The role of defamilialization in the relationship between partnership and self-rated health: a cross-national comparison of Canada and the United States

Is parenthood associated with self-rated health among women in Brazil?

BACKGROUND

Previous studies conducted in Europe and North America addressing the relationship between self-rated health and parenthood offer inconsistent results, with effects ranging from nonsignificant to significant and in opposite directions. The aim of the present study was to explore the relationship between parenthood and self-rated health (SRH) among women in Brazil (a country with strong inequalities) considering the time interval from the last delivery in the analyses, as proposed in previous studies set in Sweden.

METHODS

The study used data from cross-sectional National Health Surveys in Brazil conducted from 2013 to 2014 and 2019 to 2020 with selected groups of 20,046 and 25,100 women for whom complete data were available on the variables of interest. The primary outcome was self-rated health measured on a five-point scale. Partial proportional odds models were employed.

RESULTS

Compared to women that were not a parent, primiparous women whose delivery was within less than one year had a lower likelihood of worse SRH (OR (95% CI): 0.58-0.84 in 2013, and 0.64-0.94 in 2019), whereas multiparous women whose last delivery was more than one year earlier had greater likelihood of worse SRH (OR (95% CI): 1.08-1.27 in 2013, and 1.21-1.39 in 2019).

CONCLUSIONS

An association was found between parenthood and SRH among Brazilian women. Considering the epidemiological relevance of SRH, different aspects of parenthood concerning parity and time since the last delivery should be considered in further analyses.

Plasma amyloid beta 40/42, phosphorylated tau 181, and neurofilament light are associated with cognitive impairment and neuropathological changes among World Trade Center responders: A prospective cohort study of exposures and cognitive aging at midlife

Introduction

World Trade Center (WTC) responders are experiencing a high risk of mild cognitive impairment (MCI) and dementia, though the etiology remains inadequately characterized. This study investigated whether WTC exposures and chronic post-traumatic stress disorder (PTSD) were correlated with plasma biomarkers characteristic of Alzheimer's disease (AD) neuropathology.

Methods

Eligible participants included WTC-exposed individuals with a baseline cognitive assessment and available plasma sample. We examined levels of the amyloid beta (Aβ)40/42 ratio, phosphorylated tau 181 (p-tau181), and neurofilament light chain (NfL) and associations with a WTC exposures (duration on site ≥15 weeks, dust cloud), the PTSD Symptom Checklist for Diagnostic and Statistical Manual of Mental Disorders, 4th edition PTSD, and classification of amyloid/tau/neurodegeneration (AT[N]) profiles. Multinomial logistic regressions assessed whether biomarkers predicted increased risk of MCI or dementia.

Results

Of 1179 eligible responders, 93.0% were male, mean (standard deviation) age 56.6 years (7.8). Aβ40/42, p-tau181, and NfL intercorrelated and increased with age. In subgroup analyses of responders with available neuroimaging data (n = 75), Aβ40/42 and p-tau181 were further associated with decreased hippocampal volume (Spearman's ρ = -0.3). Overall, 58.08% of responders with dementia had ≥1 elevated biomarker, and 3.45% had elevations across all biomarkers. In total, 248 (21.05%) had MCI and 70 (5.94%) had dementia. Increased risk of dementia was associated with plasma AT(N) profile T+ or A+N+. Exposure on site ≥15 weeks was independently associated with T+ (adjusted risk ratio [aRR] = 1.03 [1.01-1.05], P = 0.009), and T+N+ profile (aRR = 2.34 [1.12-4.87]). The presence of PTSD was independently associated with risk of A+ (aRR = 1.77 [1.11-2.82]).

Discussion

WTC exposures and chronic PTSD are associated with plasma biomarkers consistent with neurodegenerative disease.

Mental retirement and health selection: Analyses from the U.S. Health and Retirement Study

BACKGROUND

Research has recently suggested that retirement may decrease cognitive engagement, resulting in cognitive aging. Few studies have systematically documented whether or how selectivity into retirement shapes the relationship between retirement and cognitive aging.

METHODS

We draw on data from the Health and Retirement Study (1998-2012) to examine the relationship between cognition and retirement for 18,575 labor force participants. Longitudinal regression discontinuity modeling was used to examine performance and decline in episodic memory. Models differentiated three forms of selection bias: indirect and direct selection as well as reverse causation. To further interrogate the disuse hypothesis, we adjust for confounding from health and socioeconomic sources.

RESULTS

Results revealed that individuals who retired over the course of the panel were substantially different in terms of health, wealth and cognition when compared to those who remained employed. However, accounting for observed selection biases, significant associations were found linking longer retirement with more rapid cognitive decline.

DISCUSSION

This study examined respondents who were in the labor force at baseline and transitioned into retirement. Analyses suggested that those who retired over the course of the panel had worse overall functioning, but also experienced more rapid declines after retirement that increased the rate of aging by two-fold, resulting in yearly losses of 3.7% (95% CI = [3.5, 4.0]) of one standard deviation in functioning attributable to retirement. Results are supportive of the view that retirement is associated with more rapid cognitive aging.

Association of partner, parental, and employment statuses with self-rated health among German women and men

The association of partner, parental, and employment statuses with health is usually discussed in terms of either the multiple role burden hypothesis or the multiple role attachment hypothesis. The first hypothesis states that combining work and family roles increases the burden of responsibility, which in turn increases the pressure and stress associated with competing roles, leading to poorer health. The multiple role attachment hypothesis argues that multiple responsibilities provide attachment to broader networks, which then provide social support and resources that enhance health. We analyzed pooled data from the German Health Update carried out by the Robert Koch Institute in 2009, 2010, and 2012. The data were collected by computer-assisted telephone interviews. The sample comprised 28,086 people aged 30-54 years. The data were assessed with logistic regression analysis and interaction models. The gender-differentiated analysis of partnership, parenthood, and employment, after adjusting for social and demographic characteristics, revealed small interaction effects among all three social roles with self-rated health in women and men. Non-employment showed the strongest relationship with poor self-rated health. It was significantly associated with lower self-rated health in both men and women in most of the family arrangements. These associations were higher in men than in women. Furthermore, in all family arrangements, female part-time employees were as healthy as female fulltime employees. A more subtle association was found in men: the odds of reporting poorer self-rated health were greater among non-parents employed part time than among those employed full time, but lower than among those who were non-employed. Among fathers, part-time employees did not have statistically better health than full-time employees.The findings support somewhat the multiple role attachment hypothesis, rather than the multiple role burden hypothesis. Because employment has great importance for both women's and men's health, the compatibility of work and family roles should be improved.

Educational Inequalities in Health Behaviors at Midlife: Is There a Role for Early-life Cognition?

Education is a fundamental cause of social inequalities in health because it influences the distribution of resources, including money, knowledge, power, prestige, and beneficial social connections, that can be used in situ to influence health. Recent studies have highlighted early-life cognition as commonly indicating the propensity for educational attainment and determining health and age of mortality. Health behaviors provide a plausible mechanism linking both education and cognition to later-life health and mortality. We examine the role of education and cognition in predicting smoking, heavy drinking, and physical inactivity at midlife using data from the Wisconsin Longitudinal Study (N = 10,317), National Survey of Health and Development (N = 5,362), and National Childhood Development Study (N = 16,782). Adolescent cognition was associated with education but was inconsistently associated with health behaviors. Education, however, was robustly associated with improved health behaviors after adjusting for cognition. Analyses highlight structural inequalities over individual capabilities when studying health behaviors.

The role of partnership status on late-life physical function

This study examined the socioeconomic pathways linking partnership status to physical functioning, assessed using objective measures of late life physical functioning, including peak flow and grip strength. Using Wave 4 of the Survey of Health, Ageing and Retirement in Europe (SHARE), we ran multilevel models to examine the relationship between partnership status and physical function in late life, adjusting for social-network characteristics, socioeconomic factors, and health behaviours. We found a robust relationship between partnership status and physical function. Incorporating social-network characteristics, socioeconomic factors, and health behaviours showed independent robust relationships with physical function. Co-variates attenuated the impact of cohabitation, separation, and widowhood on physical function; robust effects were found for singlehood and divorce. Sex-segregated analyses suggest that associations between cohabitation, singlehood, divorce, and widowhood were larger for men than for women. Results suggest that social ties are important to improved physical function.