China
| | - Yuanyuan Ma
- Wenlan School of Business, Zhongnan University of Economics and Law, Wuhan, China
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13
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Patsiou V, Moysidis DV, Kartas A, Samaras A, Papazoglou AS, Bekiaridou A, Tsagkaris C, Vouloagkas I, Loudovikou A, Papanastasiou A, Vrana E, Baroutidou A, Botis M, Liampas E, Karvounis H, Tzikas A, Giannakoulas G. Education level predicts mortality and morbidity in hospitalised patients with atrial fibrillation. Hellenic J Cardiol 2022; 65:19-24. [DOI: 10.1016/j.hjc.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/30/2022] [Accepted: 03/13/2022] [Indexed: 11/04/2022] Open
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14
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Chigangaidze RK. A call for a new perspective in social work and health care: the developmental-clinical social work perspective. COVID-19 pandemic through the human rights perspective. SOCIAL WORK IN HEALTH CARE 2022; 61:15-35. [PMID: 35240950 DOI: 10.1080/00981389.2022.2027847] [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: 06/29/2021] [Revised: 12/17/2021] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
Human rights are essential in shaping the pandemic response both for the public health emergency and the broader impact on people's well-being. Utilizing the human rights lenses, this article expatiates on a developmental-clinical social work approach to the COVID-19 pandemic response. The disquisition explores human rights to health, education, adequate food and nutrition, water and sanitation, and development. It conducts projections and a cost-benefit analysis of remedial and developmental focus on health. The paper emphasizes that it is criminal to deprive human beings of their entitlements. The paper argues that socio-economic inequalities deprive people of their human rights. To this end, it calls for the equal distribution of wealth to end poverty and ultimately address human rights concerns. It advances for the integration of health in all policies. The article calls for the social work profession and other helping professions to rethink of their priorities in the enhancement of people's welfare: either to be an agent of social control or an agent of social change. Social work should face the socio-economic inequalities head-on if it is to truly reflect its professional philosophy of social justice.
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15
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Taple BJ, Chapman R, Schalet BD, Brower R, Griffith JW. The Impact of Education on Depression Assessment: Differential Item Functioning Analysis. Assessment 2022; 29:272-284. [PMID: 33218257 PMCID: PMC9060911 DOI: 10.1177/1073191120971357] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A person's level of education can affect their access to health care, and their health outcomes. Increasing rates of depression are another looming public health concern. Therefore, vulnerability is compounded for individuals who have a lower level of education and depression. Assessment of depressive symptoms is integral to many domains of health care including primary care and mental health specialty care. This investigation examined the degree to which education influences the psychometric properties of self-report items that measure depressive symptoms. This study was a secondary data analysis derived from three large internet panel studies. Together, the studies included the Beck Depression Inventory-II, the Center for Epidemiologic Studies Depression Scale, the Patient Health Questionnaire, and the Patient Reported Outcomes Measurement Information System measures of depression. Using a differential item functioning (DIF) approach, we found evidence of DIF such that some items on each of the questionnaires were flagged for DIF with effect sizes ranging from McFadden's Pseudo R2 = .005 to .022. For example, results included several double-barreled questions flagged for DIF. Overall, questionnaires assessing depression vary in level of complexity, which interacts with the respondent's level of education. Measurement of depression should include consideration of possible educational disparities, to identify people who may struggle with a written questionnaire, or may be subject to subtle psychometric biases associated with education.
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Affiliation(s)
- Bayley J Taple
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Robert Chapman
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Rylee Brower
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - James W Griffith
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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16
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Jammula VR, Leeper H, Gilbert MR, Cooper D, Armstrong TS. Effects of Cognitive Reserve on Cognition in Individuals With Central Nervous System Disease. Cogn Behav Neurol 2021; 34:245-258. [PMID: 34508028 PMCID: PMC8635253 DOI: 10.1097/wnn.0000000000000282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/13/2021] [Indexed: 11/27/2022]
Abstract
Cognitive reserve (CR) has been proposed to account for functional outcome differences in brain pathology and its clinical manifestations. The purpose of our paper is to systematically review the effects of CR on cognitive outcomes in individuals with neurodegenerative and structural CNS diseases. We performed a systematic search of PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PsychInfo using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Seventeen studies met the predetermined inclusion criteria and were selected for review. Education level was the most commonly used measure for CR, and various neuropsychological tests were used to measure cognitive outcomes. Regardless of the CNS disease of the individuals, almost all of the studies reported a positive association between CR and cognitive outcomes when they were evaluated cross-sectionally. However, when evaluated longitudinally, CR had either no effect on, or a negative association with, cognitive outcomes. Based on studies across a broad spectrum of CNS diseases, our findings suggest that CR may serve as a predictor of cognitive outcomes in individuals with CNS diseases. However, studies to date are limited by a lack of imaging analyses and standardized assessment strategies. The ability to use a standardized measure to assess the longitudinal effects of CR may allow for the development of more targeted treatment methods, resulting in improved disease outcomes for individuals.
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Affiliation(s)
- Varna R. Jammula
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Heather Leeper
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Mark R. Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Diane Cooper
- NIH Library/Office of Research Services, National Institutes of Health, Bethesda, Maryland
| | - Terri S. Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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17
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The Health Effects of Workforce Involvement and Transitions for Europeans 50–75 Years of Age: Heterogeneity by Financial Difficulties and Gender. Can J Aging 2021; 41:304-319. [DOI: 10.1017/s0714980821000556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
A prominent demographic trend throughout the industrialized world is population aging. Concerns about economic growth and labour force shortages have led many European nations to enact policies aimed at prolonging working life. Understanding how paid work among late-middle-aged and senior adults is associated with health is therefore important. Using a sample of persons who were 50–75 years of age in 2015 from waves six (2015) and seven (2017) of the Survey of Health, Ageing and Retirement in Europe (n = 38,884), this study shows how a comprehensive set of six workforce involvement/transitions patterns are associated with health. The results show benefits of paid work, especially among respondents having financial difficulties. There is further heterogeneity by gender. The more fragmented employment histories of 50–75-year-old women are associated with stable paid work being of less benefit for addressing financial difficulties and with their health being especially vulnerable to unemployment while they are undergoing financial troubles.
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18
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Atella V, Goldman D, McFadden D. Disparate ageing: The role of education and socioeconomic gradients in future health and disability in an international context. HEALTH ECONOMICS 2021; 30 Suppl 1:3-10. [PMID: 34128290 DOI: 10.1002/hec.4374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Vincenzo Atella
- Department of Economics and Finance, University of Rome Tor vergata and CEIS Tor Vergata, Roma, Italy
| | - Dana Goldman
- Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, California, USA
| | - Daniel McFadden
- Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, California, USA
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19
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Lacroix G, Laliberté-Auger F, Michaud PC, Parent D. The effect of college education on health and mortality: Evidence from Canada. HEALTH ECONOMICS 2021; 30 Suppl 1:105-118. [PMID: 31762143 DOI: 10.1002/hec.3975] [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: 04/03/2019] [Revised: 09/12/2019] [Accepted: 10/20/2019] [Indexed: 06/10/2023]
Abstract
We investigate the returns to college attendance in Canada in terms of health and mortality reduction. To do so, we first use a dynamic health microsimulation model to document how interventions that incentivize college attendance among high school graduates may impact their health trajectory, health care consumption, and life expectancy. We find large returns both in terms of evity (4.1 years additional years at age 51), reduction in the prevalence of various health conditions (10-15 percentage points reduction in diabetes and 5 percentage points for stroke), and health care consumption (27.3% reduction in lifetime hospital stays, 19.7 for specialists). We find that education impacts mortality mostly by delaying the incidence of health conditions as well as providing a survival advantage conditional on having diseases. Second, we provide quasi-experimental evidence on the impact of college attendance on long-term health outcomes by exploiting the Canadian Veteran's Rehabilitation Act, a program targeted towards returning WW-II veterans and which incentivized college attendance. The impact on mortality is found to be larger than those estimated from the health microsimulation model (hazard ratio of 0.216 compared with 0.6 in the simulation model), which suggests substantial returns to college education in terms of healthy life extension which we estimate to be approximately one million canadian dollars.
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Affiliation(s)
- Guy Lacroix
- Department of Economics, Université Laval, Quebec City, Quebec, Canada
- Department of Applied Economics, HEC Montreal Institute of Applied Economics, Montreal, Quebec, Canada
| | - Francois Laliberté-Auger
- Department of Applied Economics, HEC Montreal Institute of Applied Economics, Montreal, Quebec, Canada
| | - Pierre-Carl Michaud
- Department of Applied Economics, HEC Montreal Institute of Applied Economics, Montreal, Quebec, Canada
| | - Daniel Parent
- Department of Applied Economics, HEC Montreal Institute of Applied Economics, Montreal, Quebec, Canada
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20
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Rauscher E, Burns A. Unequal Opportunity Spreaders: Higher COVID-19 Deaths with Later School Closure in the United States. SOCIOLOGICAL PERSPECTIVES : SP : OFFICIAL PUBLICATION OF THE PACIFIC SOCIOLOGICAL ASSOCIATION 2021; 64:831-856. [PMID: 37332490 PMCID: PMC10275350 DOI: 10.1177/07311214211005486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Mixed evidence on the relationship between school closure and COVID-19 prevalence could reflect focus on large-scale levels of geography, limited ability to address endogeneity, and demographic variation. Using county-level Centers for Disease Control and Prevention (CDC) COVID-19 data through June 15, 2020, two matching strategies address potential heterogeneity: nearest geographic neighbor and propensity scores. Within nearest neighboring pairs in different states with different school closure timing, each additional day from a county's first case until state-ordered school closure is related to 1.5 to 2.4 percent higher cumulative COVID-19 deaths per capita (1,227-1,972 deaths for a county with median population and deaths/capita). Results are consistent using propensity score matching, COVID-19 data from two alternative sources, and additional sensitivity analyses. School closure is more strongly related to COVID-19 deaths in counties with a high concentration of Black or poor residents, suggesting schools play an unequal role in transmission and earlier school closure is related to fewer lives lost in disadvantaged counties.
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21
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Rivera-González AC, Stimpson JP, Roby DH, Canino G, Purtle J, Bellamy SL, Ortega AN. The Other US Border: Health Insurance Coverage Among Latino Immigrants In Puerto Rico. Health Aff (Millwood) 2021; 40:1117-1125. [PMID: 34228518 DOI: 10.1377/hlthaff.2021.00049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Puerto Rico is a US territory and a popular destination for Latino immigrants in the Caribbean. Even with few language and cultural barriers, however, many Latino immigrants in Puerto Rico are uninsured. Using data from the 2014-19 Puerto Rico Community Survey, we examined inequities in health insurance coverage for non-Puerto Rican Latinos ages 18-64 living in Puerto Rico according to citizenship status and Latino subgroup (Dominican, Cuban, Mexican, and other Latino). After controlling for potential confounders, we found that noncitizen Dominicans had a significantly lower probability of having any health insurance (57.2 percent) and having any private insurance (31.5 percent). Regardless of similarities in culture and language, Latino immigrants on the island, particularly Dominicans, experience major health insurance coverage inequities. Considering that Puerto Rico's immigration system is regulated by US federal statute, both federal and local policy makers should acknowledge and focus on reducing these immigrant disparities in health insurance coverage.
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Affiliation(s)
- Alexandra C Rivera-González
- Alexandra C. Rivera-González is a PhD student in the Department of Health Management and Policy, Drexel University Dornsife School of Public Health, in Philadelphia, Pennsylvania
| | - Jim P Stimpson
- Jim P. Stimpson is a professor in the Department of Health Management and Policy, Drexel University Dornsife School of Public Health
| | - Dylan H Roby
- Dylan H. Roby is an associate professor in and associate chair of the Department of Health Policy and Management at the University of Maryland School of Public Health, in College Park, Maryland; an adjunct associate professor in the Fielding School of Public Health, University of California Los Angeles (UCLA), in Los Angeles, California; and a faculty associate in the UCLA Center for Health Policy Research
| | - Glorisa Canino
- Glorisa Canino is a professor in the Department of Pediatrics and director of the Behavioral Sciences Research Institute in the School of Medicine, University of Puerto Rico, in Rio Piedras, Puerto Rico
| | - Jonathan Purtle
- Jonathan Purtle is an associate professor in the Department of Health Management and Policy, Drexel University Dornsife School of Public Health
| | - Scarlett L Bellamy
- Scarlett L. Bellamy is a professor in the Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health
| | - Alexander N Ortega
- Alexander N. Ortega is a professor in the Department of Health Management and Policy, Drexel University Dornsife School of Public Health
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22
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Ahrenfeldt LJ, Möller S. The Reciprocal Relationship between Socioeconomic Status and Health and the Influence of Sex: A European SHARE-Analysis Based on Structural Equation Modeling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095045. [PMID: 34068750 PMCID: PMC8126237 DOI: 10.3390/ijerph18095045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 01/19/2023]
Abstract
It is well recognized that socioeconomic status (SES) is an important determinant of health, but many studies fail to address the possibility of reverse causation. We aim to investigate the reciprocal relationship between trajectories of SES and health, and how these associations differ by sex. We performed a longitudinal study including 29,824 men and 37,263 women aged 50+ participating in at least two consecutive waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using structural equation modeling, we found that baseline household income and wealth led to improvements in cognitive function, grip strength, quality of life and depressive symptoms, and a better initial health led to higher income and wealth for both sexes. However, the results indicated that the relative effect of cognitive function and grip strength on SES trajectories was overall greater than the corresponding effect of SES on health changes, particularly regarding income among women, but for quality of life and depressive symptoms, the reverse was indicated, though most pronounced for the associations with wealth. The reciprocal associations between SES and physical function were stronger for men than for women, whereas most associations with cognitive function and mental health were similar between sexes. This study demonstrates that both social causation and health selection contribute to social inequalities in health, but the influence of each direction and the importance of sex differences may vary according to the health outcomes investigated.
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Affiliation(s)
- Linda Juel Ahrenfeldt
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
- Correspondence: ; Tel.: +45-6550-3844
| | - Sören Möller
- OPEN–Open Patient Data Explorative Network, Odense University Hospital, 5000 Odense, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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Abstract
This article reviews the literature on racial and socioeconomic disparities in the management of osteoarthritis. Treatments investigated include arthritis education, dietary weight management, exercise/physical therapy, pharmacologic therapy with nonsteroidal antiinflammatory drugs and opioids, intra-articular steroid injections, and total joint replacement. The amount of evidence for each treatment modality varied, with the most evidence available for racial and socioeconomic disparities in total joint arthroplasty. Black patients, Hispanic patients, and patients with low socioeconomic status (SES) are less likely to undergo total joint replacement than white patients or patients with high SES, and generally have worse functional outcomes and more complications.
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Affiliation(s)
- Angel M Reyes
- Department of Orthopaedic Surgery, Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Harvard Medical School, BWH Orthopaedics, OrACORe Group, 75 Francis Street, BTM Suite 5016, Boston, MA 02115, USA.
| | - Jeffrey N Katz
- Department of Orthopaedic Surgery, Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Harvard Medical School, BWH Orthopaedics, OrACORe Group, 75 Francis Street, BTM Suite 5016, Boston, MA 02115, USA; Section of Clinical Sciences, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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24
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Naghipour M, Joukar F, Nikbakht HA, Hassanipour S, Asgharnezhad M, Arab-Zozani M, Mansour-Ghanaei F. High Prevalence of Metabolic Syndrome and Its Related Demographic Factors in North of Iran: Results from the PERSIAN Guilan Cohort Study. Int J Endocrinol 2021; 2021:8862456. [PMID: 33859688 PMCID: PMC8024063 DOI: 10.1155/2021/8862456] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 02/14/2021] [Accepted: 03/20/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION The prevalence of metabolic syndrome has increased in recent decades around the world and is currently reaching epidemic levels as it is a major public health and clinical concern. The aim of this study was to evaluate the prevalence of metabolic syndrome and its related demographic factors in a population-based study. METHODS In this cross-sectional study, the target population consisted of 10520 individuals aged 35-70 years in Phase 1 of the Persian Guilan cohort study (Guilan site/Some'e Sara) that was conducted in 2014-2017. Demographic, anthropometric, blood pressure, and biochemical data were used in this study. The IDF definitions were used to diagnose the metabolic syndrome. RESULTS The prevalence of the syndrome according to IDF and ATP definition was 42.87% (95% CI: 41.92-41.81) and 40.68% (95% CI: 39.74-41.62), respectively. The prevalence of components for central obesity, high triglyceride, HDL cholesterol, blood glucose, and hypertension components was 75.8%, 43.1%, 40.6%, 39.2% and 37.9%, respectively. All demographic variables were related to the syndrome, and among them age, gender, and residence were identified as independent and strong predictive variables in the regression model. More than 92% of the population had at least one component of the syndrome. CONCLUSION The results of the study show a high prevalence of metabolic syndrome risk factors. It is essential to educate healthy lifestyle behaviors and further health education in the high-risk groups identified in this study, especially the elderly, women, and rural residents.
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Affiliation(s)
- Mohammadreza Naghipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Hassanipour
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehrnaz Asgharnezhad
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
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25
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Evaluation of Diet Quality Among American Adult Cancer Survivors: Results From 2005-2016 National Health and Nutrition Examination Survey. J Acad Nutr Diet 2020; 121:217-232. [PMID: 33158797 DOI: 10.1016/j.jand.2020.08.086] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/17/2020] [Accepted: 08/24/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diet quality among adult cancer survivors is low, and there is minimal information on the Healthy Eating Index (HEI)-2015 score, a measure of diet quality and adherence to the 2015-2020 Dietary Guidelines for Americans, in this population. OBJECTIVE This study aimed to examine HEI-2015 total and component scores and associated factors among adult cancer survivors. Also, this study examined which dietary components needed the most change to improve diet quality in this population. DESIGN The National Health and Nutrition Examination Survey (NHANES) is an ongoing nationally representative population-based cross-sectional study that is conducted annually. PARTICIPANTS/SETTING In all, 1971 adults with a self-reported cancer diagnosis in their lifetime (both individuals with cancer currently and those that are cancer-free) from NHANES 2005-2016 were included in this study. MAIN OUTCOME MEASURES HEI-2015 total and 13 component scores were calculated using the simple scoring algorithm method from the average of 2 24-hour recalls. STATISTICAL ANALYSES The associations of the HEI-2015 total score with sociodemographic, lifestyle, and health-related factors were analyzed using the least square means comparisons. A multivariable survey regression model was used to identify associations with the HEI-2015 total score after adjustment for potential confounders. The 13 component scores were also compared by participant characteristics to identify target food groups for subgroup-specific nutrition intervention. RESULTS The average HEI-2015 total score was 55.6 (95% confidence interval = 54.8-56.4). Factors associated with the HEI-2015 total score included age, race/ethnicity, education, smoking status, body mass index, and oral health status. Overall, poor adherence to the 2015-2020 Dietary Guidelines for Americans was found for most HEI-2015 components, with Whole Grains, Greens and Beans, Sodium, and Fatty Acids components having less than 50% of the maximum possible scores. CONCLUSIONS Results indicate poor diet quality among American adult cancer survivors, with significant disparities observed across sociodemographic and lifestyle factors, particularly education levels, body mass index, and smoking status. Nutrition interventions for cancer survivors should consider focusing on improving diet quality by increasing intakes of whole grains and greens and beans, lowering sodium consumption, and achieving a healthy balance of fatty acids (ie, a favorable ratio of unsaturated fats to saturated fats).
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Vall Castelló J, Tubianosa C. Linking Mediterranean Diet and Lifestyle with Cardio Metabolic Disease and Depressive Symptoms: A Study on the Elderly in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197053. [PMID: 32993183 PMCID: PMC7579231 DOI: 10.3390/ijerph17197053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/02/2020] [Accepted: 09/04/2020] [Indexed: 01/03/2023]
Abstract
Against a backdrop of an aging population in Europe, promoting health in older adults becomes a pressing issue. This study aimed to explore if correlations exist between the adherence to the Mediterranean diet and specific health outcomes such as the incidence of chronic cardio metabolic illnesses and experiencing depressive symptoms for elderly individuals. We also looked into probable links between regularly engaging in vigorous physical activities and these health outcomes. Our goal was to clearly demonstrate these relationships while controlling for several individual characteristics and socio-demographic factors on a cross-national scale within Europe. Using the Survey of Health, Aging and Retirement in Europe (SHARE) data for adults aged 50 years and above, we found that following the Mediterranean diet was negatively correlated with the incidence of chronic illnesses, as well as with levels of depressive symptoms. These results were robust to the inclusion of a number of individual and socio-demographic controls. We also showed that regular participation in sports and other strenuous physical activities were associated with lesser chronic disorders and lower levels of depressive symptoms. These findings may have important implications in formulating preventive interventions on ensuring the quality of life of the older population.
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Affiliation(s)
- Judit Vall Castelló
- Department of Economics, Universitat de Barcelona, 08034 Barcelona, Spain
- Barcelona Institute of Economics, Universitat de Barcelona, 08034 Barcelona, Spain;
- Correspondence:
| | - Charisse Tubianosa
- Barcelona Institute of Economics, Universitat de Barcelona, 08034 Barcelona, Spain;
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Limbers CA, McCollum C, Ylitalo KR, Hebl M. Physical activity in working mothers: Running low impacts quality of life. ACTA ACUST UNITED AC 2020; 16:1745506520929165. [PMID: 32495707 PMCID: PMC7273560 DOI: 10.1177/1745506520929165] [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] [Indexed: 12/19/2022]
Abstract
Objectives: The transition to motherhood is associated with declines in physical activity
in women. Working mothers may be particularly at-risk for low levels of
physical activity, since they have to balance the competing interests of
work and family life, and exercise often takes a backseat to more seemingly
pressing concerns. The potential benefits working mothers can experience
from physical activity are numerous. The objectives of this study were to
evaluate the percentage of working mothers from the United States who met
the World Health Organization’s and the American College of Sports
Medicine’s recommended guidelines for weekly physical activity and
investigate the associations between physical activity, quality of life, and
self-rated work productivity in this sample of working mothers. Methods: Participants were 334 working mothers from the United States (mean
age = 35.00 years; standard deviation (SD) = 5.85; 77.8% White) recruited
from a Qualtrics research panel. To be eligible to participate in the study,
a woman had to be 18 years or older with at least one child aged 5 years or
younger, work at least 30 h per week at a job, live with her child(ren) at
least 50% of the time, and have a minimum of a bachelor’s degree.
Participants completed the Godin leisure time exercise questionnaire, the
World Health Organization—five well-being index, a single-item indicator of
self-rated work productivity, and a demographic questionnaire. Results: Of the working mothers in the sample, 45.5% met the recommended guidelines of
at least 150 min of moderate exercise in the past week. Approximately 39% of
working mothers reported engaging in no 30-min bouts of strenuous exercise
in the past week. Non-white working mothers, working mothers with a higher
singular annual income, and working mothers who obtained a higher
educational level were more likely to meet the recommended guidelines for
physical activity in the past week. Meeting the recommended physical
activity guidelines in the past week was associated with better quality of
life (r = 0.39; p < 0.001) and
self-rated work productivity (r = 0.13;
p < 0.05). Only the association between physical
activity and quality of life remained significant in a multivariate analysis
(standardized beta coefficient = 0.33; p < 0.001) after
controlling for race/ethnicity, maternal singular annual income, and
maternal highest level of education. Conclusion: Our findings highlight that working mothers in the United States are a group
at risk for low levels of physical activity. Given the great benefits that
these women do experience as a function of getting exercise, it is
critically important we pay more attention to how individual,
organizational, and societal-level interventions might assist them in
attaining target levels of physical activity.
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Affiliation(s)
| | - Christina McCollum
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Kelly R Ylitalo
- Department of Public Health, Baylor University, Waco, TX, USA
| | - Mikki Hebl
- Department of Psychological Science, Rice University, Houston, TX, USA
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Amegbor PM, Rosenberg MW. Health and socioeconomic risk factors for overnight admission among older adults in Ghana. JOURNAL OF POPULATION AGEING 2020. [DOI: 10.1007/s12062-020-09294-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Impact of Gender Inequalities in the Causes of Mortality on the Competitiveness of OECD Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103698. [PMID: 32456300 PMCID: PMC7277152 DOI: 10.3390/ijerph17103698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/05/2020] [Accepted: 05/22/2020] [Indexed: 12/30/2022]
Abstract
The aim of the present study is to quantify the relations between gender inequalities in mortality by selected causes of mortality and between competitiveness of Organisation for Economic Co-operation and Development (OECD) countries. Data for the analyses were obtained from OECD databases and the World Economic Forum (Global Competitiveness Index), for the years 2011–2016, for all 36 countries. The methods of descriptive analysis, analysis of differences in causes of mortality by gender characteristics, regression analysis, relationship analysis of gender inequalities in causes of mortality and competitiveness, and cluster analysis were used for the statistical data processing. Based on the research findings, it can be concluded that gender inequality occurs in most of the examined mortality groups of diagnoses, while it was most significant in the case of mortality due to neoplasms. The impacts of mortality on competitiveness are significant. In assessing gender inequalities in causes of mortality, significant impacts were seen in most mortality causes, but the most significant impact was identified within mortality due to neoplasms. Emphasis should be placed on men when reducing inequalities. Health and health equity should be supported by national governments, and health equity should be one of the key performance indicators of the country.
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Veenstra G, Vanzella-Yang A. Does household income mediate the association between education and health in Canada? Scand J Public Health 2020; 49:857-864. [PMID: 32400282 DOI: 10.1177/1403494820917534] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives: The study aim was to investigate whether household income mediates the association between education and health in a nationally representative sample of Canadian adults. Methods: The data came from the Longitudinal and International Study of Adults linked to income data from the Canada Revenue Agency. Odds ratios and predicted probabilities from binary logistic regression models were used to describe associations between education and (a) self-rated health, (b) longstanding illness or health problem, (c) emotional, psychological or mental health problem and (d) symptoms of psychological distress. The Karlson-Holm-Breen decomposition method was used to investigate the potentially mediating role of household income in these associations. The analyses were conducted separately for women and men. Results: Education was significantly associated with all four health indicators for both women and men. Of the four health indicators, education was most strongly associated with self-rated health for both women and men. Education was more strongly associated with self-rated health and the presence of an emotional, psychological or mental health problem for women than for men. Curiously, men with a postgraduate degree were significantly more likely than men with a bachelor degree to report symptoms of psychological distress. Only modest proportions of the associations between education and health could be attributed to differences in household income. Education and household income manifested independent associations with all four health indicators among women and with three of four health indicators among men. Conclusions: Education and household income are joint and independent predictors of health in Canada. Accordingly, both should be included in research on socioeconomic health inequalities in this context.
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Affiliation(s)
- Gerry Veenstra
- Department of Sociology, University of British Columbia, Vancouver, BC, Canada
| | - Adam Vanzella-Yang
- Department of Sociology, University of British Columbia, Vancouver, BC, Canada
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Raghupathi V, Raghupathi W. The influence of education on health: an empirical assessment of OECD countries for the period 1995-2015. ACTA ACUST UNITED AC 2020; 78:20. [PMID: 32280462 PMCID: PMC7133023 DOI: 10.1186/s13690-020-00402-5] [Citation(s) in RCA: 210] [Impact Index Per Article: 52.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/26/2020] [Indexed: 11/20/2022]
Abstract
Background A clear understanding of the macro-level contexts in which education impacts health is integral to improving national health administration and policy. In this research, we use a visual analytic approach to explore the association between education and health over a 20-year period for countries around the world. Method Using empirical data from the OECD and the World Bank for 26 OECD countries for the years 1995–2015, we identify patterns/associations between education and health indicators. By incorporating pre- and post-educational attainment indicators, we highlight the dual role of education as both a driver of opportunity as well as of inequality. Results Adults with higher educational attainment have better health and lifespans compared to their less-educated peers. We highlight that tertiary education, particularly, is critical in influencing infant mortality, life expectancy, child vaccination, and enrollment rates. In addition, an economy needs to consider potential years of life lost (premature mortality) as a measure of health quality. Conclusions We bring to light the health disparities across countries and suggest implications for governments to target educational interventions that can reduce inequalities and improve health. Our country-level findings on NEET (Not in Employment, Education or Training) rates offer implications for economies to address a broad array of vulnerabilities ranging from unemployment, school life expectancy, and labor market discouragement. The health effects of education are at the grass roots-creating better overall self-awareness on personal health and making healthcare more accessible.
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Affiliation(s)
- Viju Raghupathi
- 1Koppelman School of Business, Brooklyn College of the City University of New York, 2900 Bedford Ave, Brooklyn, NY 11210 USA
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Brito A, Boller K. Changing the Pediatric Paradigm: Focusing on Strengths. Pediatr Clin North Am 2020; 67:247-258. [PMID: 32122558 DOI: 10.1016/j.pcl.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Pediatricians need to adopt a strengths-based approach within their practices to better address their patients' health-related social needs. This approach becomes even more important as the pediatric population in the United States becomes increasingly diverse. Pediatricians must be cognizant of and address biases within their practices to maximize effectiveness of a strengths-based approach. With evidence mounting about their significance to health, a paradigm shift is needed to address health-related social needs by focusing on assets, not deficits. This shift will hopefully improve pediatric health outcomes which have languished in the United States, despite outspending other wealthy nations for decades.
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Affiliation(s)
- Arturo Brito
- The Nicholson Foundation, 60 Park Place, 19th Floor, Newark, NJ 07102, USA.
| | - Kimberly Boller
- The Nicholson Foundation, 60 Park Place, 19th Floor, Newark, NJ 07102, USA. https://twitter.com/KimBoller1
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Kilpeläinen TP, Talala K, Taari K, Raitanen J, Kujala P, Pylväläinen J, Tammela TL, Auvinen A. Patients' education level and treatment modality for prostate cancer in the Finnish Randomized Study of Screening for Prostate Cancer. Eur J Cancer 2020; 130:204-210. [PMID: 32229417 DOI: 10.1016/j.ejca.2020.02.045] [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: 10/10/2019] [Revised: 01/22/2020] [Accepted: 02/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND In prostate cancer (PCa), lower education level is associated with less screening, more advanced stage at diagnosis and worse survival. The aim of this study was to estimate the association between education level and treatment modality and subsequently survival. METHODS The 9255 men diagnosed with PCa in the Finnish Randomized Study of Screening for Prostate Cancer were included. Cancer stage, comorbidity, education level and primary treatment modality were extracted from the patient records, the Finnish Cancer Registry, Statistics Finland and the National Institute of Health and Welfare, and these covariates were used in logistic regression (treatment selection) and Cox regression (survival analysis). RESULTS In high-risk cancers, men with tertiary education were more likely to be treated with radical prostatectomy (odds ratio [OR] = 1.76; 95% confidence interval [CI] = 1.27-2.44) than men with primary education. Men with secondary (OR = 0.57; 95% CI = 0.38-0.84) or tertiary (OR = 0.42; 95% CI = 0.29-0.60) education were managed less frequently with mere hormonal therapy. In locally advanced cases, tertiary education was associated with more curatively aimed therapies and less hormonal therapy (OR for radical prostatectomy = 2.34; 95% CI = 1.49-3.66; OR for radiotherapy = 1.42; 95% CI = 1.09-1.85; OR for hormonal therapy = 0.45; 95% CI = 0.33-0.60). The hazard ratio for PCa death was lower in men with secondary (0.81; 95% CI = 0.69-0.95) and tertiary (0.75; 95% CI = 0.65-0.87) education than in the patients with primary education. CONCLUSIONS When controlled for the cancer risk group, comorbidity and patient's age, low education level is independently associated with less curatively aimed treatment in men with high-risk or locally advanced PCa and subsequently worse prognosis.
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Affiliation(s)
- Tuomas P Kilpeläinen
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | | | - Kimmo Taari
- Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jani Raitanen
- UKK Institute for Health Promotion Research, Tampere, Finland; Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
| | - Paula Kujala
- Department of Pathology, Fimlab Laboratories, Tampere, Finland
| | - Juho Pylväläinen
- Department of Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Teuvo Lj Tammela
- Department of Urology, Tampere University Hospital, Tampere, Finland
| | - Anssi Auvinen
- Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
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Beutel ME, Klein EM, Henning M, Werner AM, Burghardt J, Tibubos AN, Schmutzer G, Brähler E. Somatic Symptoms in the German General Population from 1975 to 2013. Sci Rep 2020; 10:1595. [PMID: 32005895 PMCID: PMC6994459 DOI: 10.1038/s41598-020-58602-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 01/14/2020] [Indexed: 11/23/2022] Open
Abstract
The study determines how burden and patterns of somatic symptom reporting developed over almost four decades in the general German population. Additionally, we studied how socio-demographic factors affected the degree of somatic symptoms. Population-based samples representative for West Germany between 18 and 60 years of age were analyzed comparing three cross-sectional samples of 1975 (N = 1601), 1994 (N = 1416), and 2013 (N = 1290) by conducting a three-way analysis of variance (sex, age, survey). The prevalence rates for somatic symptoms in men and women were lower in the more recent surveys; this affected women most strongly. Exhaustion and musculoskeletal complaints remained leading symptoms (affecting 25%, resp. 11% of the men and 30%, resp. 19% of the women). There was a slight increase in women’s prevalence of exhaustion from 1994 (15%) to 2013 (19%). As determined by stepwise multiple regression, somatic symptoms were consistently associated with female sex and higher age. In the 2013 survey, education became an additional negative predictor of somatic symptom load, while the impact of age and sex on somatic symptoms reporting decreased. Somatic symptoms remain a major burden in the general population. Findings are interpreted with regard to improved living and health care conditions, different cohort experiences, and more public health information.
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Affiliation(s)
- Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva M Klein
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michaela Henning
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.,Department of Psychosomatics and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Antonia M Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Juliane Burghardt
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ana Nanette Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Gabriele Schmutzer
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, University of Leipzig, Leipzig, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.,Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, University of Leipzig, Leipzig, Germany
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Renson A, Herd P, Dowd JB. Sick Individuals and Sick (Microbial) Populations: Challenges in Epidemiology and the Microbiome. Annu Rev Public Health 2019; 41:63-80. [PMID: 31635533 DOI: 10.1146/annurev-publhealth-040119-094423] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The human microbiome represents a new frontier in understanding the biology of human health. While epidemiology in this area is still in its infancy, its scope will likely expand dramatically over the coming years. To rise to the challenge, we argue that epidemiology should capitalize on its population perspective as a critical complement to molecular microbiome research, allowing for the illumination of contextual mechanisms that may vary more across populations rather than among individuals. We first briefly review current research on social context and the gut microbiome, focusing specifically on socioeconomic status (SES) and race/ethnicity. Next, we reflect on the current state of microbiome epidemiology through the lens of one specific area, the association of the gut microbiome and metabolic disorders. We identify key methodological shortcomings of current epidemiological research in this area, including extensive selection bias, the use of noncompositionally robust measures, and a lack of attention to social factors as confounders or effect modifiers.
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Affiliation(s)
- Audrey Renson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina 27599, USA;
| | - Pamela Herd
- McCourt School of Public Policy, Georgetown University, Washington, DC 20057, USA;
| | - Jennifer B Dowd
- Department of Global Health and Social Medicine, King's College London, London WC2B 4BG, United Kingdom; .,Current affiliation: Leverhulme Center for Demographic Science, University of Oxford, Oxford OX1 1JD, United Kingdom;
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The Value of High School Graduation in the United States: Per-Person Shadow Price Estimates for Use in Cost–Benefit Analysis. ADMINISTRATIVE SCIENCES 2019. [DOI: 10.3390/admsci9040081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
One way for jurisdictions with limited analytic resources to increase their capability for doing cost–benefit analysis (CBA) is to use existing shadow prices, or “plug-ins”, for important social impacts. This article contributes to the further development of one important shadow price: the value of an additional high school graduation in the United States. Specifically, how valuable to a student, government, and the rest of society in aggregate is a high school graduation? The analysis builds on the method developed by the Washington State Institute for Public Policy and presents numerical updates and extensions to their analysis. For the U.S., the estimated net present value (the social value) using a 3 percent real discount rate of this shadow price is approximately $300,000 per each additional graduate. In appropriate circumstances, this value can be “plugged-in” to CBAs of policies that either directly or indirectly seeks to increase the number of students who graduate from high school.
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Homelessness, health and the policy process: A literature review. Health Policy 2019; 123:1125-1132. [PMID: 31522758 DOI: 10.1016/j.healthpol.2019.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 08/14/2019] [Accepted: 08/19/2019] [Indexed: 11/20/2022]
Abstract
Homelessness has serious consequences for the health of people experiencing homelessness, and presents a challenge to the provision of quality care by health services. Policymaking to address homelessness, as with other social determinants of health (SDH), is complicated by issues of complex causation, intersectoral working and the dominance of biomedicine within health policy. This paper investigates how policies addressing homelessness have been explored using formal policy process theories (PPT). It also examines how health (as an actor and an idea) has intersected with the issue of homelessness reaching policy agendas and in policy implementation. A systematised search of academic databases for peer-reviewed literature from 1986 to 2018 identified six studies of homelessness policy change from Australia, Canada, France and the United States. PPT were able to articulate the interplay of actors, ideas and structures in homelessness policymaking. When the health sector was involved, it tended to be in terms of healthcare service utilisation rather than a broader public health framework emphasising structural social determinants of homelessness. Tensions between differing the priorities of local homelessness actors and a biomedical evidence-based policy paradigm were noted. Future policy action on homelessness requires new models of intersectoral governance that account for the complexity of health determinants, a health workforce enabled to engage with the SDH, and meaningful inclusion of those with lived and living experience of homelessness in policy formulation.
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Xu RH, Cheung AWL, Wong ELY. The relationship between patient engagement and health-related quality of life in patients: a cross-sectional study in general outpatient clinic in Hong Kong SAR, China. Patient Prefer Adherence 2019; 13:1451-1462. [PMID: 31692547 PMCID: PMC6717150 DOI: 10.2147/ppa.s216891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/14/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Patient engagement (PE) helps healthcare professionals to collaborate with patients to work together to improve health outcomes. However, the studies of PE and its relationship with health-related quality of life (HRQoL) is very rare in Hong Kong (HK) and China. The aim of this study was to assess the PE level and its association with HRQoL in the general outpatient clinic (GOPC) in Hong Kong. METHODS A cross-sectional survey was conducted in a GOPC in 2017. Patient engagement index (PEI) was used as a valid and reliable instrument to assess the PE level in the primary care setting. EQ-5D-5L HK Chinese version was used to evaluate the patients' HRQoL. ANOVA, ANCOVA and robust linear regression were used to analyse the data. RESULTS 686 patients successfully completed the survey (response rate =64%). The mean utility of EQ-5D (0~1.0) was 0.92. Male, highly educated and younger respondents got higher utility. For PEI (0~100), the mean score was 37.02, whereas female (38.03), highly educated and younger respondents performed better. The regression model indicated that there is a positive relationship between PE and HRQoL (beta =2.66, SE =5.11, p<0.05). However, after adjusting a series of socio-economic characteristics, the relationship was weakened (beta =1.77, SE =4.64, p<0.05) and even insignificant. CONCLUSION This is the first study in HK to assess the PE level and its relationship with HRQoL in the primary care setting. The result indicated that improve PE could bring a positive influence on the HRQoL. However, the PE-HRQoL relationship might be deeply influenced by an individual's physical, psychological or social characteristics.
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Affiliation(s)
- Richard Huan Xu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Annie Wai Ling Cheung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
| | - Eliza Lai Yi Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People’s Republic of China
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Does having highly educated adult children reduce mortality risks for parents with low educational attainment in Europe? AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19000795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractIt is known that the education of significant others may affect an individual's mortality. This paper extends an emerging body of research by investigating the effect of having highly educated adult children on the longevity of older parents in Europe, especially parents with low educational attainment. Using a sample of 15,015 individuals (6,620 fathers and 8,395 mothers) aged 50 and above, with 1,847 recorded deaths, over a mean follow-up period of 10.9 years from the Survey of Health, Ageing and Retirement in Europe (SHARE), we examine whether the well-established socio-economic gradient in mortality among parents is modified when their adult children have higher educational attainment than their parents. We find that having highly educated adult children is associated with reduced mortality risks for fathers and mothers with low educational attainment, compared to their counterparts whose adult children have only compulsory education. The association is stronger in early older age (ages 50–74) than in later older age (ages 75 and over). Part of the association appears to be explained by health behaviours (physical (in)activity) and health status (self-rated health). Our findings suggest that the socio-economic–mortality gradient among older parents might be better captured using an intergenerational approach that recognises the advantage of having highly educated adult children, especially for fathers and mothers with only compulsory education.
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Vermeulen FM, Gerbens LAA, Bosma AL, Apfelbacher CJ, Irvine AD, Arents BWM, Barbarot S, Deleuran M, Eichenfield LF, Manca A, Schmitt J, Vestergaard C, Wall D, Weidinger S, Middelkamp-Hup MA, Spuls PI, Flohr C. TREatment of ATopic eczema (TREAT) Registry Taskforce: consensus on how and when to measure the core dataset for atopic eczema treatment research registries. Br J Dermatol 2019; 181:492-504. [PMID: 30719709 PMCID: PMC6771812 DOI: 10.1111/bjd.17715] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2019] [Indexed: 01/25/2023]
Abstract
Background Comparative, real‐life and long‐term evidence on the effectiveness and safety of phototherapy and systemic therapy in moderate‐to‐severe atopic eczema (AE) is limited. Such data must come from well‐designed prospective patient registries. Standardization of data collection is needed for direct comparisons and data pooling. Objectives To reach a consensus on how and when to measure the previously defined domain items of the TREatment of ATopic eczema (TREAT) Registry Taskforce core dataset for research registries for paediatric and adult patients with AE. Methods Proposals for the measurement instruments were based on recommendations of the Harmonising Outcome Measures for Eczema (HOME) initiative, the existing AE database of TREATgermany, systematic reviews of the literature and expert opinions. The proposals were discussed at three face‐to‐face consensus meetings, one teleconference and via e‐mail. The frequency of follow‐up visits was determined by an expert survey. Results A total of 16 experts from seven countries participated in the ‘how to measure’ consensus process and 12 external experts were consulted. A consensus was reached for all domain items on how they should be measured by assigning measurement instruments. A minimum follow‐up frequency of initially 4 weeks after commencing treatment, then every 3 months while on treatment and every 6 months while off treatment was defined. Conclusions This core dataset for national AE research registries will aid in the comparability and pooling of data across centres and country borders, and enables international collaboration to assess the long‐term effectiveness and safety of phototherapy and systemic therapy used in patients with AE. What's already known about this topic? Comparable, real‐life and long‐term data on the effectiveness and safety of phototherapy and systemic therapy in patients with atopic eczema (AE) are needed. There is a high diversity of outcomes and instruments used in AE research, which require harmonization to enhance comparability and allow data pooling.
What does this study add? Our taskforce has reached international consensus on how and when to measure core domain items for national AE research registries. This core dataset is now available for use by researchers worldwide and will aid in the collection of unified data.
What are the clinical implications of this work? The data collected through this core dataset will help to gain better insights into the long‐term effectiveness and safety of phototherapy and systemic therapy in AE and will provide important information for clinical practice. Standardization of such data collection at the national level will also allow direct data comparisons and pooling across country borders (e.g. in the analysis of treatment‐related adverse events that require large patient numbers).
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Affiliation(s)
- F M Vermeulen
- Amsterdam UMC, University of Amsterdam, Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Meibergdreef 9, Amsterdam, the Netherlands
| | - L A A Gerbens
- Amsterdam UMC, University of Amsterdam, Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Meibergdreef 9, Amsterdam, the Netherlands
| | - A L Bosma
- Amsterdam UMC, University of Amsterdam, Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Meibergdreef 9, Amsterdam, the Netherlands
| | - C J Apfelbacher
- Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - A D Irvine
- Department of Paediatric Dermatology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.,Department of Clinical Medicine, Trinity College Dublin, Dublin, Ireland.,National Children's Research Centre, Dublin, Ireland
| | - B W M Arents
- Dutch Association for People with Atopic Dermatitis, Nijkerk, the Netherlands
| | - S Barbarot
- Department of Dermatology, Nantes University Hospital, Nantes, France
| | - M Deleuran
- Department of Dermatology and Venereology, Aarhus University Hospital, Aarhus, Denmark
| | - L F Eichenfield
- Departments of Dermatology and Pediatrics, University of California, San Diego, CA, U.S.A
| | - A Manca
- Centre for Health Economics, University of York, York, U.K
| | - J Schmitt
- Centre for Evidence-based Healthcare, Medizinische Fakultät Carl Gustav Carus, Technical University of Dresden, Dresden, Germany.,University Allergy Centre, University Hospital Carl Gustav Carus, Dresden, Germany
| | - C Vestergaard
- Department of Dermatology and Venereology, Aarhus University Hospital, Aarhus, Denmark
| | - D Wall
- Department of Paediatric Dermatology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.,Irish Skin Foundation, Dublin, Ireland
| | - S Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M A Middelkamp-Hup
- Amsterdam UMC, University of Amsterdam, Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Meibergdreef 9, Amsterdam, the Netherlands
| | - P I Spuls
- Amsterdam UMC, University of Amsterdam, Department of Dermatology, Amsterdam Public Health, Infection and Immunity, Meibergdreef 9, Amsterdam, the Netherlands
| | - C Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, U.K
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Paslakis G, Fischer-Jacobs J, Pape L, Schiffer M, Gertges R, Tegtbur U, Zimmermann T, Nöhre M, de Zwaan M. Assessment of Use and Preferences Regarding Internet-Based Health Care Delivery: Cross-Sectional Questionnaire Study. J Med Internet Res 2019; 21:e12416. [PMID: 31099338 PMCID: PMC6542248 DOI: 10.2196/12416] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/14/2019] [Accepted: 04/08/2019] [Indexed: 12/30/2022] Open
Abstract
Background There has been an incremental increase in the use of technology in health care delivery. Feasibility, acceptability, and efficacy of interventions based on internet technologies are supported by a growing body of evidence. Objective The aim of this study was to investigate use and preferences in the general adult population in Germany for remote, internet-based interaction (eg, email, videoconferencing, electronic medical records, apps). Methods A nationwide cross-sectional questionnaire survey in adults that was representative in terms of age, sex and educational level was carried out. Results A total of 22.16% (538/2428) of survey participants reported not using the internet for work or private use. The nonuser phenotype can be described as being older, having lower educational and income status, and living in less populated areas. The majority of participants within the cohort of internet users reported that they would not consider using electronic medical records (973/1849, 52.62%), apps (988/1854, 53.29%), or emails to report symptoms (1040/1838, 56.58%); teleconference with one (1185/1852, 63.98%) or more experts (1239/1853, 66.86%); or participate in video psychotherapy (1476/1853, 79.65%) for the purpose of medical consultation or treatment. Older age and lower educational level were the most robust predictors of assumed future denial of use. Conclusions Our results point toward low use and preference rates among the general population for the use of telemedicine. It also seems that those who might benefit from telemedical interventions the most, are, in fact, those who are most hesitating. These low use and preference rates of eHealth should be considered prior to designing and providing future telemedical care, supporting the need for easy-to-use, data secure solutions.
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Affiliation(s)
- Georgios Paslakis
- University Health Network, Toronto General Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Josefine Fischer-Jacobs
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Lars Pape
- Department of Pediatric, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.,Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany
| | - Mario Schiffer
- Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany.,Department of Nephrology, University Hospital, Friedrich-Alexander University, Erlangen, Germany
| | - Raoul Gertges
- Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany
| | - Uwe Tegtbur
- Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany.,Department of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Tanja Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.,Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.,Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany
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Goldberg SK, Conron KJ, Halpern CT. Metabolic Syndrome and Economic Strain Among Sexual Minority Young Adults. LGBT Health 2019; 6:1-8. [PMID: 30650052 DOI: 10.1089/lgbt.2018.0053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The study tested if sexual orientation is associated with metabolic syndrome (MetS) in young adulthood (ages 24-32), and if economic strain impacts associations. METHODS Gender-stratified logistic regressions were fit among 11,575 young adults (1644 sexual minority [SM]) in Wave IV of The National Longitudinal Study of Adolescent to Adult Health. RESULTS MetS was not associated with sexual orientation for either gender, yet economic strain was more prevalent among both SM males and females. Additional MetS risk factors (smoking, binge drinking, and lower education) emerged for SM females. CONCLUSION Although MetS did not differ by sexual orientation, emergent sexual orientation disparities among females suggest increased future risk.
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Affiliation(s)
- Shoshana K Goldberg
- 1 Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,2 Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kerith J Conron
- 1 Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,3 The Williams Institute, UCLA School of Law, Los Angeles, California
| | - Carolyn T Halpern
- 1 Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,2 Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Krueger PM, Dehry IA, Chang VW. The Economic Value of Education for Longer Lives and Reduced Disability. Milbank Q 2019; 97:48-73. [PMID: 30883958 DOI: 10.1111/1468-0009.12372] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Policy Points Although it is well established that educational attainment improves health and longevity, the economic value of this benefit is unknown. We estimate that the economic value of education for longer, healthier lives is comparable to or greater than the value of education for lifetime earnings. Policies that increase rates of completion of high school and college degrees could result in longer, healthier lives and substantial economic value for the population. We provide a template for assigning an economic value to the health benefits associated with education or other social determinants, allowing policymakers to prioritize those interventions that yield the greatest value for the population. CONTEXT Policymakers often frame the value of educational attainment in terms of economic outcomes (eg, employment, productivity, wages). But that approach may understate the value of education if it ignores the economic value of both longer lives and the reduced disability associated with more education. METHODS In this article, we estimated the present value of the longer life and reduced disability associated with higher educational attainment at age 25 through age 84. We used prospective survival data and cross-sectional disability data from the National Health Interview Survey-Linked Mortality Files and drew on published estimates of the economic value of a statistical life. In addition, we used data from the Current Population Survey-Annual Social and Economic supplement to estimate the present value of education for lifetime earnings at age 25 through age 64 in order to provide a benchmark for comparing the value of education for health. FINDINGS Compared with those with less than a high school degree, the longer lives of those with a high school degree are worth an additional $450,000 for males and $479,000 for females, and the additional disability-adjusted life for those with a high school degree is worth $693,000 for males and $757,000 for females. By comparison, the additional lifetime earnings for those with a high school degree, rather than less than a high school degree, is $213,000 for males and $194,000 for females. Compared with those with a high school degree, the longer lives for those with a baccalaureate degree are worth an additional $446,000 for males and $247,000 for females. The value of the additional disability-adjusted life associated with having a baccalaureate degree rather than a high school degree is $611,000 for males and $407,000 among females. By comparison, the additional lifetime earnings for those with a baccalaureate degree, rather than a high school degree, is $628,000 for males and $459,000 for females. CONCLUSIONS The value of education for longer, healthier lives may surpass the value for earnings. Estimates of the economic value of the social determinants of health, such as education, can help policymakers prioritize those policies that provide the greatest value for population health.
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Affiliation(s)
- Patrick M Krueger
- University of Colorado Denver and Institute of Behavioral Sciences, University of Colorado Boulder
| | - Ilham A Dehry
- Trachtenberg School of Public Policy and Public Administration, George Washington University
| | - Virginia W Chang
- College of Global Public Health and School of Medicine, New York University
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Abstract
Introduction The National Pupil Database (NPD) is a record-level administrative data resource curated by the UK government’s Department for Education that is used for funding purposes, school performance tables, policy making, and research. Processes Data are sourced from schools, exam awarding bodies, and local authorities who collect data on an on-going basis and submit to the Department for Education either termly or yearly. Data contents NPD contains child-level and school-level data on all pupils in state schools in England (6.6 million in the 2016/17 academic year). The primary module is the census, which has information on characteristics and school enrolment. Other modules include alternative provision, exam attainment, absence and exclusions. Data from children’s social care are also available on children referred for support and those who become looked after. Children’s records are linkable across different modules and across time using a nationally unique, anonymised child-level identifier. Linkage to external datasets has also been accomplished using child-level identifiers. Conclusions The NPD is an especially valuable data resource for researchers interested in the educational experience and outcomes of children and young people in England. Although limited by the fact that children in private schools or who are home schooled are not included, it provides a near-complete picture of school trajectories and outcomes for the majority of children. Linkage to other datasets can enhance analyses and provide answers to questions that would otherwise be costly, time consuming and difficult to find
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Affiliation(s)
- Matthew Alexander Jay
- UCL Great Ormond Street Institute of Child Health, Population Policy & Practice Programme 30 Guilford Street London WC1N 1EH.,Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Anaesthesia and Pain Medicine Great Ormond Street London WC1N 3JH
| | - Louise McGrath-Lone
- UCL Great Ormond Street Institute of Child Health, Population Policy & Practice Programme 30 Guilford Street London WC1N 1EH.,The Rees Centre for Research in Fostering and Education University of Oxford 15 Norham Gardens Oxford OX2 6PY
| | - Ruth Gilbert
- UCL Great Ormond Street Institute of Child Health, Population Policy & Practice Programme 30 Guilford Street London WC1N 1EH
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Ma Y, Nolan A, Smith JP. The value of education to health: Evidence from Ireland. ECONOMICS AND HUMAN BIOLOGY 2018; 31:14-25. [PMID: 30077041 DOI: 10.1016/j.ehb.2018.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/18/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
Does education have a causal impact on health? The existing literature presents mixed results. More evidence is required from contexts that have not been explored in the literature, and using clinically-measured health outcomes. Using data from the Irish Longitudinal Study on Ageing (TILDA), and exploiting a policy change in the 1960s that eliminated public secondary school fees, we investigate whether additional years of schooling for those with lower socio-economic status (SES) have a causal effect on the prevalence of cardiovascular disease in later life. We find significant sizable effects of education on the prevalence of both hypertension and diabetes. An additional year of schooling decreases the probability of having hypertension by approximately 3% points, and decreases the probability of having diabetes by approximately 1% point, effects that are large given existing prevalence. Further analysis of possible mechanisms shows that additional schooling increases the probability of engaging in high levels of physical activity and refraining from smoking. In the context of an increasing focus on strategies to prevent chronic disease, evidence such as this provides important insights for policymakers tasked with designing public health interventions targeting risk factors for chronic disease.
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Affiliation(s)
- Yuanyuan Ma
- Wenlan School of Business, Zhongnan University of Economics and Law, Wuhan, China; The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland.
| | - Anne Nolan
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College, Dublin, Ireland; Economic and Social Research Institute, Dublin, Ireland
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Brigance C, Soto Mas F, Sanchez V, Handal AJ. The Mental Health of the Organic Farmer: Psychosocial and Contextual Actors. Workplace Health Saf 2018; 66:606-616. [DOI: 10.1177/2165079918783211] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite the large body of research and literature on the health and mental health of farmers, we should not assume that research findings necessarily apply to the organic farmer. The limited literature on the mental health of the organic farmer points to potential differences. Research has found that workers on organic farms may be happier than their counterparts; others have identified added sources of stress related to the perceived need of organic farmers to embrace concepts linked to the organic movement. However, further research is needed to identify both risk and protective factors for mental health among organic farmers. The purpose of this qualitative descriptive study was to explore the psychosocial and contextual factors that may relate to the mental health of the organic farmer. Key informant interviews were conducted with 10 farm producers and 20 farm workers. The findings indicated that respondents recognized mental health as influential in the workplace and the future of organic practices (e.g., the mental, financial, physical stress). Some of the risk factors mentioned by participants reflected those experienced by conventional, nonorganic farmers. Participants also reported contentment with farming as an occupation, the benefits of being connected to the land, feelings of social and environmental responsibility, and engagement in social activities that may promote human and social capital. These feelings and activities ultimately benefit the farmer, contribute to social cohesion, and may have positive implications for mental health. Results suggest that there may be protective mental health factors unique to the organic farmer.
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Schroeder K, Malone SK, McCabe E, Lipman T. Addressing the Social Determinants of Health: A Call to Action for School Nurses. J Sch Nurs 2018; 34:182-191. [PMID: 29343161 PMCID: PMC6083826 DOI: 10.1177/1059840517750733] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Social determinants of health (SDOH), the conditions in which children are born, grow, live, work or attend school, and age, impact child health and contribute to health disparities. School nurses must consider these factors as part of their clinical practice because they significantly and directly influence child well-being. We provide clinical guidance for addressing the SDOH when caring for children with three common health problems (obesity, insufficient sleep, and asthma). Given their unique role as school-based clinical experts, care coordinators, and student advocates, school nurses are well suited to serve as leaders in addressing SDOH.
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Affiliation(s)
- Krista Schroeder
- University of Pennsylvania School of Nursing, Philadelphia,
PA, USA
| | - Susan Kohl Malone
- Center for Sleep and Circadian Neurobiology, University of
Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Rory Meyers College of Nursing, New York University, New
York, NY, USA
| | - Ellen McCabe
- University of Pennsylvania School of Nursing, Philadelphia,
PA, USA
| | - Terri Lipman
- University of Pennsylvania School of Nursing, Philadelphia,
PA, USA
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Acciai F. The age pattern of social inequalities in health at older ages: are common measures of socio-economic status interchangeable? Public Health 2018. [PMID: 29524811 DOI: 10.1016/j.puhe.2018.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Social inequalities in health have been largely documented in social science research. Members of the most disadvantaged groups experience worse health and higher mortality from birth throughout adulthood. However, it is not clear whether this association persists at older ages. Some studies have found a narrowing of the social gradient in health, at least when 'traditional' measures of socio-economic status (SES)-income, education, and occupation-are used. The main goal of the article is to highlight similarities and discrepancies in the age trend of social inequalities in health that arise when multiple measures of SES are considered. STUDY DESIGN The present study uses a longitudinal sample of over 7000 individuals age 50+ from the Survey of Health, Ageing, and Retirement in Europe to examine the age trend of social inequalities in health. METHODS By using growth curve models, individual trajectories of self-rated health and physical functioning were analyzed. SES is measured through wealth, income, and education. RESULTS The findings show that for both health outcomes, the choice of the indicator of SES is very consequential, as the age trend of social inequalities in health is substantially different for different measures of SES. CONCLUSION Using multiple measures of SES is recommended, as using only one measure would give only a partial account of the age trend of social inequalities in health. In particular, wealth seems to better capture individual's socio-economic position, as it is able to detect health gradients even where education and income fail to do so.
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Affiliation(s)
- F Acciai
- School of Nutrition and Health Promotion, Arizona State University, 425 N. 5th Street, Phoenix, AZ 85004, United States.
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Rieger K, Vogel M, Engel C, Ceglarek U, Harms K, Wurst U, Lengfeld H, Richter M, Kiess W. Does physiological distribution of blood parameters in children depend on socioeconomic status? Results of a German cross-sectional study. BMJ Open 2018; 8:e019143. [PMID: 29500207 PMCID: PMC5855248 DOI: 10.1136/bmjopen-2017-019143] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 12/05/2017] [Accepted: 01/30/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In the present study, we examined the relation between socioeconomic status (SES) and the physiological distribution of iron-related blood parameters. DESIGN This is a cross-sectional analysis of longitudinal population-based cohort study. SETTING Based on a sample of healthy participants from a German research centre, various blood parameters and values of clinical examinations and questionnaires were collected. PARTICIPANTS A total of 1206 healthy volunteers aged 2.5 to 19 years, one child per family randomly selected, were included. PRIMARY AND SECONDARY OUTCOME MEASURES Associations between the SES of children by Winkler-Stolzenberg Index (WSI) and its dimensions (income, education, occupation) and iron-related blood parameters (haemoglobin, ferritin and transferrin) were analysed by linear regression analyses. Gender and pubertal stage were included as covariables. Additionally, associations between SES of children by WSI and physical activity (side-to-side jumps, push-ups) as well as body mass index (BMI) were analysed by linear regression analyses. RESULTS Children with high WSI or family income showed significantly increased z-scores for haemoglobin (P=0.046; P<0.001). Children with increased WSI or family income showed significantly lower z-scores for transferrin (P<0.001). There was a significant correlation between haemoglobin and gender (P<0.001) and between transferrin and pubertal stage (P=0.024). Furthermore, physical activity was positively correlated and BMI was negatively correlated with WSI (P<0.001). DISCUSSION Our data show an association between SES and the distribution of iron-dependent parameters. Lower SES is correlated with lower values for haemoglobin and higher values for transferrin. Furthermore, we demonstrate that physical activity and BMI are associated with SES. Whereas higher SES is correlated with higher values for physical activity and lower BMI. Our parameters are standardised as z-scores with the advantages that the results are comparable across different age groups and present physiological courses. TRIAL REGISTRATION NUMBER NCT02550236; Results.
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Affiliation(s)
- Kristin Rieger
- Clinic and Polyclinic for Pediatrics and Adolescent Medicine, Center for Pediatric Research, University Hospital Leipzig (Public-Law Institution), Leipzig, Germany
| | - Mandy Vogel
- LIFE-Leipzig Research Center for Diseases of Civilization, University of Leipzig, Leipzig, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Uta Ceglarek
- Institute for Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University Hospital Leipzig (Public-Law Institution), Leipzig, Germany
| | - Kristian Harms
- Institute for Laboratory Medicine, Clinical Chemistry, and Molecular Diagnostics, University Hospital Leipzig (Public-Law Institution), Leipzig, Germany
| | - Ulrike Wurst
- Clinic and Polyclinic for Pediatrics and Adolescent Medicine, Center for Pediatric Research, University Hospital Leipzig (Public-Law Institution), Leipzig, Germany
| | - Holger Lengfeld
- Institute for Sociology, University of Leipzig, Leipzig, Germany
| | - Matthias Richter
- Institute of Medical Sociology, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Wieland Kiess
- Clinic and Polyclinic for Pediatrics and Adolescent Medicine, Center for Pediatric Research, University Hospital Leipzig (Public-Law Institution), Leipzig, Germany
- LIFE-Leipzig Research Center for Diseases of Civilization, University of Leipzig, Leipzig, Germany
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Elo IT, Martikainen P, Aaltonen M. Children's educational attainment, occupation, and income and their parents' mortality. POPULATION STUDIES 2018; 72:53-73. [PMID: 28994347 PMCID: PMC6034683 DOI: 10.1080/00324728.2017.1367413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Using data from Finland, this paper contributes to a small but growing body of research regarding adult children's education, occupation, and income and their parents' mortality at ages 50+ in 1970-2007. Higher levels of children's education are associated with 30-36 per cent lower parental mortality at ages 50-75, controlling for parents' education, occupation, and income. This association is fully mediated by children's occupation and income, except for cancer mortality. Having at least one child educated in healthcare is associated with 11-16 per cent lower all-cause mortality at ages 50-75, an association that is largely driven by mortality from cardiovascular diseases. Children's higher white-collar occupation and higher income is associated with 39-46 per cent lower mortality in the fully adjusted models. At ages 75+, these associations are much smaller overall and children's schooling remains more strongly associated with mortality than children's occupation or income.
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Affiliation(s)
| | - Pekka Martikainen
- University of Helsinki
- Stockholms University and Karolinska Institute
- The Max Planck Institute for Demographic Research
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