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Noghanibehambari H, Noghani F. Long-run intergenerational health benefits of women empowerment: Evidence from suffrage movements in the US. HEALTH ECONOMICS 2023; 32:2583-2631. [PMID: 37482956 PMCID: PMC10592160 DOI: 10.1002/hec.4744] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/22/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023]
Abstract
An ongoing body of research documents that women empowerment is associated with improved outcomes for children. However, little is known about the long-run effects on health outcomes. This paper adds to this literature and studies the association between maternal exposure to suffrage reforms and children's old-age longevity. We utilize changes in suffrage laws across US states and over time as a source of incentivizing maternal investment in children's health and education. Using the universe of death records in the US over the years 1979-2020 and implementing a difference-in-difference econometric framework, we find that cohorts exposed to suffrage throughout their childhood live 0.6 years longer than unexposed cohorts. Furthermore, we show that these effects are not driven by preexisting trends in longevity, endogenous migration, selective fertility, and changes in the demographic composition of the sample. Additional analysis reveals that improvements in education and income are candidate mechanisms. Moreover, we find substantial improvements in early-adulthood socioeconomic standing, height, and height-for-age outcomes due to childhood exposure to suffrage movements. A series of state-level analyses suggest reductions in infant and child mortality following suffrage law change. We also find evidence that counties in states that passed the law experienced new openings of County Health Departments and increases in physicians per capita.
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Affiliation(s)
- Hamid Noghanibehambari
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Farzaneh Noghani
- Department of Management, College of Business, University of Houston-Clear Lake, Houston, Texas, USA
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2
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Longstanding health risk across the life course: The influence of early-life experience on health status throughout the life span. J Biosoc Sci 2022:1-27. [PMID: 36120813 DOI: 10.1017/s002193202200027x] [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: 11/07/2022]
Abstract
This study tracked the longstanding effect of childhood adversities on health status over the course of a life. This study used the data from China Health and Retirement Longitudinal Study which was a nationally representative survey and documented the generation who had arrived in the middle- and old-age phase and experienced the difficult time in the early founding of PR China in their childhood. Results shown the significant associations between multiple forms of children adversities (economic distress, child neglect, child abuse, lack of friends, parental mental health problems) and health status in adolescence (from 0.068 to 0.102, p<0.01), and health status in mid and late adulthood, including self-rated general health problems (from 0.039 to 0.061, p<0.01), chronic conditions (from 0.014 to 0.120, p<0.01 except for lack of friends), body aches (from 0.016 to 0.062, p<0.01 except for child neglect), and depression (from 0.047 to 0.112, p<0.01). Meanwhile, results also shown an underlying pathway (i.e., health status in adolescence) linking childhood adversities and health status in mid and late adulthood. Results suggested that the experience of multiple forms of adversities in childhood represented a substantial source of health risk throughout life.
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Lietzén R, Suominen S, Sillanmäki L, Virtanen P, Virtanen M, Vahtera J. Multiple adverse childhood experiences and asthma onset in adulthood: Role of adulthood risk factors as mediators. J Psychosom Res 2021; 143:110388. [PMID: 33639528 DOI: 10.1016/j.jpsychores.2021.110388] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This population-based study of 21,902 Finnish adults examined whether adulthood risk factors for asthma mediate the association between the exposure to multiple adverse childhood experiences (ACEs) assessed retrospectively and the risk of new-onset asthma in adulthood. METHODS Baseline characteristics, occurrence of ACEs, and risk factors of asthma in adulthood were collected with a postal survey at baseline in 1998. The participants were linked to records on incident asthma from national health registers from 1999 to 2012. Counterfactual mediation analysis was used to examine the effects of multiple ACEs (≥2) on asthma through adulthood risk factors of asthma (mediators). RESULTS Of the 21,902 participants without asthma at baseline, 7552 (34%) were exposed to multiple ACEs during childhood. During the follow-up period, 2046 participants were diagnosed with incident asthma. Exposure to multiple ACEs increased the risk of asthma onset by 31% compared with ≤1 ACE. The association between ACEs and asthma onset was partly mediated by the following adulthood risk factors: severe life events (29%), smoking (15%), allergic rhinitis (8%), low education level (6%), and obesity (3%). Specific stressful life events mediating the ACE-asthma association were 'severe financial difficulties' (24%), 'emotional, physical or sexual violence' (15%), 'major increase in marital problems' (8%), 'severe conflicts with supervisor' (7%), and 'divorce or separation' (5%). CONCLUSIONS Exposure to multiple ACEs increased the risk of asthma in adulthood. Adulthood risk factors of asthma mediated a significant proportion of the effect of ACEs on the risk of asthma onset.
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Affiliation(s)
- Raija Lietzén
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
| | - Sakari Suominen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland; University of Skövde, School of Health Sciences, Department of Public Health, Sweden.
| | - Lauri Sillanmäki
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland; Department of Public Health, University of Helsinki, Finland.
| | - Pekka Virtanen
- Faculty of Social Sciences, Tampere University, Tampere, Finland.
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
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Rocha V, Fraga S, Moreira C, Carmeli C, Lenoir A, Steptoe A, Giles G, Goldberg M, Zins M, Kivimäki M, Vineis P, Vollenweider P, Barros H, Stringhini S. Life-course socioeconomic disadvantage and lung function: a multicohort study of 70 496 individuals. Eur Respir J 2021; 57:2001600. [PMID: 33214206 DOI: 10.1183/13993003.01600-2020] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/10/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Lung function is an important predictor of health and a marker of physical functioning at older ages. This study aimed to quantify the years of lung function lost according to disadvantaged socioeconomic conditions across the life-course. METHODS This multicohort study used harmonised individual-level data from six European cohorts with information on life-course socioeconomic disadvantage and lung function assessed by forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). 70 496 participants (51% female) aged 18-93 years were included. Socioeconomic disadvantage was measured in early life (low paternal occupational position), early adulthood (low educational level) and adulthood (low occupational position). Risk factors for poor lung function (e.g. smoking, obesity, sedentary behaviour, cardiovascular and respiratory diseases) were included as potential mediators. The years of lung function lost due to socioeconomic disadvantage were computed at each life stage. RESULTS Socioeconomic disadvantage during the life-course was associated with a lower FEV1. By the age of 45 years, individuals experiencing disadvantaged socioeconomic conditions had lost 4-5 years of healthy lung function versus their more advantaged counterparts (low educational level -4.36 (95% CI -7.33--2.37) for males and -5.14 (-10.32--2.71) for females; low occupational position -5.62 (-7.98--4.90) for males and -4.32 (-13.31--2.27) for females), after accounting for the risk factors for lung function. By the ages of 65 years and 85 years, the years of lung function lost due to socioeconomic disadvantage decreased by 2-4 years, depending on the socioeconomic indicator. Sensitivity analysis using FVC yielded similar results to those using FEV1. CONCLUSION Life-course socioeconomic disadvantage is associated with lower lung function and predicts a significant number of years of lung function loss in adulthood and at older ages.
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Affiliation(s)
- Vânia Rocha
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- These authors contributed equally
| | - Sílvia Fraga
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- These authors contributed equally
| | - Carla Moreira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Centre of Mathematics, University of Minho, Braga, Portugal
| | - Cristian Carmeli
- Population Health Laboratory, Dept of Community Health, University of Fribourg, Fribourg, Switzerland
| | - Alexandra Lenoir
- Dept of Medicine, Respiratory Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Andrew Steptoe
- Dept of Behavioural Science and Health, University College London, London, UK
| | - Graham Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
| | - Marcel Goldberg
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
- Paris Descartes University, Paris, France
| | - Marie Zins
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
- Paris Descartes University, Paris, France
| | - Mika Kivimäki
- Dept of Epidemiology and Public Health, University College London, London, UK
| | - Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Dept of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Peter Vollenweider
- Dept of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Henrique Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Silvia Stringhini
- Center for Primary Care and Public Health (UNISANTE), University of Lausanne, Lausanne, Switzerland
- Unit of Population Epidemiology, Dept of Primary Care, Geneva University Hospitals, Geneva, Switzerland
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Sironi M, Ploubidis GB, Grundy EM. Fertility History and Biomarkers Using Prospective Data: Evidence From the 1958 National Child Development Study. Demography 2020; 57:529-558. [PMID: 32133595 PMCID: PMC7162827 DOI: 10.1007/s13524-020-00855-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Research on the later-life health implications of fertility history has predominantly considered associations with mortality or self-reported indicators of health. Most of this previous research has either not been able to account for selection factors related to both early-life and later-life health or has had to rely on retrospectively reported accounts of childhood circumstances. Using the 1958 National Child Development Study, and in particular the biomedical survey conducted in 2002-2003, we investigate associations between fertility histories (number of children and age at first and at last birth) and biomarkers for cardiometabolic risk and respiratory function in midlife among both men and women. Results from models that adjusted for a very wide range of childhood factors, including early-life socioeconomic position, cognitive ability, and mental health, showed weak associations between parity and biomarkers. However, we found an inverse association between age at first birth and biomarkers indicative of worse cardiometabolic health, with poorer outcomes for those with very young ages at entry to parenthood and increasingly better outcomes for those becoming parents at older ages. A very young age at last birth was also associated with less favorable biomarker levels, especially among women. Results highlight the value of prospectively collected data and the availability of biomarkers in studies of life course determinants of health in midlife and later.
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Affiliation(s)
- Maria Sironi
- Department of Social Science, University College London, 55-59 Gordon Square, London, WC1H 0NU United Kingdom
| | - George B. Ploubidis
- Department of Social Science, University College London, 55-59 Gordon Square, London, WC1H 0NU United Kingdom
- UCL Center for Longitudinal Studies, University College London, 55-59 Gordon Square, London, WC1H 0NU United Kingdom
| | - Emily M. Grundy
- Institute for Social & Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ United Kingdom
- Centre for Fertility and Health, Norwegian Institute for Public Health, Lovisenberggata 8, 0456 Oslo, Norway
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6
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Russ TC, Kivimäki M, Batty GD. Respiratory Disease and Lower Pulmonary Function as Risk Factors for Dementia: A Systematic Review With Meta-analysis. Chest 2020; 157:1538-1558. [PMID: 31952950 DOI: 10.1016/j.chest.2019.12.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 11/13/2019] [Accepted: 12/12/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND In addition to affecting the oxygen supply to the brain, pulmonary function is a marker of multiple insults throughout life (including smoking, illness, and socioeconomic deprivation). In this meta-analysis of existing longitudinal studies, the hypothesis that lower pulmonary function and respiratory illness are linked to an elevated risk of dementia was tested. METHODS A systematic review was conducted of longitudinal studies using PubMed until April 1, 2019, and, where possible, results were pooled in random effects meta-analyses. RESULTS Ten studies relating pulmonary function to later dementia risk and 11 studies of respiratory illness and dementia (including one that assessed both factors) were identified. The lowest quartile of FEV1 compared with the highest was associated with a 1.4-fold (hazard ratio [HR], 1.46; 95% CI, 0.77-2.75) increased dementia risk (Ntotal = 62,209; two studies). A decrease of 1 SD in FEV1 was associated with a 28% increase in dementia risk (HR, 1.28; 95% CI, 1.03-1.60; Ntotal = 67,505; six studies). Respiratory illness was also associated with increased dementia risk to a similar degree (pooled HR, 1.54; 95% CI, 1.30-1.81; Ntotal = 288,641; 11 studies). CONCLUSIONS Individuals with poor pulmonary function experience an increased risk of dementia. The extent to which the association between poor pulmonary function and dementia is causal remains unclear and requires examination.
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Affiliation(s)
- Tom C Russ
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; School of Philosophy, Psychology, and Language Sciences; and Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, UK; Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College, London, United Kingdom
| | - G David Batty
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing & Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Department of Epidemiology and Public Health, University College, London, United Kingdom; School of Biological & Population Health Sciences, Oregon State University, Corvallis, OR
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Cable N, Sacker A. Validating overcrowding measures using the UK Household Longitudinal Study. SSM Popul Health 2019; 8:100439. [PMID: 31334323 PMCID: PMC6614532 DOI: 10.1016/j.ssmph.2019.100439] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/01/2019] [Accepted: 06/24/2019] [Indexed: 10/31/2022] Open
Abstract
Overcrowding has been regarded as indicating material deprivation and treated as a proxy measure for individual socioeconomic status. Conventionally, 'persons per room' (PPR) has been employed to identify overcrowded households in UK survey data, though the 'bedroom standard' (BS) approach or the 'modified bedroom standard' (MBS) approach has been thought to capture overcrowded households better. Little is known about which overcrowding measure will perform well in regard to construct and face validity. In this work, associations between three overcrowding measures and socioeconomic (income and household tenure status) and health (satisfied with health and GHQ12) indicators were assessed, using the UK Household Longitudinal Study Wave 6 data. PPR, BS and MBS were derived using relevant housing grid information and housing information from the dataset, which were aggregated at a household level (N = 18,848). Raw scores were categorised into 'under occupied (rooms < people)', 'balanced (rooms = people)', 'overcrowded (rooms < people)' according to an established cut-off point for each overcrowding measure. Kappa coefficient was used to assess the level of agreement between overcrowding measures. Construct validity of the measures were tested against log-transformed household equivalised income and housing tenure status as well as with each component of overcrowding measures. Using individual data (N = 38,455), face validity of the overcrowding measures was tested against satisfaction with health and mental health indicated by GHQ12. Each overcrowding measure has a fair agreement with the others (kappa = 0.44, p<0.001). All overcrowding measures were significantly correlated with income and household tenure in a similar manner. However, components of overcrowding measures were associated differently to these socioeconomic indicators, while they were better correlated with satisfaction with health compared to GHQ12, showing a complex aspect of overcrowding measures. In sum, use of PPR as a socioeconomic indicator is reasonable. However, given the complexity of the mechanism of health inequalities, the relevant household information is required to understand the link.
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Affiliation(s)
- Noriko Cable
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom
| | - Amanda Sacker
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, United Kingdom
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8
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Carney C, Benzeval M. The moderating effect of childhood disadvantage on the associations between smoking and occupational exposure and lung function; a cross sectional analysis of the UK Household Longitudinal Study (UKHLS). BMC Public Health 2019; 19:690. [PMID: 31164109 PMCID: PMC6549314 DOI: 10.1186/s12889-019-7039-z] [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: 01/31/2019] [Accepted: 05/23/2019] [Indexed: 12/04/2022] Open
Abstract
Background Lung function is lower in people with disadvantaged socio-economic position (SEP) and is associated with hazardous health behaviours and exposures. The associations are likely to be interactive, for example, exposure to socially patterned environmental tobacco smoke (ETS) in childhood is associated with an increased effect of smoking in adulthood. We hypothesise that disadvantaged childhood SEP increases susceptibility to the effects of hazards in adulthood for lung function. We test whether disadvantaged childhood SEP moderates smoking, physical activity, obesity, occupational exposures, ETS and air pollution’s associations with lung function. Methods Data are from the Nurse Health Assessment (NHA) in waves two and three of the United Kingdom Household Longitudinal Study (UKHLS). Analysis is restricted to English residents aged at least 20 for women and 25 for men, producing a study population of 16,339. Lung function is measured with forced expiratory volume in the first second (FEV1) and standardised to the percentage of expected FEV1 for a healthy non-smoker of equivalent age, gender, height and ethnicity (FEV1%). Using STATA 14, a mixed linear model was fitted with interaction terms between childhood SEP and health behaviours and occupational exposures. Cross level interactions tested whether childhood SEP moderated household ETS and neighbourhood air pollution’s associations with FEV1%. Results SEP, smoking, physical activity, obesity, occupational exposures and air pollution were associated with lung function. Interaction terms indicated a significantly stronger negative association between disadvantaged childhood SEP and currently smoking (coefficient -6.47 %, 95% confidence intervals (CI): 9.51 %, 3.42 %) as well as with formerly smoking and occupational exposures. Significant interactions were not found with physical activity, obesity, ETS and air pollution. Conclusion The findings suggest that disadvantaged SEP in childhood may make people’s lung function more susceptible to the negative effects of smoking and occupational exposures in adulthood. This is important as those most likely to encounter these exposures are at greater risk to their effects. Policy to alleviate this inequality requires intervention in health behaviours through public health campaigns and in occupational health via health and safety legislation.
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Affiliation(s)
- Caroline Carney
- Institute for Social and Economic Research (ISER), University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK. .,LSE Health, London School of Economics and Political Science (LSE), Cowdray House, Houghton Street, London, WC2A 2AE, UK.
| | - Michaela Benzeval
- Institute for Social and Economic Research (ISER), University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK
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9
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von Bonsdorff MB, Kokko K, Salonen M, von Bonsdorff ME, Poranen-Clark T, Alastalo H, Kajantie E, Osmond C, Eriksson JG. Association of childhood adversities and home atmosphere with functioning in old age: the Helsinki birth cohort study. Age Ageing 2019; 48:80-86. [PMID: 30272114 DOI: 10.1093/ageing/afy153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 09/12/2018] [Indexed: 01/13/2023] Open
Abstract
Objective childhood adversities have been linked with adverse health outcomes, but less is known about the long-term consequences of childhood home atmosphere. We investigated whether childhood adversities and home atmosphere were associated with physical and mental functioning in older age. Methods in the Helsinki Birth Cohort Study 2003, participants born in the year 1934-44 had data available on nine childhood home atmosphere items, e.g. whether it was supportive and warm (sum score ranged between 0 and 36, higher score indicating better atmosphere), and nine childhood adversities, e.g. unemployment and divorce (sum score 0-9, coded into no; one; and two or more adversities) assessed in 2001-04. Of those, 835 had data on physical and mental functioning assessed using the Short Form 36 questionnaire in 2011-13. Results those who had experienced two or more childhood adversities were more likely to have poorer physical and mental functioning in older age compared to those with no adversities. A better home atmosphere score was associated with better mental functioning (per one unit higher score β 0.24, 95% CI 0.16-0.32, P < 0.001). In models including both childhood adversities and home atmosphere, a more favourable home atmosphere was associated with better mental functioning while the association for childhood adversities attenuated. There were no associations between childhood adversities or home atmosphere and physical functioning in the models that included both childhood exposures. Conclusions childhood adversities and home atmosphere have long-term associations with physical and mental functioning in older age.
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Affiliation(s)
- Mikaela B von Bonsdorff
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Katja Kokko
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
| | - Minna Salonen
- Folkhälsan Research Center, Helsinki, Finland
- Division of Welfare and Health Promotion, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Monika E von Bonsdorff
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Taina Poranen-Clark
- Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland
| | - Hanna Alastalo
- Ageing, Disability and Functional Capacity Unit, Department of Welfare, National Institute for Health and Welfare, Helsinki, Finland
| | - Eero Kajantie
- Division of Welfare and Health Promotion, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Hospital for Children and Adolescents, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
- PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland
- Division of Welfare and Health Promotion, Department of Chronic Disease Prevention, Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki and Unit of General Practice, Helsinki University Hospital, Helsinki, Finland
- Vasa Central Hospital, Vasa, Finland
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10
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Birth Weight and Lung Function in Adulthood: A Systematic Review and Meta-analysis. Ann Am Thorac Soc 2018; 14:994-1004. [PMID: 28362513 DOI: 10.1513/annalsats.201609-746sr] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
RATIONALE There is evidence suggesting that birth weight may influence lung function in adulthood, but it is unclear whether it might differentially affect restrictive (FVC) and obstructive (FEV1/FVC) patterns. OBJECTIVES To summarize evidence available on the association of birth weight, weight at 1 year, and weight gain in the first year of life with FVC and FEV1/FVC in adulthood. METHODS We performed a systematic review of the literature by searching MEDLINE, EMBASE, and Web of Science through January 2015. Data were combined using inverse-variance weighted meta-analysis with random effects models and between-study heterogeneity evaluated. We conducted a priori subgroup or sensitivity analyses by age, country wealth, ethnicity, sex, and smoking. We evaluated risk of bias using the Newcastle Ottawa Scale and reporting bias using funnel plots. RESULTS Eighteen articles were included in the review and 13 in the meta-analyses. Most studies were from high-income countries, and all had a low risk of bias. We found strong evidence of an association of birth weight with adult FVC, a 59.4 ml higher FVC in adulthood per kilogram increase in birth weight (95% confidence interval, 43.3-75.5), with no evidence of heterogeneity. Evidence of an association of birth weight with FEV1/FVC was weaker and showed some inconsistency across studies. Only one study investigated weight at 1 year, and another one reported weight gain in the first year. CONCLUSIONS Our meta-analyses show strong and consistent evidence of an association of birth weight with adult FVC, a measure of restrictive impairment, with much weaker evidence for airflow obstruction.
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Janzen B, Karunanayake C, Rennie D, Pickett W, Lawson J, Kirychuk S, Hagel L, Senthilselvan A, Koehncke N, Dosman J, Pahwa P. Gender Differences in the Association of Individual and Contextual Exposures with Lung Function in a Rural Canadian Population. Lung 2016; 195:43-52. [PMID: 27738826 DOI: 10.1007/s00408-016-9950-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/01/2016] [Indexed: 01/25/2023]
Abstract
INTRODUCTION To investigate the association of individual and contextual exposures with lung function by gender in rural-dwelling Canadians. METHODS A cross-sectional mail survey obtained completed questionnaires on exposures from 8263 individuals; a sub-sample of 1609 individuals (762 men, 847 women) additionally participated in clinical lung function testing. The three dependent variables were forced expired volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. Independent variables included smoking, waist circumference, body mass index, indoor household exposures (secondhand smoke, dampness, mold, musty odor), occupational exposures (grain dust, pesticides, livestock, farm residence), and socioeconomic status. The primary analysis was multiple linear regression, conducted separately for each outcome. The potential modifying influence of gender was tested in multivariable models using product terms between gender and each independent variable. RESULTS High-risk waist circumference was related to reduced FVC and FEV1 for both genders, but the effect was more pronounced in men. Greater pack-years smoking was associated with lower lung function values. Exposure to household smoke was related to reduced FEV1, and exposure to livestock, with increased FEV1. Lower income adequacy was associated with reduced FVC and FEV1. CONCLUSION High-risk waist circumference was more strongly associated with reduced lung function in men than women. Longitudinal research combined with rigorous exposure assessment is needed to clarify how sex and gender interact to impact lung function in rural populations.
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Affiliation(s)
- Bonnie Janzen
- Department of Community Health & Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Road, Saskatoon, SK, S7N-5E5, Canada.
| | - Chandima Karunanayake
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Donna Rennie
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada.,College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - William Pickett
- Department of Public Health Sciences, Queens University, Kingston, ON, Canada
| | - Joshua Lawson
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Shelley Kirychuk
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Louise Hagel
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Niels Koehncke
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - James Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
| | - Punam Pahwa
- Department of Community Health & Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Road, Saskatoon, SK, S7N-5E5, Canada.,Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada
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12
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Non AL, Román JC, Gross CL, Gilman SE, Loucks EB, Buka SL, Kubzansky LD. Early childhood social disadvantage is associated with poor health behaviours in adulthood. Ann Hum Biol 2016; 43:144-53. [PMID: 26727037 DOI: 10.3109/03014460.2015.1136357] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Individual health behaviours are considered important risk factors for cardiometabolic diseases. These behaviours may be socially patterned by early exposure to social disadvantage, but few studies have prospectively tested this hypothesis empirically. AIM This study investigated whether childhood social disadvantage was associated with likelihood of engaging in less healthy behaviours 40 years later. SUBJECTS AND METHODS Prospective data were analysed from the New England Family Study, a 2005-2007 adult follow-up of a cohort initiated in 1959-1966 (n = 565). Childhood social environment (age 7 years) was assessed using a cumulative index of socioeconomic and family stability factors. Logistic regression models evaluated associations between social disadvantage and each health-related behaviour and obesity in adulthood. RESULTS Relative to low disadvantage, higher disadvantage was associated with 3.6-fold greater odds of smoking (95% CI = 1.9-7.0), 4.8-fold greater odds (in women only) of excess alcohol consumption (95% CI = 1.6-14.2) and 2.7-fold greater odds of obesity (95% CI = 1.3-5.5), but was not associated with unhealthy diet or physical inactivity. CONCLUSION These findings suggest childhood social disadvantage may contribute to adult cardiometabolic disease by predisposing children to adopt certain unhealthy behaviours. If replicated, such findings may support intervention strategies that target social environmental factors and behavioural pathways that are established early in life.
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Affiliation(s)
- Amy L Non
- a Department of Anthropology , University of California , San Diego, La Jolla, CA , USA
| | - Jorge Carlos Román
- b Department of Mathematics and Statistics , San Diego State University , San Diego , CA , USA
| | - Christopher L Gross
- c Department of Medicine , Health, and Society, Vanderbilt University , Nashville , TN , USA
| | - Stephen E Gilman
- d Division of Intramural Population Health Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development , Bethesda , MD , USA ;,e Department of Social and Behavioural Sciences , Harvard T.H. Chan School of Public Health , Boston , MA , USA ;,f Department of Epidemiology , Harvard T.H. Chan School of Public Health , Boston , MA , USA
| | - Eric B Loucks
- g Department of Epidemiology , Brown University , Providence , RI , USA
| | - Stephen L Buka
- g Department of Epidemiology , Brown University , Providence , RI , USA
| | - Laura D Kubzansky
- e Department of Social and Behavioural Sciences , Harvard T.H. Chan School of Public Health , Boston , MA , USA
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Minelli C, Dean CH, Hind M, Alves AC, Amaral AFS, Siroux V, Huikari V, Soler Artigas M, Evans DM, Loth DW, Bossé Y, Postma DS, Sin D, Thompson J, Demenais F, Henderson J, Bouzigon E, Jarvis D, Järvelin MR, Burney P. Association of Forced Vital Capacity with the Developmental Gene NCOR2. PLoS One 2016; 11:e0147388. [PMID: 26836265 PMCID: PMC4737618 DOI: 10.1371/journal.pone.0147388] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 01/04/2016] [Indexed: 12/31/2022] Open
Abstract
Background Forced Vital Capacity (FVC) is an important predictor of all-cause mortality in the absence of chronic respiratory conditions. Epidemiological evidence highlights the role of early life factors on adult FVC, pointing to environmental exposures and genes affecting lung development as risk factors for low FVC later in life. Although highly heritable, a small number of genes have been found associated with FVC, and we aimed at identifying further genetic variants by focusing on lung development genes. Methods Per-allele effects of 24,728 SNPs in 403 genes involved in lung development were tested in 7,749 adults from three studies (NFBC1966, ECRHS, EGEA). The most significant SNP for the top 25 genes was followed-up in 46,103 adults (CHARGE and SpiroMeta consortia) and 5,062 children (ALSPAC). Associations were considered replicated if the replication p-value survived Bonferroni correction (p<0.002; 0.05/25), with a nominal p-value considered as suggestive evidence. For SNPs with evidence of replication, effects on the expression levels of nearby genes in lung tissue were tested in 1,111 lung samples (Lung eQTL consortium), with further functional investigation performed using public epigenomic profiling data (ENCODE). Results NCOR2-rs12708369 showed strong replication in children (p = 0.0002), with replication unavailable in adults due to low imputation quality. This intronic variant is in a strong transcriptional enhancer element in lung fibroblasts, but its eQTL effects could not be tested due to low imputation quality in the eQTL dataset. SERPINE2-rs6754561 replicated at nominal level in both adults (p = 0.036) and children (p = 0.045), while WNT16-rs2707469 replicated at nominal level only in adults (p = 0.026). The eQTL analyses showed association of WNT16-rs2707469 with expression levels of the nearby gene CPED1. We found no statistically significant eQTL effects for SERPINE2-rs6754561. Conclusions We have identified a new gene, NCOR2, in the retinoic acid signalling pathway pointing to a role of vitamin A metabolism in the regulation of FVC. Our findings also support SERPINE2, a COPD gene with weak previous evidence of association with FVC, and suggest WNT16 as a further promising candidate.
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Affiliation(s)
- Cosetta Minelli
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom
- * E-mail:
| | - Charlotte H. Dean
- Leukocyte Biology, National Heart and Lung Institute, Imperial College London, London, United Kingdom
- Mammalian Genetics Unit, MRC Harwell, Oxon, United Kingdom
| | - Matthew Hind
- Respiratory Department, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - Alexessander Couto Alves
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - André F. S. Amaral
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom
- MRC-PHE Centre for Environment & Health, London, United Kingdom
| | - Valerie Siroux
- Univ. Grenoble Alpes, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, F-38000, Grenoble, France
- INSERM, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, F-38000, Grenoble, France
- CHU de Grenoble, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, F-38000, Grenoble, France
| | | | - María Soler Artigas
- Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - David M. Evans
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Daan W. Loth
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Yohan Bossé
- Institut universitaire de cardiologie et de pneumologie de Québec, Department of Molecular Medicine, Laval University, Québec, Canada
| | - Dirkje S. Postma
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Don Sin
- The University of British Columbia Center for Heart Lung Innovation, St-Paul’s Hospital, Vancouver, Canada
| | - John Thompson
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Florence Demenais
- INSERM, UMRS-946, Genetic Variation of Human Diseases Unit, Paris, France
- Univ. Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d’Hématologie, F-75007, Paris, France
| | - John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - SpiroMeta consortium
- SpiroMeta consortium, Genetic Epidemiology Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - CHARGE consortium
- CHARGE consortium, Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, United States of America
| | - Emmanuelle Bouzigon
- INSERM, UMRS-946, Genetic Variation of Human Diseases Unit, Paris, France
- Univ. Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d’Hématologie, F-75007, Paris, France
| | - Deborah Jarvis
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom
- MRC-PHE Centre for Environment & Health, London, United Kingdom
| | - Marjo-Riitta Järvelin
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- MRC-PHE Centre for Environment & Health, London, United Kingdom
- Biocenter Oulu, University of Oulu, Oulu, Finland
- Center for Life Course Epidemiology, Faculty of Medicine, P.O. Box 5000, FI-90014 University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Kajaanintie 50, P.O. Box 20, FI-90220, Oulu, 90029 OYS, Finland
| | - Peter Burney
- Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom
- MRC-PHE Centre for Environment & Health, London, United Kingdom
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Morrison J, Pikhart H, Ruiz M, Goldblatt P. Systematic review of parenting interventions in European countries aiming to reduce social inequalities in children's health and development. BMC Public Health 2014; 14:1040. [PMID: 25287010 PMCID: PMC4203958 DOI: 10.1186/1471-2458-14-1040] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 09/09/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Early child development influences many aspects of wellbeing, health, competence in literacy and numeracy, criminality, and social and economic participation throughout the life course. Children from disadvantaged groups have less possibilities of achieving full development. By providing a positive start for all children across the social gradient, improved developmental outcomes will be seen during later childhood and throughout their lives. The objective of this systematic review was to identify interventions during early childhood in countries from the World Health Organisation European Region in 1999-2013 which reduced inequalities in children's health and development. METHODS A systematic review was carried out adhering to the PRISMA guidelines. The review examined universal, targeted and proportionate universalism interventions, programs and services using an electronic search strategy in PubMed and the International Bibliography of the Social Sciences [IBSS] databases. A further search was performed in the grey literature. Interventions were included only if they were aimed at children or their parents and had been evaluated. RESULTS We identified 23 interventions in total: 6 in the PubMed data base, 5 in IBSS and 12 in grey literature. All but 1 intervention-delivered in Sweden-were carried out in the United Kingdom and the Republic of Ireland. These aimed to improve parenting abilities, however, some had additional components such as: day-care provision, improving housing conditions and speech or psychological therapies. Programmes offering intensive support, information and home visits using a psycho-educational approach and aimed at developing parent's and children's skills showed more favourable outcomes. These were parenting behaviours, overall children's health and higher level of fine motor skills and cognitive functioning. Child injuries and abuse were also reduced. Two interventions were universally proportionate and all others were aimed at a specific target population. CONCLUSIONS Interventions with better outcomes and a higher level of evidence combined workshops and educational programmes for both parents and children beginning during early pregnancy and included home visits by specialised staff. Further evaluation and publication of early years interventions should be carried out also within a wider range of countries than just the UK and Ireland.
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Affiliation(s)
- Joana Morrison
- />Department of Epidemiology and Public Health, University College London, London, UK
| | - Hynek Pikhart
- />Department of Epidemiology and Public Health, University College London, London, UK
| | - Milagros Ruiz
- />Department of Epidemiology and Public Health, University College London, London, UK
| | - Peter Goldblatt
- />Institute of Health Equity, Department of Epidemiology and Public Health, University College London, London, UK
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Ploubidis GB, Benova L, Grundy E, Laydon D, DeStavola B. Lifelong Socio Economic Position and biomarkers of later life health: Testing the contribution of competing hypotheses. Soc Sci Med 2014; 119:258-65. [DOI: 10.1016/j.socscimed.2014.02.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 01/31/2014] [Accepted: 02/11/2014] [Indexed: 10/25/2022]
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Non AL, Rewak M, Kawachi I, Gilman SE, Loucks EB, Appleton AA, Román JC, Buka SL, Kubzansky LD. Childhood social disadvantage, cardiometabolic risk, and chronic disease in adulthood. Am J Epidemiol 2014; 180:263-71. [PMID: 24970845 DOI: 10.1093/aje/kwu127] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Adverse social environments in early life are hypothesized to become biologically embedded during the first few years of life, with potentially far-reaching implications for health across the life course. Using prospective data from a subset of a US birth cohort, the Collaborative Perinatal Project, started in 1959-1966 (n = 566), we examined associations of social disadvantage assessed in childhood with cardiometabolic function and chronic disease status more than 40 years later (in 2005-2007). Social disadvantage was measured with an index that combined information on adverse socioeconomic and family stability factors experienced between birth and age 7 years. Cardiometabolic risk (CMR) was assessed by combining information from 8 CMR biomarkers; an index of chronic disease status was derived by assessing 8 chronic diseases. Poisson models were used to investigate associations between social disadvantage and CMR or chronic disease scores while adjusting for childhood covariates and potential pathway variables. A high level of social disadvantage was significantly associated with both higher CMR (incident rate ratio = 1.69, 95% confidence interval: 1.19, 2.39) and with a higher number of chronic diseases (incident rate ratio = 1.39, 95% confidence interval: 1.00, 1.92) in minimally adjusted models. Associations with CMR persisted even after accounting for childhood and adult covariates.
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Halonen JI, Vahtera J, Kivimäki M, Pentti J, Kawachi I, Subramanian SV. Adverse experiences in childhood, adulthood neighbourhood disadvantage and health behaviours. J Epidemiol Community Health 2014; 68:741-6. [PMID: 24764352 DOI: 10.1136/jech-2013-203441] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Early life adversities may play a role in the associations observed between neighbourhood contextual factors and health behaviours. METHODS We examined whether self-reported adverse experiences in childhood (parental divorce, long-term financial difficulties, serious conflicts, serious/chronic illness or alcohol problem in the family, and frequent fear of a family member) explain the association between adulthood neighbourhood disadvantage and co-occurrence of behavioural risk factors (smoking, moderate/heavy alcohol use, physical inactivity). Study population consisted of 31 271 public sector employees from Finland. The cross-sectional associations were analysed using two-level cumulative logistic regression models. RESULTS Childhood adverse experiences were associated with the sum of risk factors (cumulative OR 1.32 (95% CI 1.25 to 1.40) among those reporting 3-6 vs 0 adversities). Adverse experiences did not attenuate the association between neighbourhood disadvantage and risk factors; this cumulative OR was 1.52 (95% CI 1.43 to 1.62) in the highest versus lowest quartile of neighbourhood disadvantage when not including adversities, and 1.50 (95% CI 1.40 to 1.60) when adjusted for childhood adversities. In adversity-stratified analyses those reporting 3-6 adversities had 1.60-fold (95% CI 1.42 to 1.80) likelihood of risk factors if living in the neighbourhood of the highest disadvantage, while in those with fewer adversities this likelihood was 1.09-1.34-fold (95% CI 0.98 to 1.53) (p interaction 0.07). CONCLUSIONS Childhood adverse experiences and adulthood neighbourhood disadvantage were associated with behavioural risk factors. Childhood experiences did not explain associations between neighbourhood disadvantage and the risk factors. However, those with more adverse experiences may be susceptible for the socioeconomic conditions of neighbourhoods.
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Affiliation(s)
| | - Jussi Vahtera
- Finnish Institute of Occupational Health, Helsinki, Finland Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland Department of Epidemiology and Public Health, University College London Medical School, London, UK
| | - Jaana Pentti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA
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Cable N, Kelly Y, Bartley M, Sato Y, Sacker A. Critical role of smoking and household dampness during childhood for adult phlegm and cough: a research example from a prospective cohort study in Great Britain. BMJ Open 2014; 4:e004807. [PMID: 24747796 PMCID: PMC4010851 DOI: 10.1136/bmjopen-2014-004807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To examine independent associations between childhood exposures to smoking and household dampness, and phlegm and cough in adulthood. DESIGN A prospective cohort study. PARTICIPANTS 7320 of the British cohort who were born during 1 week in 1970 and had complete data for childhood and adult information. MAIN OUTCOME MEASURES Experiences of phlegm and coughing over the previous 3 months were assessed using questions from the Medical Research Council (MRC) Questionnaire on respiratory symptoms when the cohort participants were 29 years of age. 4 response patterns (no symptoms, phlegm only, cough only, both symptoms present) were created based on the responses to these questions. RESULTS Childhood smoking and exposure to marked household dampness at age 10 were associated with phlegm (childhood smoking: relative risk ratio (RRR)=1.45, 95% CI 1.02 to 2.05; dampness: RRR=2.05, 95% CI 1.07 to 3.91) and co-occurring cough and phlegm (childhood smoking: RRR=1.35. 95% CI 1.08 to 1.67; dampness: RRR=2.73, 95% CI 1.88 to 3.99), while exposure to two or more adult smokers in the household was associated with cough-related symptoms (cough only: RRR=1.28, 95% CI 1.04 to 1.58; phlegm and cough: RRR=1.32, 95% CI 1.06 to 1.64). These associations were independent from adult smoking, childhood phlegm and cough, early social background and sex. Current smoking at age 29 contributed to all symptom patterns; however, a substantial association between household dampness and co-occurring phlegm and cough suggest long-term detrimental effects of childhood environmental exposures. CONCLUSIONS Our findings give support to current public health interventions for adult smoking and raise concerns about the long-term effects of a damp home environment on the respiratory health of children.
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Affiliation(s)
- Noriko Cable
- International Centre for Life Course Studies in Society and Health (ICLS), Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Yvonne Kelly
- International Centre for Life Course Studies in Society and Health (ICLS), Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Mel Bartley
- International Centre for Life Course Studies in Society and Health (ICLS), Research Department of Epidemiology and Public Health, University College London, London, UK
| | - Yuki Sato
- Centre for Environmental Health Sciences, National Institute for Environmental Studies, Tsukuba-city, Ibaragi, Japan
| | - Amanda Sacker
- International Centre for Life Course Studies in Society and Health (ICLS), Research Department of Epidemiology and Public Health, University College London, London, UK
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Korkeila J, Lietzen R, Sillanmäki LH, Rautava P, Korkeila K, Kivimäki M, Koskenvuo M, Vahtera J. Childhood adversities and adult-onset asthma: a cohort study. BMJ Open 2012; 2:e001625. [PMID: 23069774 PMCID: PMC3488721 DOI: 10.1136/bmjopen-2012-001625] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 09/07/2012] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Childhood adversities may be important determinants of later illnesses and poor health behaviour. However, large-scale prospective studies on the associations between childhood adversities and the onset of asthma in adulthood are lacking. DESIGN Prospective cohort study with 7-year follow-up. SETTING Nationally representative study. Data were collected from the Health and Social Support (HeSSup) survey and national registers. PARTICIPANTS The participants represent the Finnish population from the following age groups: 20-24, 30-34, 40-44, and 50-54 years at baseline in 1998 (24 057 survey participants formed the final cohort of this study). The occurrence of childhood adversities was assessed at baseline with a six-item survey scale. The analyses were adjusted for sociodemographic characteristics, behavioural health risks and common mental disorders. PRIMARY AND SECONDARY OUTCOMES The survey data were linked to data from national health registers on incident asthma during a 7-year follow-up to define new-onset asthma cases with verified diagnoses. RESULTS A total of 12 126 (59%) participants reported that they encountered a childhood adversity. Of them 3677 (18% of all) endured three to six adversities. During a follow-up of 7 years, 593 (2.9%) participants were diagnosed with incident asthma. Those who reported three or more childhood adversities had a 1.6-fold (95% CI 1.31 to 2.01) greater risk of asthma compared to those without childhood adversities. This hazard attenuated but remained statistically significant after adjustment for conventional risk factors (HR 1.33; 95% CI 1.06 to 1.67). CONCLUSIONS Adults who report having encountered adversities in childhood may have an increased risk of developing asthma.
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Affiliation(s)
- Jyrki Korkeila
- Department of Psychiatry, University of Turku, and Harjavalta Hospital, Satakunta Hospital District, Finland
| | - Raija Lietzen
- Department of Public Health, University of Turku, Turku, Finland
| | | | - Päivi Rautava
- Department of Public Health, Clinical Research Centre, Turku University Hospital, University of Turku, Turku, Finland
| | - Katariina Korkeila
- Department of Health Centre of Raisio, Raisio Municipal Health Care and Social Services, Raisio, Finland
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Markku Koskenvuo
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital and Finnish Institute of Occupational Health, Helsinki, Finland
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