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Qing Z, Wu C, Gao T. The impact of social participation on Subjective Wellbeing in the older adult: the mediating role of anxiety and the moderating role of education. Front Public Health 2024; 12:1362268. [PMID: 38818440 PMCID: PMC11137287 DOI: 10.3389/fpubh.2024.1362268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/29/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction The study aims to examine the mediating role of anxiety in the relationship between social participation and Subjective Wellbeing among Chinese older adults. Additionally, it investigates the moderating ed of education in this relationship. Methods The data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) published by peking University, with a sample size of 10,626 individuals aged 60 years and above. SPSS 21.0 was used for the statistical analysis of the data, and Mplus 8.0 was used for the statistical processing of the mediating and moderating effects analysis. Results (1) The social participation significantly and positively predicated Subjective Wellbeing; (2) Anxiety partially mediated the eect between social participation and Subjective Wellbeing. The mediating eect value was 0.103; (3) Education plays a moderating role in the impact of social participation on subjective Wellbeing. Discussion In summary, social participation can reduce the anxiety and enhance their Subjective Wellbeing. Meanwhile, the eet of social participation on Subjective Wellbeing was the greatest for the older adult with high education. The findings suggest that community-led activities can be initiated to improve social participation in the older adult. Furthermore, educational courses could be to support the healthy aging of older adults in China.
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Affiliation(s)
- Zaihua Qing
- Hunan University of Finance and Economics, Changsha, China
| | - Caihong Wu
- Hunan University of Finance and Economics, Changsha, China
| | - Tao Gao
- Guangdong Industry Polytechnic, Guangzhou, China
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2
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Fletcher J, Noghanibehambari H. The effects of education on mortality: Evidence using college expansions. HEALTH ECONOMICS 2024; 33:541-575. [PMID: 38093403 PMCID: PMC10900482 DOI: 10.1002/hec.4787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 02/03/2024]
Abstract
This paper explores the long-run health benefits of education for longevity. Using mortality data from the Social Security Administration (1988-2005) linked to geographic locations in the 1940-census data, we exploit changes in college availability across cohorts in local areas. Our treatment on the treated calculations suggest increases in longevity between 1.3 and 2.7 years. Some further analyses suggest the results are not driven by pre-tends, endogenous migration, and other time-varying local confounders. This paper adds to the literature on the health and social benefits of education.
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Affiliation(s)
- Jason Fletcher
- La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, Wisconsin, USA
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3
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Gorman E. Does Schooling Have Lasting Effects on Cognitive Function? Evidence From Compulsory Schooling Laws. Demography 2023; 60:1139-1161. [PMID: 37470819 DOI: 10.1215/00703370-10875853] [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] [Indexed: 07/21/2023]
Abstract
This study assesses whether an additional year of secondary schooling has lasting causal effects on cognitive function. I use data from Understanding Society, the largest longitudinal household study in the United Kingdom, and exploit quasi-experimental variation in schooling from the 1972 raising of the school-leaving age in England and Wales. This reform increased the minimum secondary school‒leaving age from 15 to 16 years. Cognitive function outcomes were measured when participants were aged 48 to 60. Using a fuzzy regression discontinuity design, I show that remaining in school until age 16 improved working memory by one third to one half of a standard deviation. I find limited evidence for causal effects on verbal fluency and measures of numeric ability. Analyses of potential mechanisms showed statistically significant effects of remaining in school until age 16 on the type of occupation entered immediately after leaving school and at older ages. These patterns are consistent with basic education improving cognitive outcomes through occupation choice. The findings are robust to sensitivity analyses.
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Affiliation(s)
- Emma Gorman
- School of Organisations, Economy and Society, University of Westminster, London, UK; IZA, Bonn, Germany
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4
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Amin V, Fletcher JM, Lu Q, Song J. Re-examining the relationship between education and adult mental health in the UK: A research note. ECONOMICS OF EDUCATION REVIEW 2023; 93:102354. [PMID: 37033902 PMCID: PMC10078235 DOI: 10.1016/j.econedurev.2023.102354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Previous studies using variation in education arising from compulsory schooling laws have found no causal effects of education on mental health in the UK. We re-examine the relationship between education and mental health in the UK by taking a different approach: sibling fixed-effects with controls for polygenic scores (summary measures of genetic predisposition) for educational attainment and adult depressive symptoms. We find that higher educational attainment is associated with better adult mental health, that sibling controls reduce these associations by ~40-70% but important associations remain and find evidence for non-monotonic effects. We also find suggestive evidence that education partially "rescues" genetic predictors of poor mental health.
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Affiliation(s)
- Vikesh Amin
- Central Michigan University
- Corresponding author. (V. Amin)
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5
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Zhang W, Zhang Y, Wang J. Effect and mechanism of reading habits on physical and mental health among the elderly: Evidence from China. Front Public Health 2022; 10:1031939. [PMID: 36299756 PMCID: PMC9589148 DOI: 10.3389/fpubh.2022.1031939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/20/2022] [Indexed: 01/29/2023] Open
Abstract
Responding to an aging society worldwide and ensuring the physical and mental health of the elderly are important problems that need to be addressed. Thus, this study aimed to improve the quality of providing the spiritual and cultural needs of the elderly and study the internal transmission of reading habits and its effect on the physical and mental health of the elderly. Using the data from China's comprehensive social survey in 2018, this study applied the Probit model and ordinary least squares method to comprehensively estimate the influence of reading habits of the elderly on their physical and mental health. Stepwise regression and bootstrap method were combined to explore the influencing mechanism, and an instrumental variable method was used to solve endogeneity problems. Results indicate that the reading habits of the elderly have a significantly positive effect on their own physical and mental health. Social activity is the positive conduction path, whereas social justice perception and learning willingness are the negative conduction path. Among low-income families, agricultural workers, and the elderly whose household registration is in rural areas, the benefits of reading to the body and mind are more significant. After dealing with endogeneity problems and a series of robustness tests, the conclusion of this paper still holds. Finally, reference policy suggestions are proposed for the follow-up active aging policy, such as promoting reading for all, organizing various social activities, formulating active pension policies for the elderly, and allocating more public resources for vulnerable elderly groups.
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Affiliation(s)
- Wang Zhang
- Business School, Yangzhou University, Yangzhou, China
- Research Center for Government Governance and Public Policy of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Yu Zhang
- Business School, Yangzhou University, Yangzhou, China
- Research Center for Government Governance and Public Policy of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Jie Wang
- Business School, Yangzhou University, Yangzhou, China
- Research Center for Government Governance and Public Policy of Yangzhou University, Yangzhou University, Yangzhou, China
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6
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Kondirolli F, Sunder N. Mental health effects of education. HEALTH ECONOMICS 2022; 31 Suppl 2:22-39. [PMID: 35797349 PMCID: PMC9796491 DOI: 10.1002/hec.4565] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
We analyze the role of education as a determinant of mental health. To do this, we leverage the age-specific exposure to an educational reform as an instrument for years of education and find that the treated cohorts gained more education. This increase in education had an effect on mental health more than 2 decades later. An extra year of education led to a lower likelihood of reporting any symptoms related to depression (11.3%) and anxiety (9.8%). More educated people also suffered less severe symptoms - depression (6.1%) and anxiety (5.6%). These protective effects are higher among women and rural residents. The effects of education on mental well-being that we document are potentially mediated through better physical health, improved health behavior and knowledge, and an increase in women's empowerment.
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Begerow T, Jürges H. Does compulsory schooling affect health? Evidence from ambulatory claims data. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:953-968. [PMID: 34779933 PMCID: PMC9304067 DOI: 10.1007/s10198-021-01404-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/28/2021] [Indexed: 05/20/2023]
Abstract
Using claims data on more than 23 million statutorily insured, we investigate the causal effect of schooling on health in the largest and most comprehensive analysis for Germany to date. In a regression discontinuity approach, we exploit changes in compulsory schooling in West Germany to estimate the reduced form effect of the reforms on health, measured by doctor diagnoses in ICD-10 format covering physical as well as mental health conditions. To mitigate the problem that empirical results depend on subjective decisions made by the researcher, we perform specification curve analyses to assess the robustness of findings across various model specifications. We find that the reforms have, at best, very small impacts on the examined doctor diagnoses. In most of the specifications we estimate insignificant effects that are close to zero and often of the "wrong" sign. Therefore, our study questions the presence of the large positive effects of education on health that are found in the previous literature.
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Affiliation(s)
- Tatjana Begerow
- Schumpeter School of Business and Economics, University of Wuppertal, Rainer-Gruenter-Str. 21 (FN), 42119 Wuppertal, Germany
| | - Hendrik Jürges
- Schumpeter School of Business and Economics, University of Wuppertal, Rainer-Gruenter-Str. 21 (FN), 42119 Wuppertal, Germany
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Wang TH, Lu J. Does Advanced Human Capital Structure Provide Positive Feedback on Public Health? Evidence From China. Front Public Health 2022; 10:829716. [PMID: 35356015 PMCID: PMC8959410 DOI: 10.3389/fpubh.2022.829716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
This paper explores the relationship of advanced human capital structure with public health applying the panel threshold regression model in China. The empirical results highlight that the advanced human capital structure has a non-linear single threshold effect on population health indicators. The health-promoting effect of advanced human capital structure is significantly weaker when exceeding the threshold. These asymmetric effects are strongly related to the response of China's health policies. The promotion effect of the advanced human capital structure on public health has significant heterogeneity in different regions. There is a single threshold value in the eastern and central regions, but the threshold value and facilitation effect are different. However, the western region has no threshold. The heterogeneity effects are caused by the different levels of advanced human capital structure. Governments should adopt appropriate public health policies according to the development characteristics of different regions.
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Lleras-Muney A. EDUCATION AND INCOME GRADIENTS IN LONGEVITY: THE ROLE OF POLICY. THE CANADIAN JOURNAL OF ECONOMICS. REVUE CANADIENNE D'ECONOMIQUE 2022; 55:5-37. [PMID: 37987018 PMCID: PMC10659761 DOI: 10.1111/caje.12582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Education and income are strong predictors of health and longevity. In the last 20 years many efforts have been made to understand if these relationships are causal and what the possible role of policy should be as a result. The evidence from various studies is ambiguous: the effects of education and income policies on health are heterogeneous and vary over time, and across places and populations. I discuss explanations for these disparate results and suggest directions for future research.
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Affiliation(s)
- Adriana Lleras-Muney
- NATIONAL BUREAU OF ECONOMIC RESEARCH, 1050 Massachusetts Avenue, Cambridge, MA 02138
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10
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Dai X, Li W. Impact of Education, Medical Services, and Living Conditions on Health: Evidence from China Health and Nutrition Survey. Healthcare (Basel) 2021; 9:healthcare9091122. [PMID: 34574896 PMCID: PMC8466347 DOI: 10.3390/healthcare9091122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 11/19/2022] Open
Abstract
Education, medical services, and living conditions can influence individual health and health literacy. We used the 2015 China Health and Nutrition Survey data to analyze the impact of education, medical services, and living conditions on individual health by extending the Grossman model. As a result, using the instrumental variable (read, write, and draw) two-stage least square method, we found that education, medical services, and living conditions have a positive impact on individual health, both physical health and psychological health. Among them, medical services have the largest influence, followed by living conditions and education. In addition, the results are robust. However, individual characteristics, family income, and working status also affect individual health. Moreover, we observed heterogeneity in age, sex, and residence in the impact of education, medical services, and living conditions on individual health. In particular, the health of the rural elderly and elderly women is more sensitive to education, the medical services of middle-aged women and young men have a greater impact on their health, and the living conditions of the rural elderly and youth have a greater impact on their health. All the findings are helpful for optimizing the path of the Healthy China program.
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Affiliation(s)
- Xianhua Dai
- School of Public Administration, Central China Normal University, Wuhan 430079, China;
- Center for Labor and Social Security Research, Central China Normal University, Wuhan 430079, China
- Correspondence: or
| | - Wenchao Li
- School of Public Administration, Central China Normal University, Wuhan 430079, China;
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11
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Dudovitz RN, Biely C, Barnert ES, Coker TR, Guerrero AD, Jackson N, Schickedanz A, Szilagyi PG, Iyer S, Chung PJ. Association between school racial/ethnic composition during adolescence and adult health. Soc Sci Med 2021; 272:113719. [PMID: 33545496 DOI: 10.1016/j.socscimed.2021.113719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/24/2020] [Accepted: 01/24/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES School racial/ethnic segregation in U.S. schoolsDifferences in school racial/ethnic composition may increase health disparities by concentrating educational opportunities that confer long-term health benefits in schools serving predominantly wwhite students. For racial minority students, high concentrations of white students may increase exposure to racismis also associated with psychologicstress, which may ultimately reduceing the long-term health benefits from educational opportunities. Meanwhile associations of racial/ethnic academic tacking within schools and health have been mixed. We sought to test whether: 1) differences in racial/ethnic composition between schools and, 2) racial/ethnic distribution of students in academic tracks within schools are associated with long-term health benefits or risks for white, Black and Latinx students. METHODS We analyzed the National Longitudinal Study of Adolescent to Adult Health (12,438 participants, collected 1994-2008), to test whether the school-level segregation (percent of non-Latinx white students at participants' school during adolescence) was associated with adult health outcomes at ages 18-26 & 24-32, controlling for contextual factorscomparing Black, Latinx, and white students, and controlling for contextualf factors. A secondary analysis explored whether racial/ethnic cohorting across levels of English courses was associated with each health outcome. RESULTS Attending a school with a higher percent of white students was associated with higher adult depression scores, substance abuse, and worse self-rated health for black Black students; lower depression scores, better self-rated health, and alcohol abuse for white students; and no health differences for Latinx students. Greater within school racial/ethnic cohorting across English courses was associated with increased odds of alcohol abuse for white students; decreased odds of alcohol abuse for Black and Latinx students; and decreased odds of drug abuse for Black students. CONCLUSION Among Bblack youth, attending a school with a higher percentage of white students is associated with worse behavioral health in adulthood. Understanding the potential impacts of school racial/ethnic composition on health is critical to designing policies that maximize access to opportunity and health.Education policies should comprehensively address school quality and racism to maximize adult health.
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Affiliation(s)
- R N Dudovitz
- UCLA Department of Pediatrics and Children's Development and Innovation Institute, United States.
| | - C Biely
- UCLA Department of Pediatrics and Children's Development and Innovation Institute, United States
| | - E S Barnert
- UCLA Department of Pediatrics and Children's Development and Innovation Institute, United States
| | - T R Coker
- University of Washington Center for Child Health Behavior and Development, United States
| | - A D Guerrero
- UCLA Department of Pediatrics and Children's Development and Innovation Institute, United States
| | - N Jackson
- UCLA Division of General Internal Medicine and Health Services Research, United States
| | - A Schickedanz
- UCLA Department of Pediatrics and Children's Development and Innovation Institute, United States
| | - P G Szilagyi
- UCLA Department of Pediatrics and Children's Development and Innovation Institute, United States
| | - S Iyer
- UCLA Department of Pediatrics and Children's Development and Innovation Institute, United States
| | - P J Chung
- Kaiser Permanente School of Medicine, Health System Science, United States
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12
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Hu Z, Wu Y, Yang H, Xie L, Zhang A, Lin X, Nie Y, Zhang X. Effects of Fertility Behaviors on Depression Among the Elderly: Empirical Evidence From China. Front Public Health 2021; 8:570832. [PMID: 33575236 PMCID: PMC7870999 DOI: 10.3389/fpubh.2020.570832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 12/30/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Increased population aging is associated with increased incidence of depression among the elderly. Existing studies have shown that ill-advised fertility behaviors during their youth also affect the health of the elderly. However, insufficient attention has been paid to depression among elderly in China. This paper focuses on how fertility behaviors affect senile depression among parents by examining the heterogeneity of such effects and tests the applicability of existing theoretical findings in a Chinese sample. Methods: The effects of fertility behaviors on depression among the elderly were investigated using the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative dataset. The effects of early-age fertility behaviors on the degree of depression among the elderly were investigated using ordinary least squares and ordered probit models that adjusted for demographic and socioeconomic factors. Results: (1) The age of first childbirth, childbearing period, and number of births were significantly and positively correlated with the degree of depression among the elderly (particularly rural persons aged 50–70 and older womens). (2) Elderly persons with sons had no better mental health status than those without sons, thus indicating the inapplicability of the traditional concept of “more sons are equal to more happiness” to the actual mental health situation of the elderly in China today. Conclusion: Overall, multiple, late, and boy-oriented childbearing and overly long childbearing periods had negative effects on mental health among Chinese elderly persons. This study tested the applicability of existing theoretical inferences and empirical conclusions in China, thereby further expanding the current literature regarding the effects of fertility behaviors on depression among the elderly.
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Affiliation(s)
- Zhen Hu
- School of Economics and Management, Northwest Agricultural and Forestry University, Xianyang, China
| | - Yuanyang Wu
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Hualei Yang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Lin Xie
- Institution of Population and Labor Economics, The Chinese Academy of Social Science, Beijing, China
| | - Anqi Zhang
- School of Public Economy and Management, Shanghai University of Finance and Economics, Shanghai, China
| | - Xueyu Lin
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Yafeng Nie
- School of Economics and Management, Northwest Agricultural and Forestry University, Xianyang, China
| | - Xiaoyu Zhang
- School of Economics and Management, Northwest Agricultural and Forestry University, Xianyang, China
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Intergenerational social mobility predicts midlife well-being: Prospective evidence from two large British cohorts. Soc Sci Med 2020; 261:113217. [PMID: 32745822 DOI: 10.1016/j.socscimed.2020.113217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/14/2020] [Accepted: 07/10/2020] [Indexed: 01/12/2023]
Abstract
RATIONALE It is often assumed that experiencing an upward shift in social position from one generation to the next will provide happiness, yet empirical evidence demonstrating such a connection is limited. OBJECTIVE We provide a large-scale test of the relationship between intergenerational mobility and midlife life satisfaction using data from two prospective UK studies (N = 20,948). METHOD Intergenerational mobility was modelled as a formative construct gauging the extent to which individuals moved up or down the social hierarchy compared to their parents, on a continuum ranging from high levels of downward mobility to high levels of upward mobility. RESULTS An intergenerational increase in social mobility, captured by greater educational attainment, social status, and home size than one's parents was positively associated with life satisfaction at age 42 in both cohorts. Mediation analyses revealed that almost half of this relationship was explained by better self-reported health and fewer perceived financial difficulties amongst the upwardly mobile. CONCLUSION This study provides evidence that enhanced satisfaction with life may be a key outcome of intergenerational increases in social status.
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14
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Maharlouei N, Cobb S, Bazargan M, Assari S. Subjective Health and Happiness in the United States: Gender Differences in the Effects of Socioeconomic Status Indicators. ACTA ACUST UNITED AC 2020; 4:8-17. [PMID: 32568256 DOI: 10.29245/2578-2959/2020/2.1196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background Education, employment, and marital status are among the main socioeconomic status (SES) indicators that are associated with subjective health and happiness. The effects of these SES indicators may, however, be different for various demographic groups. Aims To understand if SES indicators differently impact men and women, we tested gender differences in the effects of education, employment, and marital status on the subjective health and happiness of American adults. Methods This cross-sectional study used data of the General Social Survey (GSS), a series of nationally representative surveys between 1972 and 2018 in the US. Our analytical sample included 65,814 adults. The main independent variables were education attainment, marital status, and employment. Outcomes were self-rated health (SRH) and happiness measured using single items. Age and year of the study were covariates. Gender was the moderator. Results Overall, high education, being employed, and being married were associated with better SRH and happiness. We, however, found significant interactions between gender and educational attainment, marital status, and employment on the outcomes, which suggested that the effect of high education and marital status were stronger for women. In comparison, the effect of employment was stronger for men. Some inconsistencies in the results were observed for SRH compared to happiness. Conclusions In the United States, while education, employment, and marital status are critical social determinants of subjective health and happiness, these effects vary between women and men. Men's outcomes seem to be more strongly shaped by employment, while women's outcomes are more strongly shaped by education and marital status.
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Affiliation(s)
- Najmeh Maharlouei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | - Sharon Cobb
- School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA.,Department of Family Medicine, UCLA, Los Angeles, CA
| | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
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Xin Y, Ren X. Social Capital as a Mediator through the Effect of Education on Depression and Obesity among the Elderly in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113977. [PMID: 32512694 PMCID: PMC7312359 DOI: 10.3390/ijerph17113977] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 02/06/2023]
Abstract
Objectives: Global aging is an increasingly serious problem. The health problems faced by the elderly, such as depression and obesity, require serious consideration. Education, depression and obesity are inextricably linked; for the elderly, education is constant, and the factors which can mediate the relationship between education, depression and obesity are still being discussed by scholars. The mediating effect of social capital is rarely studied. The objective of this study was to assess the mediating role of cognitive social capital and structural social capital, as well as the effect of education on depression and obesity among the elderly using China Family Panel Studies (CFPS) data. Methods: In total, 4919 respondents were included in the final analysis. Education was measured by years of schooling. Trust and participation were used as measures of cognitive social capital and structural social capital. Depression symptoms and BMI were used as outcomes. Structural equation models were developed to examine the direct and indirect effect of social capital and education on health outcomes. Results: Education was negatively correlated with depression symptom (r = −0.15, p < 0.001), while education was positively correlated with BMI (r = 0.08, p < 0.001). Older adults with a higher education level have higher cognitive social capital (r = 0.11, p < 0.001) and structural social capital (r = 0.20, p < 0.001). Social capital plays a mediatory role. Older adults with higher social capital have a lower risk of depression (cognitive: r = −0.23, p < 0.001; structural: r = −0.03, p < 0.01) but a higher risk of obesity (cognitive: r = 0.06, p < 0.01; structural: r = 0.03, p < 0.01). For depression, the mediating function of cognitive social capital (a1b1= −0.025) is stronger than that of structural social capital (a2b2 = −0.006). While, for obesity, the effects of both cognitive and structural social capital are the same (a1c1 = a2c2 = 0.005). Conclusions: Social capital as a mediator through the effect of education on depression and obesity among the elderly in China. Meanwhile, using the positive effects of social capital to avoid negative effects should also be seriously considered.
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McLaughlin SJ, Kim S, Li LW, Zhang J. Educational differences in trajectories and determinants of healthy ageing in midlife and older Americans. Maturitas 2020; 134:21-28. [DOI: 10.1016/j.maturitas.2020.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 11/28/2019] [Accepted: 01/07/2020] [Indexed: 11/26/2022]
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17
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Albarrán P, Hidalgo-Hidalgo M, Iturbe-Ormaetxe I. Education and adult health: Is there a causal effect? Soc Sci Med 2020; 249:112830. [PMID: 32087484 DOI: 10.1016/j.socscimed.2020.112830] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/28/2020] [Accepted: 02/03/2020] [Indexed: 11/16/2022]
Abstract
Many studies find a strong positive correlation between education and adult health. A subtler question is whether this correlation can be interpreted as a causal relationship. We combine multi-country data from two cross-sections of the European Union Statistics on Income and Living Conditions (EU-SILC) survey and use exogenous variation in compulsory years of schooling across countries and cohorts induced by compulsory schooling laws. We find no causal effect of education on any of our several health measures. This finding is extremely robust to different changes in our main specification and holds using other databases. We discuss different explanations for our results.
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Affiliation(s)
- Pedro Albarrán
- Fundamentos del Análisis Económico (FAE), Universidad de Alicante, Spain
| | - Marisa Hidalgo-Hidalgo
- Dpto. Economía, Métodos Cuantitativos e Historia Económica, Universidad Pablo de Olavide de Sevilla, Spain.
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Torres JL, Castro CMSD, Lustosa LP. [Ongoing employment and chronic conditions among community-dwelling elderly people: evidence from Rede Fibra in Belo Horizonte]. CIENCIA & SAUDE COLETIVA 2019; 24:1845-1852. [PMID: 31166517 DOI: 10.1590/1413-81232018245.13302017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 08/03/2017] [Indexed: 11/22/2022] Open
Abstract
This cross-sectional study was based on a probabilistic sample of 597 community-dwelling elderly people living in Belo Horizonte. Theaim was to assess which chronic conditions are independently associated with ongoing employment among elderly people. It was conducted to assess the isolated effect of each one. The multivariate analysis was based on Poisson regression models with robust variance, adjusted by sex, age, schooling, retirement and chronic conditions. Arthritis (or rheumatism) was the only chronic condition with independent and statistic significant association with ongoing employment, even after adjustment for other chronic conditions: older people with medical diagnosis of arthritis have lower odds of being in the labor market (Fully adjusted Prevalence ratio [PR] = 0.54; CI 95%: 0.35-0.85). Moreover, our results showed that gender modifies this association, with a lower propensity among females (PR=0.45; CI 95%: 0.25-0.84). Our results highlight the importance of health promotion among workers, mostly arthritis prevention and management among women.
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Affiliation(s)
- Juliana Lustosa Torres
- Departamento de Medicina Preventiva, Universidade Federal do Rio de Janeiro. Av. Horácio Macedo S/N, Ilha do Fundão. 21941-598 Rio de Janeiro RJ
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Combalbert N, Pennequin V, Ferrand C, Keita M, Geffray B. Effect of age, time spent in prison and level of education on the perceived health and quality of life of elderly prisoners. Int J Prison Health 2019; 15:168-180. [PMID: 31172858 DOI: 10.1108/ijph-09-2018-0048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to assess the level of perceived health and quality of life of elderly prisoners in France, and to see whether there is a link between aging, time spent in prison and level of education and scores for perceived health and quality of life. DESIGN/METHODOLOGY/APPROACH The authors' recruited 138 male prisoners aged 50 and over in seven French prisons. The research protocol comprised a semi-structured interview and two scales. FINDINGS The results revealed low levels of perceived health and quality of life among the elderly inmates. They also showed that age was not statistically associated with most of the dimensions of perceived health on the Nottingham Health Profile (NHP), with the exception of poor mobility. By contrast, age was statistically associated with most of the dimensions of quality of life on the WHOQOL-Bref. Time spent in prison was only associated negatively with the "sleep" dimension of the NHP. Emotional reactions were perceived most positively by the inmates with the highest level of education. PRACTICAL IMPLICATIONS It seems particularly important to assess the perceived health and quality of life of elderly prisoners in order to ensure their appropriate treatment and management. ORIGINALITY/VALUE Very few studies have examined the perceived health and quality of life of prisoners, even though this population is particularly vulnerable in terms of physical and mental health.
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Affiliation(s)
- Nicolas Combalbert
- Universite Francois-Rabelais de Tours UFR Lettres et Langues , Tours, France
| | - Valérie Pennequin
- Universite Francois-Rabelais de Tours UFR Lettres et Langues , Tours, France
| | - Claude Ferrand
- Universite Francois-Rabelais de Tours UFR Lettres et Langues , Tours, France
| | - Moussa Keita
- Universite Francois-Rabelais de Tours UFR Lettres et Langues , Tours, France
| | - Brigitte Geffray
- Universite Francois-Rabelais de Tours UFR Lettres et Langues , Tours, France
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20
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Peterson L, Ralston M. Aging well in an aging world: The impact of material conditions, culture, and societal disruptions. Soc Sci Med 2019; 220:245-253. [DOI: 10.1016/j.socscimed.2018.11.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/28/2018] [Accepted: 11/13/2018] [Indexed: 11/28/2022]
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21
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Schmitz AL, Pförtner TK. Health inequalities in old age: the relative contribution of material, behavioral and psychosocial factors in a German sample. J Public Health (Oxf) 2018; 40:e235-e243. [PMID: 29294096 DOI: 10.1093/pubmed/fdx180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Indexed: 01/28/2023] Open
Abstract
Background Whereas the association between education and health in later life is well described, investigations about the underlying mechanisms of these health inequalities are scarce. This study examines the relative contribution of material, behavioral and psychosocial factors to health inequalities in older Germans. Methods Data were drawn from the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE). The analytic sample included 3246 participants aged 60-85 years. We examined the independent and indirect contribution of material, behavioral and psychosocial factors to the association between education and self-rated health based on logistic regression models. Results Material factors were most important as they were additionally working through behavioral and psychosocial factors whereas the independent contribution of behavioral and psychosocial factors was much lower than suggested in the separate analyses of the three explanatory pathways. Conclusions Policy interventions that focus on the improvement of material living conditions might reduce health inequalities in old age. In studies on the underlying mechanisms of health inequalities, material, behavioral and psychosocial factors should be modeled as inter-related predictors as the separate analysis does not reveal their actual contribution so that the relevance of single explanatory pathways might be overestimated.
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Affiliation(s)
- A L Schmitz
- The Institute for Social Research and Social Policy, Cologne, Germany
| | - T-K Pförtner
- Faculty of Human Sciences and Faculty of Medicine, The Institute of Medical Sociology Health Services Research, and Rehabilitation Science, University of Cologne, Cologne, Germany
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22
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Hamad R, Elser H, Tran DC, Rehkopf DH, Goodman SN. How and why studies disagree about the effects of education on health: A systematic review and meta-analysis of studies of compulsory schooling laws. Soc Sci Med 2018; 212:168-178. [PMID: 30036767 PMCID: PMC6209316 DOI: 10.1016/j.socscimed.2018.07.016] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 07/06/2018] [Accepted: 07/10/2018] [Indexed: 12/11/2022]
Abstract
Rich literatures across multiple disciplines document the association between increased educational attainment and improved health. While quasi-experimental studies have exploited variation in educational policies to more rigorously estimate the health effects of education, there remains disagreement about whether education and health are causally linked. The aim of this study was to conduct a systematic review and meta-analysis to characterize this literature, with a focus on quasi-experimental studies of compulsory schooling laws (CSLs). Articles from 1990 to 2015 were obtained through electronic searches and manual searches of reference lists. We searched for English-language studies and included manuscripts if: (1) they involved original data analysis; (2) outcomes were health-related; and (3) the primary predictor utilized variation in CSLs. We identified 89 articles in 25 countries examining over 25 health outcomes, with over 600 individual point estimates. We systematically characterized heterogeneity on key study design features and conducted a meta-analysis of studies with comparable health outcome and exposure variables. Within countries, studies differed in terms of birth cohorts included, the measurement of health outcomes within a given category, and the type of CSL variation examined. Over 90% of manuscripts included multiple analytic techniques, such as econometric and standard regression methods, with as many as 31 "primary" models in a single study. A qualitative synthesis of study findings indicated that educational attainment has an effect on the majority of health outcomes-most beneficial, some negative-while the meta-analysis demonstrated small beneficial effects for mortality, smoking, and obesity. Future work could focus on inconsistent findings identified by this study, or review the health effects of other types of educational policies.
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Affiliation(s)
- Rita Hamad
- University of California San Francisco, Philip R. Lee Institute for Health Policy Studies, Department of Family & Community Medicine, 995 Potrero Avenue, Building 80, Ward 83, San Francisco, CA, 94110, USA.
| | - Holly Elser
- University of California Berkeley, School of Public Health, Division of Epidemiology, Berkeley, CA, USA; Stanford University, School of Medicine, Stanford, CA, USA
| | - Duy C Tran
- Stanford University, School of Medicine, Stanford, CA, USA
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Kämpfen F, Maurer J. Does education help “old dogs” learn “new tricks”? The lasting impact of early-life education on technology use among older adults. RESEARCH POLICY 2018. [DOI: 10.1016/j.respol.2018.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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De Neve JW, Kawachi I. Spillovers between siblings and from offspring to parents are understudied: A review and future directions for research. Soc Sci Med 2017; 183:56-61. [PMID: 28478353 DOI: 10.1016/j.socscimed.2017.04.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/24/2017] [Accepted: 04/07/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND While a large literature has highlighted the protective effects of human capital on an individual's health and to some extent their offspring's health, little evidence is available on the positive spillover benefits of human capital for other family members. We conducted a scoping review of the evidence and identify future directions for research. METHODS We systematically searched the public health and economics literature on spillover effects from human capital, as indicated by educational attainment, to the health and/or survival of family members. We assessed (i) downward spillover effects (from parents and/or grandparents to offspring), (ii) horizontal spillover effects (from partners, spouses, and/or siblings), and (iii) upward spillover effects (from offspring to their parents and/or grandparents). We assessed the frequency of studies, their study designs, findings, and identified priority areas to inform future research on spillover effects of human capital. FINDINGS A total of 567 studies met our selection criteria. 286 studies assessed downward spillovers, 22 studies assessed horizontal spillovers, and five studies assessed upward spillovers. Studies on horizontal and upward spillovers found universally positive associations between additional education and better health in family members. The majority of studies used cross-sectional and longitudinal study designs as opposed to (quasi-)experimental designs. Further research is needed on horizontal and upward spillovers and research in low-resource settings, in addition to understanding what level of education matters the most, as well as mechanisms. CONCLUSIONS Although positive spillovers of human capital between siblings and from offspring to parents are likely, they have been understudied. Estimates of the returns to human capital that exclude these benefits may be too low.
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Affiliation(s)
- Jan-Walter De Neve
- Institute of Public Health, Heidelberg University, Im Neuenheimer Feld 130.3, Heidelberg 69120, Germany; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston MA 02115, United States.
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston MA 02115, United States.
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Age and Socioeconomic Gradients of Health of Indian Adults: An Assessment of Self-Reported and Biological Measures of Health. J Cross Cult Gerontol 2017; 31:193-211. [PMID: 26895999 DOI: 10.1007/s10823-016-9283-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This paper describes overall socioeconomic gradients and the age patterns of socioeconomic gradients of health of Indian adults for multiple health indicators encompassing the multiple aspects of health. Cross-sectional data on 11,230 Indians aged 18 years and older from the WHO-SAGE India Wave 1, 2007 were analyzed. Multivariate logit models were estimated to examine effects of socioeconomic status (education and household wealth) and age on four health domains: self-rated health, self-reported functioning, chronic diseases, and biological health measures. Results show that socioeconomic status (SES) was negatively associated with prevalence of each health measure but with considerable heterogeneity across age groups. Results for hypertension and COPD were inconclusive. SES effects are significant while adjusting for background characteristics and health risk factors. The age patterns of SES gradient of health depict divergence with age, however, no conclusive age pattern emerged for biological markers. Overall, results in this paper dispelled the conclusion of negative SES-health association found in some previous Indian studies and reinforced the hypothesis of positive association of SES with health for Indian adults. Higher prevalence of negative health outcomes and SES disparities of health outcomes among older age-groups highlight need for inclusive and focused health care interventions for older adults across socioeconomic spectrum.
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Dudovitz RN, Nelson BB, Coker TR, Biely C, Li N, Wu LC, Chung PJ. Long-term health implications of school quality. Soc Sci Med 2016; 158:1-7. [PMID: 27100212 DOI: 10.1016/j.socscimed.2016.04.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 04/05/2016] [Accepted: 04/10/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Individual academic achievement is a well-known predictor of adult health, and addressing education inequities may be critical to reducing health disparities. Disparities in school quality are well documented. However, we lack nationally representative studies evaluating the impact of school quality on adult health. We aim to determine whether high school quality predicts adult health outcomes after controlling for baseline health, socio-demographics and individual academic achievement. METHODS We analyzed data from 7037 adolescents who attended one of 77 high schools in the Unites States and were followed into adulthood from the National Longitudinal Study of Adolescent to Adult Health. Selected school-level quality measures-average daily attendance, school promotion rate, parental involvement, and teacher experience-were validated based on ability to predict high school graduation and college attendance. Individual adult health outcomes included self-rated health, diagnosis of depression, and having a measured BMI in the obese range. RESULTS Logistic regressions controlling for socio-demographics, baseline health, health insurance, and individual academic performance demonstrated that school quality significantly predicted all health outcomes. As hypothesized, attending a school with lower average daily attendance predicted lower self-rated health (Adjusted Odds Ratio (AOR) 1.59, p = 0.003) and higher odds of depression diagnosis (AOR 1.35, p = 0.03); and attending a school with higher parent involvement predicted lower odds of obesity (AOR 0.69, p = 0.001). However, attending a school with higher promotion rate also predicted lower self-rated health (AOR1.20, p < 0.001). CONCLUSIONS High school quality may be an important, but complex, social determinant of health. These findings highlight the potential inter-dependence of education and health policy.
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Affiliation(s)
- Rebecca N Dudovitz
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave. 12-358 CHS, Los Angeles, CA, 90095, USA, MC: 175217.
| | - Bergen B Nelson
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave. 12-358 CHS, Los Angeles, CA, 90095, USA, MC: 175217.
| | - Tumaini R Coker
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave. 12-358 CHS, Los Angeles, CA, 90095, USA, MC: 175217; RAND Health, RAND Corporation, 1776 Main St, Santa Monica, CA, 9040, USA.
| | - Christopher Biely
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave. 12-358 CHS, Los Angeles, CA, 90095, USA, MC: 175217.
| | - Ning Li
- Department of Biomathematics, University of California Los Angeles, BOX 951766, 5222 Life Sciences, Los Angeles, CA, 90095-1766, USA.
| | - Lynne C Wu
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave. 12-358 CHS, Los Angeles, CA, 90095, USA, MC: 175217.
| | - Paul J Chung
- Fielding School of Public Health and Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave. 12-358 CHS, Los Angeles, CA, 90095, USA, MC: 175217; RAND Health, RAND Corporation, 1776 Main St, Santa Monica, CA, 9040, USA.
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White CM, St John PD, Cheverie MR, Iraniparast M, Tyas SL. The role of income and occupation in the association of education with healthy aging: results from a population-based, prospective cohort study. BMC Public Health 2015; 15:1181. [PMID: 26607694 PMCID: PMC4660771 DOI: 10.1186/s12889-015-2504-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 11/17/2015] [Indexed: 11/26/2022] Open
Abstract
Background The beneficial effects of higher education on healthy aging are generally accepted, but the mechanisms are less well understood. Education may influence healthy aging through improved employment opportunities that enhance feelings of personal control and reduce hazardous exposures, or through higher incomes that enable individuals to access better health care or to reside in better neighbourhoods. Income and occupation have not been explored extensively as potential mediators of the effect of education on healthy aging. This study investigates the role of income and occupation in the association between education and healthy aging including potential effect modification by gender. Methods Logistic regression was used to explore the association of education, income (perceived income adequacy, life satisfaction with finances) and occupation (occupational prestige) with healthy aging five years later in 946 community-dwelling adults 65+ years from a population-based, prospective cohort study in Manitoba, Canada. Results Higher levels of education generally increased the likelihood of healthy aging. After adjusting for education, both income measures, but not occupation, predicted healthy aging among men; furthermore, the association between education and healthy aging was no longer significant. Income and occupation did not explain the significant association between education and healthy aging among women. Conclusions Perceived income adequacy and life satisfaction with finances explained the beneficial effects of higher education on healthy aging among men, but not women. Identifying predictors of healthy aging and the mechanisms through which these factors exert their effects can inform strategies to maximize the likelihood of healthy aging. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2504-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christine M White
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Philip D St John
- Department of Medicine and Centre on Aging, Section of Geriatric Medicine, University of Manitoba, 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada.
| | - Madelon R Cheverie
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Maryam Iraniparast
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Suzanne L Tyas
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
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Castro CMSD, Mambrini JVDM, Sampaio RF, Macinko J, Lima-Costa MF. Aspectos sociodemográficos e de saúde associados ao trabalho remunerado em adultos (50-69 anos) na Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil. CAD SAUDE PUBLICA 2015; 31:1775-87. [DOI: 10.1590/0102-311x00166214] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Foram examinados os fatores associados ao trabalho remunerado em uma amostra probabilística de 3.320 indivíduos (50-69 anos de idade), residentes na Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil. A prevalência do trabalho remunerado foi de 62,8% entre homens e 35,8% entre mulheres. Em ambos os gêneros, o trabalho remunerado apresentou associação positiva com o nível de escolaridade e negativa com a autoavaliação da saúde. A propensão de ter trabalho remunerado foi maior entre mulheres sem cônjuge e aquelas que conheciam alguém que havia sido discriminado no ambiente de trabalho. Entre os homens, a prevalência do trabalho remunerado caiu de 67,2%, entre aqueles com ≥ 8 anos de escolaridade e que avaliaram melhor a sua saúde, para 37,8% entre aqueles com escolaridade mais baixa e que avaliaram a sua saúde como ruim (RP = 0,56; IC95%: 0,37-0,87). Entre as mulheres, a prevalência correspondente caiu de 42,1% para 3,6% (RP = 0,09; IC95%: 0,03-0,26). A propensão de ter trabalho remunerado entre mulheres com baixa escolaridade e pior avaliação da saúde foi dez vezes menor do que entre seus equivalentes homens.
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Johnston DW, Lordan G, Shields MA, Suziedelyte A. Education and health knowledge: evidence from UK compulsory schooling reform. Soc Sci Med 2014; 127:92-100. [PMID: 25459203 DOI: 10.1016/j.socscimed.2014.10.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 10/08/2014] [Accepted: 10/14/2014] [Indexed: 11/29/2022]
Abstract
We investigate if there is a causal link between education and health knowledge using data from the 1984/85 and 1991/92 waves of the UK Health and Lifestyle Survey (HALS). Uniquely, the survey asks respondents what they think are the main causes of ten common health conditions, and we compare these answers to those given by medical professionals to form an index of health knowledge. For causal identification we use increases in the UK minimum school leaving age in 1947 (from 14 to 15) and 1972 (from 15 to 16) to provide exogenous variation in education. These reforms predominantly induced adolescents who would have left school to stay for one additionally mandated year. OLS estimates suggest that education significantly increases health knowledge, with a one-year increase in schooling increasing the health knowledge index by 15% of a standard deviation. In contrast, estimates from instrumental-variable models show that increased schooling due to the education reforms did not significantly affect health knowledge. This main result is robust to numerous specification tests and alternative formulations of the health knowledge index. Further research is required to determine whether there is also no causal link between higher levels of education - such as post-school qualifications - and health knowledge.
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Affiliation(s)
- David W Johnston
- Centre for Health Economics, Monash Business School, Monash University, Australia
| | | | - Michael A Shields
- Centre for Health Economics, Monash Business School, Monash University, Australia
| | - Agne Suziedelyte
- Centre for Health Economics, Monash Business School, Monash University, Australia
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