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Sloth MMB, Neble Larsen E, Mathisen J, Nilsson CJ, Osler M, Jørgensen TSH. Adult offspring's education and parental mortality: A nationwide cohort study of the mediating role of lifestyle-related diseases. Scand J Public Health 2024:14034948241234711. [PMID: 38523257 DOI: 10.1177/14034948241234711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Aim: The mechanisms behind the association between adult offspring's socioeconomic position and their parents' mortality are not well understood. This study investigates lifestyle-related diseases as a potential mediating pathway between adult offspring's education and parental mortality. Methods: This nationwide register-based cohort study consists of 963,742 older adults aged 65 years between 2000 and 2018. Lifestyle-related diseases were measured between 60 and 65 years and those with prior lifestyle-related diseases were excluded. Natural Effect Models were performed to assess potential mediation through lifestyle-related diseases of the association between offspring's education and parental mortality measured by additive hazard estimates with 95% confidence intervals (CIs). Results: Between 60 and 65 years, 150,501 (15.6%) older adults were diagnosed with lifestyle-related diseases and 149,647 (15.5%) died during follow-up. Compared with having offspring with long education, short education was associated with 631 (95% CI: 555; 707) and 581 (95% CI: 525; 638) additional deaths per 100,000 person-years for women and men, respectively, of which 15.4% (95% CI: 9.0; 21.6) and 16.8% (95% CI: 14.6; 18.9) were mediated by lifestyle-related diseases. The corresponding numbers for medium education were 276 (95% CI: 205; 347) and 299 (95% CI: 255; 343) with 26.2% (95% CI: 12.0; 40.6) and 27.6% (95% CI: 25.1; 31.8) mediated by lifestyle-related diseases. Conclusions: Lifestyle-related diseases accounted for 15-28% of the association between offspring's education and parental mortality for both men and women.
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Affiliation(s)
- Mathilde M B Sloth
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Emma Neble Larsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jimmi Mathisen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
| | - Charlotte J Nilsson
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
| | - Terese S H Jørgensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Liu Y, Liu K, Zhang X, Guo Q. Does digital infrastructure improve public Health? A quasi-natural experiment based on China's Broadband policy. Soc Sci Med 2024; 344:116624. [PMID: 38290184 DOI: 10.1016/j.socscimed.2024.116624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/28/2023] [Accepted: 01/19/2024] [Indexed: 02/01/2024]
Abstract
This study proposed a scheme for improving people's health from the perspective of digital infrastructure construction. We used the China Family Panel Studies conducted between 2010 and 2020 and the digital infrastructure construction marked by the Broadband China policy between 2014 and 2016 as a quasi-natural experiment. We adopted the multi-time difference-in-differences method to identify the causal relationship between digital infrastructure and people's health. We found that digital infrastructure construction significantly improved people's health, and the effect was more prominent among young and middle-aged residents and those with less than a university education. Moreover, digital infrastructure construction improved the utilization of medical services, helped residents develop healthy lifestyles, and increased people's health investments. Additionally, digital infrastructure reduced health inequality among people and promoted health equity. The findings could guide future policies to improve people's health and well-being.
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Affiliation(s)
- Yiwei Liu
- School of Government, Central University of Finance and Economics, 39 South College Road, Haidian District, Beijing 100081, China
| | - Keshan Liu
- School of Government, Central University of Finance and Economics, 39 South College Road, Haidian District, Beijing 100081, China
| | - XiangLin Zhang
- School of Government, Central University of Finance and Economics, 39 South College Road, Haidian District, Beijing 100081, China
| | - Qiuyue Guo
- School of Government, Central University of Finance and Economics, 39 South College Road, Haidian District, Beijing 100081, China.
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Larsen EN, Brünnich Sloth MM, Nielsen J, Osler M, Jørgensen TSH. The Association of Children and Their Educational Attainment With Diabetes-related Complications and Mortality Among Older Adults With Type 2 Diabetes: A Nationwide Cohort Study. Can J Diabetes 2023; 47:649-657.e6. [PMID: 37460085 DOI: 10.1016/j.jcjd.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Socioeconomic resources and family support have been shown to improve adherence to treatment in people with type 2 diabetes (T2D) and are associated with a lower risk of diabetes-related complications and death. We investigated the associations of having children and their educational level with diabetes-related complications and death among older adults with T2D. METHODS We included 74,588 adults who were at least 65 years of age at the time of T2D diagnosis over the period from 2000 to 2018 in Denmark and grouped them based on having children (yes [reference]/no), and their children's highest educational level (low/medium/high [reference]). Multistate models were performed with 3 states: T2D diagnosis, diabetes-related complications, and death. All models were stratified by other chronic diseases at baseline (yes/no). RESULTS During follow-up (mean, 5.5 years), 14.6% of the adults developed a complication and 24.8% died with or without complications. Not having children was associated with a higher hazard of death without complications among adults without (hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.17 to 1.33) and with (HR, 1.10; 95% CI, 1.02 to 1.18) other chronic diseases and after complications among adults without other chronic diseases (HR, 1.25; 95% CI, 1.12 to 1.38). Having children with a lower educational level was associated with a higher hazard of complications (HRlow, 1.14; 95% CI, 1.05 to 1.24; HRmedium, 1.11; 95% CI, 1.05 to 1.17), death without complications (HRlow, 1.26; 95% CI, 1.17 to 1.36; HRmedium, 1.07; 95% CI, 1.02 to 1.14), and after complications (HRlow, 1.22; 95% CI, 1.07 to 1.39) among adults without other chronic diseases. CONCLUSIONS Among adults without other chronic diseases, having no children or having children with lower educational levels was associated with a higher hazard of death. Among these adults, having children with lower educational levels was also associated with a higher hazard of diabetes-related complications.
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Affiliation(s)
- Emma Neble Larsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Mathilde Marie Brünnich Sloth
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jannie Nielsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Terese Sara Høj Jørgensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
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Larsen EN, Sloth MMB, Nielsen J, Andersen SP, Osler M, Jørgensen TSH. The interplay between the impact of household's and children's education on the risk of type 2 diabetes and death among older adults: a Danish register-based cohort study. Public Health 2023; 224:178-184. [PMID: 37804713 DOI: 10.1016/j.puhe.2023.08.033] [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: 02/15/2023] [Revised: 08/16/2023] [Accepted: 08/27/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVES This study aims to assess the association of household's and children's education on the risk of type 2 diabetes (T2D) and subsequent death. STUDY DESIGN Danish register-based cohort study. METHODS In total, 1,021,557 adults were included at their 65th birthday between 2000 and 2018. A multistate survival model was performed to estimate the association of household's and children's education on the transition between the three states: 1) 65th birthday; 2) diagnosis of T2D; and 3) all-cause death. RESULTS The incidence rates per 1000 person-years were 9.1 for T2D, 18.4 for death without T2D, and 45.0 for death with T2D. Compared to long household's education and children's education, long household's education combined with either short-medium children's education or no children were associated with a 1.49- (95% confidence interval [CI]: 1.44; 1.54] and 1.69-times (95% CI: 1.61;1.78) higher hazard of T2D, respectively. Short-medium household's education combined with either long children's education or no children were associated with 0.64- (95% CI: 0.62; 0.66) and 0.77-times (95% CI: 0.74; 0.79) lower hazard of T2D, respectively. Compared to long household's education and children's education, any other combination of household's and children's education was associated with higher hazards of death both without and with T2D. CONCLUSION Older adults living in households with long education with no children or children with short-medium education had higher hazards of T2D. Households with short-medium education and no children or children with long education were associated with lower hazards of T2D. Both household's and children's education were associated with higher hazard of death without and with T2D.
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Affiliation(s)
- E N Larsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - M M B Sloth
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - J Nielsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - S P Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - M Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, Copenhagen 1353, Denmark
| | - T S H Jørgensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
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Lei L, Yu D, Zhou Y. Better educated children, better Internet-connected elderly parents. RESEARCH POLICY 2023. [DOI: 10.1016/j.respol.2023.104743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Zhang Y, Pang Z, Lv Y, Tang H. Impact of "expanding powers and strengthening counties" reform on basic public education services: Empirical evidence from Sichuan, China. Heliyon 2023; 9:e12880. [PMID: 36685381 PMCID: PMC9853364 DOI: 10.1016/j.heliyon.2023.e12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
The quality of a country's education system is both an indicator of its present level of development and a predictor of future economic advancement. This study intended to explore the impact of the "expanding power and strengthening counties" reform on the supply of basic public education resources. A combination of qualitative and quantitative methods was used to analyze the panel data of 114 counties in Sichuan Province from 2005 to 2017, including 78 counties with expanded powers. The study found that the "expanded power strong counties (EPSC)" had a significant positive impact on the supply level of funding resources measured by per capita public education expenditure. The time effect of the EPSC on the supply of teacher resources for county public education was manifested as a sharp increase in the supply level in the three years before the reform. The supply level tended to be stable after four years of reform. The economic resources supply level was relatively stable in the first three years and rose sharply after four years. There was a downward trend after the reform for 8 years. The structural effect has shown a more significant incentive effect on the supply of public education resources to strong and weak counties. But compared with the weak counties with lower economic development levels, the strong counties with higher economic development levels have a more noticeable effect of their decentralization reform on improving the supply level of public education resources.
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Affiliation(s)
- Yan Zhang
- Research Center of the Integration of Urban and Rural Education Development, Chengdu University, Chengdu 610106, China
| | - Zhenjing Pang
- School of Public Policy and Management, Tsinghua University, Beijing 100084, China,Corresponding author.
| | - Yang Lv
- College of Teachers, Chengdu University, Chengdu 610106, China
| | - Haikang Tang
- College of Teachers, Chengdu University, Chengdu 610106, China
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Xu Y, Luo Y. The Effect of Adult Children's Education Attainment on Their Parents' Cognitive Health: An Intergenerational Support Perspective. Front Public Health 2022; 10:744333. [PMID: 35223718 PMCID: PMC8864153 DOI: 10.3389/fpubh.2022.744333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/13/2022] [Indexed: 12/14/2022] Open
Abstract
The purpose of this study is to examine the relationship between adult children's education attainment and their parents' cognitive health, and to further explore the mechanism of intergenerational support. Based on empirical analysis of data from China Health and Retirement Longitudinal Survey, our study finds a positive association between children's educational attainment and parents' cognitive health. This correlation is provided for by emotional communication of informal caregiving, financial support, and healthy behaviors shaped in the parents by adult children. The strength of the effect varied by the adult child's gender. While sons' education attainment significantly improves parental cognitive parameters through informal caregiving, financial support, and development of healthy behaviors, the effect of daughters' education derives from financial support and healthy behaviors, not being related to informal caregiving. The study enriches the evidence on the mobility of children's human capital toward their parents and provides practical insights for advancing children's participation in family caregiving.
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Affiliation(s)
| | - Yaping Luo
- School of Public Policy and Management, Guangxi University, Nanning, China
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