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Akinyemi AA, Jones A, Sweeting JA, Holman EA. Parental Preconception Adversity and Offspring Mental Health in African Americans and Native Americans in the United States: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1911-1924. [PMID: 37776310 PMCID: PMC11155212 DOI: 10.1177/15248380231200464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
This systematic review examines the impact of parental preconception adversity on offspring mental health among African Americans (AAs) and Native Americans (NAs), two populations that have experienced historical trauma and currently experience ethnic/racial mental health disparities in the United States. PsycINFO, PubMed, CINAHL, Scopus, and Web of Science were searched for studies that included at least two generations of AAs or NAs from the same family, measured parental preconception adversity and their offspring's mental health, and examined the association between these variables. Over 3,200 articles were screened, and 18 articles representing 13 unique studies were included in this review. Among the studies with samples that included AAs (n = 12, 92%), 10 (83%) reported a significant association between parental preconception adversity and adverse offspring mental health. The only study with a sample of NAs (n = 1, 8%) also reported a significant association between these variables. Although the literature suggests that parental preconception adversity is associated with offspring mental health among AAs and NAs, it must be interpreted in the context of the small number of studies on this topic and the less-than-ideal samples utilized-just one study included a sample of NAs and several studies (n = 6, 46%) used multi-ethnic/racial samples without testing for ethnic/racial disparities in their results. A more rigorous body of literature on this topic is needed as it may help explain an important factor underlying ethnic/racial mental health disparities, with important implications for interventions and policy.
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Affiliation(s)
| | - Adrianna Jones
- Department of Psychology, Miami University, Oxford, OH, USA
| | - Josiah A. Sweeting
- Department of Psychological Science, University of California, Irvine, USA
| | - E. Alison Holman
- Department of Psychological Science, University of California, Irvine, USA
- Sue & Bill Gross School of Nursing, University of California, Irvine
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Colón-López A, García C. 20th Century Puerto Rico and Later-Life Health: The Association Between Multigenerational Education and Chronic Conditions in Island-Dwelling Older Adults. J Aging Health 2023; 35:3-22. [PMID: 35536114 PMCID: PMC10081163 DOI: 10.1177/08982643221097532] [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: 12/16/2022]
Abstract
OBJECTIVES Previous research on the association between education and older adult health in the U.S. has not included Puerto Rico. We investigated the effects of multigenerational educational attainment and chronic conditions among older Puerto Ricans residing on the archipelago's main island. METHODS Data were from the longitudinal Puerto Rican Elderly Health Conditions Project. Generalized Poisson regression models were used to examine if multigenerational educational attainment was associated with chronic disease. RESULTS Findings show that parental educational attainment was associated with fewer chronic conditions among females at baseline but not at follow-up, suggesting that the effects of parental education on health over time are less pronounced. For males, educational attainment across the three generations was not significantly associated with chronic disease at baseline or follow-up. DISCUSSION Multigenerational education is an important determinant of older adult health that continues to be relevant in Puerto Rico and the Latin American and Hispanic-Caribbean region.
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Affiliation(s)
- Alejandra Colón-López
- Department of Sociology, 9968University of Alabama - Birmingham, Birmingham, AL, USA
| | - Catherine García
- Department of Human Development and Family Science, Aging Studies Institute, Center for Aging and Policy Studies, Lerner Center for Public Health Promotion, 2029Syracuse University, Syracuse, NY, USA
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3
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Mallinson PAC, Kulkarni B, Bhogadi S, Kinra S. Association between parents' socioeconomic conditions and nutritional status during childhood and the risk of cardiovascular disease in their adult offspring: an intergenerational study in south India. J Epidemiol Community Health 2021; 75:1091-1097. [PMID: 33980719 PMCID: PMC8515111 DOI: 10.1136/jech-2020-216261] [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: 12/13/2020] [Revised: 04/09/2021] [Accepted: 04/22/2021] [Indexed: 11/11/2022]
Abstract
Background Some researchers have suggested that parents’ exposure to poor socioeconomic conditions during childhood can increase their offspring’s risk of cardiovascular disease, primarily through poor maternal nutrition and growth. However, epidemiological data on this association are limited. In an intergenerational cohort from rural India, we examined the association of parental childhood socioeconomic conditions and stature with offspring’s cardiovascular risk, hypothesising an inverse association between the two. Methods We analysed data on 3175 adult offspring (aged 18–35 years, 58% men) and their parents from the third wave of the Andhra Pradesh Children and Parents’ Study (2010–12). We used multilevel linear regression to estimate the association of parents’ Standard of Living Index (SLI, an asset-based measure of socioeconomic conditions) in childhood, height and leg length with subclinical atherosclerosis and cardiovascular risk factors in their offspring. Results In multivariable models adjusted for offspring’s socioeconomic conditions in childhood and adulthood, associations (beta coefficients and 95% CIs) of mother’s and father’s childhood SLI (per SD) were −0.00 mm (−0.01, 0.01) and 0.01 mm (−0.00, 0.02) for carotid intima media thickness, −0.17 mm Hg (−0.61, 0.27) and −0.30 mm Hg (−0.78, 0.20) for systolic blood pressure, −0.43 mg/dL (−2.00, 1.15) and −1.07 mg/dL (−2.79, 0.65) for total cholesterol and −0.00mU/L (−0.04, 0.03) and 0.01mU/L (−0.03, 0.04) for log fasting insulin. Results were of similar magnitude for parental height and leg length. Conclusions Our findings do not support an inverse association between parental childhood socioeconomic conditions or stature and offspring’s risk of cardiovascular disease. Intergenerational socioeconomic influences on cardiovascular risk may be of limited public health significance for this setting.
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Affiliation(s)
| | - Bharati Kulkarni
- Clinical Division, National Institute of Nutrition, Hyderabad, India
| | - Santhi Bhogadi
- Indian Institute of Public Health Hyderabad, Public Health Foundation of India, Hyderabad, India
| | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
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McGee G, Perkins NJ, Mumford SL, Kioumourtzoglou MA, Weisskopf MG, Schildcrout JS, Coull BA, Schisterman EF, Haneuse S. Methodological Issues in Population-Based Studies of Multigenerational Associations. Am J Epidemiol 2020; 189:1600-1609. [PMID: 32608483 DOI: 10.1093/aje/kwaa125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 12/25/2022] Open
Abstract
Laboratory-based animal research has revealed a number of exposures with multigenerational effects-ones that affect the children and grandchildren of those directly exposed. An important task for epidemiology is to investigate these relationships in human populations. Without the relative control achieved in laboratory settings, however, population-based studies of multigenerational associations have had to use a broader range of study designs. Current strategies to obtain multigenerational data include exploiting birth registries and existing cohort studies, ascertaining exposures within them, and measuring outcomes across multiple generations. In this paper, we describe the methodological challenges inherent to multigenerational studies in human populations. After outlining standard taxonomy to facilitate discussion of study designs and target exposure associations, we highlight the methodological issues, focusing on the interplay between study design, analysis strategy, and the fact that outcomes may be related to family size. In a simulation study, we show that different multigenerational designs lead to estimates of different exposure associations with distinct scientific interpretations. Nevertheless, target associations can be recovered by incorporating (possibly) auxiliary information, and we provide insights into choosing an appropriate target association. Finally, we identify areas requiring further methodological development.
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Delgado-Angulo EK, Alshehri R, Scambler S, Bernabé E. Is grandparents' social class associated with adult grandchildren's oral health? Analysis of two British cohorts. Community Dent Oral Epidemiol 2020; 48:402-408. [PMID: 32463137 DOI: 10.1111/cdoe.12545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES No studies have taken a multigenerational approach to the study of oral health inequalities. This study investigated whether grandparents' social class was associated with adult grandchildren's oral health. METHODS Data from the 1958 National Child and Development Study (NCDS) and the 1970 British Cohort Study (BCS) were analysed. Cohort members' occupational social class and persistent trouble with mouth, teeth or gums in the past 12 months were reported at ages 33 years in the NCDS and 26 years in the BCS. Information on grandparents' and parents' social class was reported by the cohort members' mothers during childhood. The association between grandparents' social class and cohort members' report of persistent trouble with mouth, teeth or gums was tested in marginal structural models (MSMs). RESULTS Data from 9853 NCDS and 6487 BCS participants were analysed. Grandparents' social class was not associated with cohort members' report of persistent trouble with teeth, gums or mouth in the NCDS sample (odds ratios of 1.25 [95% Confidence Interval: 0.95-1.65] for social class IV/V and 1.12 [95% CI: 0.76-1.64] for social class IIINM-M relative to social class I/II) or the BCS sample (odds ratios of 0.98 [95% CI: 0.68-1.43] for social class IV/V and 0.88 [95% CI: 0.67-1.16] for social class IIINM-M relative to social class I/II). CONCLUSION This study provided no support for an independent association between grandparents' social class and adult grandchildren's oral health.
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Affiliation(s)
- Elsa K Delgado-Angulo
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Facultad de Estomatología Roberto Beltrán Neira, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Reem Alshehri
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Sasha Scambler
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Doku DT, Acacio-Claro PJ, Koivusilta L, Rimpelä A. Social determinants of adolescent smoking over three generations. Scand J Public Health 2019; 48:646-656. [PMID: 30973093 DOI: 10.1177/1403494819839854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: We studied how multigenerational socioeconomic circumstances influence adolescents' smoking. Previous studies have shown that low academic achievement as well as parents' low socioeconomic circumstances are associated with adolescents' smoking, but there are few studies on grandparents' influence on their grandchildren's smoking. For the chain of three generations, we hypothesised that high socioeconomic circumstances of both parents and grandparents decrease the probability of smoking and adolescents' own education and circumstances contribute to this association. We further investigated the role of intergenerational social mobility. Method: Survey data from 1979 to 1997 on 12- to 18-year-old Finns (n=54,487) were linked with 1970-2009 registry-based data of their grandparents, parents and themselves. Socioeconomic circumstances among parents and grandparents were measured by socioeconomic status, education and material resources and among adolescents by academic achievement, educational orientation, family structure and parental smoking. Logistic regression analysis was used to study the associations. Results: Associations of adolescent smoking with grandparental socioeconomic circumstances were weak and mediated through parental circumstances. Parental smoking and divorce and living in a non-intact family increased smoking. Adolescents' low academic achievement and orientation to low education level were the most important predictors of smoking. Upward intergenerational social mobility between fathers and children decreased the risk of smoking, whereas downward mobility increased it. Conclusions: The influence of grandparents' low socioeconomic circumstances on grandchildren's smoking is mediated through parents' socioeconomic circumstances. Low academic achievement in adolescence is a strong predictor of smoking and adolescents orient towards the group of their future education level, not that of their parents.
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Affiliation(s)
- David Teye Doku
- Tampere University, Finland.,University of Cape Coast, Ghana
| | | | | | - Arja Rimpelä
- Tampere University, Finland.,Tampere University Hospital, Finland
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7
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Multigenerational socioeconomic attainments and mortality among older men: An adjacent generations approach. DEMOGRAPHIC RESEARCH 2018. [DOI: 10.4054/demres.2018.39.26] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Wolfe JD, Bauldry S, Hardy MA, Pavalko EK. Multigenerational Attainments, Race, and Mortality Risk among Silent Generation Women. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2018; 59:335-351. [PMID: 29949716 DOI: 10.1177/0022146518784596] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study extends health disparities research by examining racial differences in the relationships between multigenerational attainments and mortality risk among "Silent Generation" women. An emerging literature suggests that the socioeconomic attainments of adjacent generations, one's parents and adult children, provide an array of life-extending resources in old age. Prior research, however, has demonstrated neither how multigenerational resources are implicated in women's longevity nor how racial disparities faced by Silent Generation women may differentially structure the relationships between socioeconomic attainments and mortality. With data from the National Longitudinal Survey of Mature Women, the analysis provided evidence of a three-generation model in which parent occupation, family wealth, and adult child education were independently associated with women's mortality. Although we found evidence of racial differences in the associations between parental, personal, and spousal education and mortality risk, the education of adult children was a robust predictor of survival for black and white women.
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Affiliation(s)
- Joseph D Wolfe
- 1 University of Alabama at Birmingham, Birmingham, AL, USA
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Bråbäck L, Lodge CJ, Lowe AJ, Dharmage SC, Olsson D, Forsberg B. Childhood asthma and smoking exposures before conception-A three-generational cohort study. Pediatr Allergy Immunol 2018. [PMID: 29512835 DOI: 10.1111/pai.12883] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Some human and animal studies have recently shown that maternal grandmother's smoking during pregnancy increases the risk of asthma in the grandchildren. We have investigated whether sex of the exposed parent and/or grandchild modifies the association between grandmaternal smoking and grandchild asthma. METHODS We formed a cohort study based on linkage of national registries with prospectively collected data over three generations. Smoking habits in early pregnancy were registered since 1982 and purchases of prescribed medication since 2005. In all, 10 329 children born since 2005 had information on maternal and grandmaternal smoking on both sides and were followed from birth up to 6 years of age. Ages when medication was purchased were used to classify the cohort into never, early transient (0-3 years), early persistent (0-3 and 4-6 years), and late-onset (4-6 years) phenotypes of childhood asthma. RESULTS Maternal grandmother's smoking was associated with an increased odds of early persistent asthma after adjustment for maternal smoking and other confounders (odds ratio 1.29, 95% confidence interval 1.10-1.51). Grandchild sex did not modify the association. Paternal grandmother's smoking was not associated with any of the asthma phenotypes. CONCLUSION Maternal but not paternal exposure to nicotine before conception was related to an increased risk of early persistent childhood asthma, but not other asthma phenotypes. Our findings are possibly consistent with a sex-specific mode of epigenetic transfer.
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Affiliation(s)
- Lennart Bråbäck
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Caroline J Lodge
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
| | - Adrian J Lowe
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia
| | - David Olsson
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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10
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Child and Adult Socioeconomic Status and the Cortisol Response to Acute Stress: Evidence From the Multi-Ethnic Study of Atherosclerosis. Psychosom Med 2018; 80:184-192. [PMID: 29215456 PMCID: PMC5794563 DOI: 10.1097/psy.0000000000000543] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE A long-hypothesized pathway through which low socioeconomic status (SES) harms health is through dysregulation of the physiologic stress response systems. No previous studies have tested this hypothesis by investigating cortisol reactivity and recovery to acute stress in relation to SES at different times in the life course in adults. Alteration of the cortisol response to an acute stressor could signal dysregulation of the hypothalamic-pituitary-adrenal axis and has been associated with chronic illness. METHODS We used data on 997 adults 54 years or older from a multiethnic, multisite United States study to examine associations between life course SES and cortisol response to a laboratory stress challenge. Informed by life course theory, we hypothesized that lower child and adult SES would be associated with lower reactivity (i.e., smaller increase in cortisol) and a slower recovery rate (i.e., slower rate of decline in cortisol after the challenge). RESULTS In demographics-adjusted multilevel piecewise linear regression models, low child and adult SES were associated with a 19% (95% CI = 4%-50%) and 27% (7%-55%) slower recovery rate compared with high child and adult SES, respectively. Compared with participants with stable high SES, those with stable low SES had a 48% (16%-70%) slower recovery rate. Differences in reactivity by SES were small. CONCLUSIONS Our results support the hypothesis that low SES throughout life affects the hypothalamic-pituitary-adrenal axis and in turn the ability to recover from exposure to acute stressors. This mechanism can help explain how socioeconomic disparities contribute to disparities in chronic disease.
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11
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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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Torres JM, Young MED. A life-course perspective on legal status stratification and health. SSM Popul Health 2016; 2:141-148. [PMID: 29349135 PMCID: PMC5757916 DOI: 10.1016/j.ssmph.2016.02.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 02/21/2016] [Accepted: 02/22/2016] [Indexed: 12/14/2022] Open
Abstract
Scholars have expressed growing interest in the relationship between legal status stratification and health. Nevertheless, the extant research often lacks theoretical underpinnings. We propose the life-course perspective as a theoretical lens with which to understand relationships between legal status stratification and health outcomes. In particular, the life-course perspective guides researchers׳ attention to historical contexts that have produced differential social, political, and economic outcomes for immigrants based on legal status, and to the potentially long-term and intergenerational relationships between legal status stratification and health. We review four key dimensions of the life-course perspective and make recommendations for future directions in public health research on legal status and health.
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Affiliation(s)
- Jacqueline M Torres
- RWJF Health & Society Scholars Program, University of California, San Francisco & University of California, Berkeley and UCSF Center for Health & Community, 3333 California Street, Suite 465, San Francisco, CA 94118, USA
| | - Maria-Elena D Young
- Department of Community Health Sciences, Fielding School of Public Health, University of California, 650 Charles E. Young Drive South, 36-071 CHS, Los Angeles, CA, 90095-1772, USA
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Kennedy-Hendricks A, Schwartz H, Thornton RJ, Griffin BA, Green HD, Kennedy DP, Burkhauser S, Pollack CE. Intergenerational Social Networks and Health Behaviors Among Children Living in Public Housing. Am J Public Health 2015; 105:2291-7. [PMID: 26378821 PMCID: PMC4605160 DOI: 10.2105/ajph.2015.302663] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES In a survey of families living in public housing, we investigated whether caretakers' social networks are linked with children's health status. METHODS In 2011, 209 children and their caretakers living in public housing in suburban Montgomery County, Maryland, were surveyed regarding their health and social networks. We used logistic regression models to examine the associations between the perceived health composition of caretaker social networks and corresponding child health characteristics (e.g., exercise, diet). RESULTS With each 10% increase in the proportion of the caretaker's social network that exercised regularly, the child's odds of exercising increased by 34% (adjusted odds ratio = 1.34; 95% confidence interval = 1.07, 1.69) after the caretaker's own exercise behavior and the composition of the child's peer network had been taken into account. Although children's overweight or obese status was associated with caretakers' social networks, the results were no longer significant after adjustment for caretakers' own weight status. CONCLUSIONS We found that caretaker social networks are independently associated with certain aspects of child health, suggesting the importance of the broader social environment for low-income children's health.
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Affiliation(s)
- Alene Kennedy-Hendricks
- At the time of the study, Alene Kennedy-Hendricks was a PhD candidate at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Heather Schwartz, Beth Ann Griffin, Harold D. Green Jr, David P. Kennedy, and Susan Burkhauser are with the RAND Corporation, Santa Monica, CA. Rachel Johnson Thornton and Craig Evan Pollack are with the School of Medicine, Johns Hopkins University
| | - Heather Schwartz
- At the time of the study, Alene Kennedy-Hendricks was a PhD candidate at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Heather Schwartz, Beth Ann Griffin, Harold D. Green Jr, David P. Kennedy, and Susan Burkhauser are with the RAND Corporation, Santa Monica, CA. Rachel Johnson Thornton and Craig Evan Pollack are with the School of Medicine, Johns Hopkins University
| | - Rachel Johnson Thornton
- At the time of the study, Alene Kennedy-Hendricks was a PhD candidate at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Heather Schwartz, Beth Ann Griffin, Harold D. Green Jr, David P. Kennedy, and Susan Burkhauser are with the RAND Corporation, Santa Monica, CA. Rachel Johnson Thornton and Craig Evan Pollack are with the School of Medicine, Johns Hopkins University
| | - Beth Ann Griffin
- At the time of the study, Alene Kennedy-Hendricks was a PhD candidate at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Heather Schwartz, Beth Ann Griffin, Harold D. Green Jr, David P. Kennedy, and Susan Burkhauser are with the RAND Corporation, Santa Monica, CA. Rachel Johnson Thornton and Craig Evan Pollack are with the School of Medicine, Johns Hopkins University
| | - Harold D Green
- At the time of the study, Alene Kennedy-Hendricks was a PhD candidate at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Heather Schwartz, Beth Ann Griffin, Harold D. Green Jr, David P. Kennedy, and Susan Burkhauser are with the RAND Corporation, Santa Monica, CA. Rachel Johnson Thornton and Craig Evan Pollack are with the School of Medicine, Johns Hopkins University
| | - David P Kennedy
- At the time of the study, Alene Kennedy-Hendricks was a PhD candidate at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Heather Schwartz, Beth Ann Griffin, Harold D. Green Jr, David P. Kennedy, and Susan Burkhauser are with the RAND Corporation, Santa Monica, CA. Rachel Johnson Thornton and Craig Evan Pollack are with the School of Medicine, Johns Hopkins University
| | - Susan Burkhauser
- At the time of the study, Alene Kennedy-Hendricks was a PhD candidate at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Heather Schwartz, Beth Ann Griffin, Harold D. Green Jr, David P. Kennedy, and Susan Burkhauser are with the RAND Corporation, Santa Monica, CA. Rachel Johnson Thornton and Craig Evan Pollack are with the School of Medicine, Johns Hopkins University
| | - Craig Evan Pollack
- At the time of the study, Alene Kennedy-Hendricks was a PhD candidate at the Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Heather Schwartz, Beth Ann Griffin, Harold D. Green Jr, David P. Kennedy, and Susan Burkhauser are with the RAND Corporation, Santa Monica, CA. Rachel Johnson Thornton and Craig Evan Pollack are with the School of Medicine, Johns Hopkins University
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14
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Huang JY, Gavin AR, Richardson TS, Rowhani-Rahbar A, Siscovick DS, Enquobahrie DA. Huang et al. Respond to "Multigenerational Social Determinants of Health". Am J Epidemiol 2015; 182:583-4. [PMID: 26283089 DOI: 10.1093/aje/kwv147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 05/28/2015] [Indexed: 11/12/2022] Open
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15
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Cohen AK, Lê-Scherban F. Invited Commentary: Multigenerational Social Determinants of Health—Opportunities and Challenges. Am J Epidemiol 2015; 182:579-82. [PMID: 26283087 DOI: 10.1093/aje/kwv145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 05/07/2015] [Indexed: 11/13/2022] Open
Abstract
An emerging area of social epidemiology examines the relationship between grandparental education and grandchild health. In an accompanying article, Huang et al. (Am J Epidemiol. 2015;182(7):568-578) join the small but growing body of research on this topic. It is useful to contextualize Huang et al.'s work within the much larger body of research examining relationships between education and health within a single generation or across 2 generations. These investigators have generally concluded that higher educational attainment is robustly associated with better health. There are many potential mechanisms through which education and other social exposures may affect health outcomes in a single generation or across generations, and estimating direct and indirect effects can be helpful for assessing specific mechanisms. Researchers conducting multigenerational analyses are faced with several challenges, including limited availability of data for some measures (e.g., educational attainment, and sometimes for 1 grandparent only), limited age ranges of participants, disparate social and political contexts in which study participants of different generations have lived, and patterns of social class reproduction. We encourage future researchers to weave together the careful analytical considerations illustrated by Huang et al. with a rich understanding of the social context for each of the generations studied to help overcome these challenges and advance our understanding of multigenerational social determinants of health.
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Huang JY, Gavin AR, Richardson TS, Rowhani-Rahbar A, Siscovick DS, Enquobahrie DA. Are Early-Life Socioeconomic Conditions Directly Related to Birth Outcomes? Grandmaternal Education, Grandchild Birth Weight, and Associated Bias Analyses. Am J Epidemiol 2015; 182:568-78. [PMID: 26283086 DOI: 10.1093/aje/kwv148] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 03/12/2015] [Indexed: 01/20/2023] Open
Abstract
Grandmaternal education may be related to grandchild birth weight (GBW) through maternal early-life development; however, conventional regression models may be endogenously confounded. Alternative models employing explicit structural assumptions may provide incrementally clearer evidence. We used data from the US National Longitudinal Study of Adolescent to Adult Health (1995-2009; 1,681 mother-child pairs) to estimate "direct effects" of grandmaternal educational level (less than high school, high school diploma or equivalent, or college degree) at the time of the mother's birth on GBW, adjusted for maternal life-course factors: maltreatment as a child, education and income as an adult, prepregnancy overweight, and prenatal smoking. Using conventional and marginal structural model (MSM) approaches, we estimated 54-g (95% confidence interval: -14.0, 122.1) and 87-g (95% confidence interval: 10.9, 162.5) higher GBWs per increase in educational level, respectively. The MSM allowed simultaneous mediation by and adjustment for prepregnancy overweight. Estimates were insensitive to alternate structural assumptions and mediator parameterizations. Bias analysis suggested that a single unmeasured confounder would have to have a strong influence on GBW (approximately 150 g) or be greatly imbalanced across exposure groups (approximately 25%) to completely explain the findings. Coupling an MSM with sensitivity analyses provides some evidence that maternal early-life socioeconomic environment is directly associated with offspring birth weight.
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Chaparro MP, Koupil I. The impact of parental educational trajectories on their adult offspring's overweight/obesity status: a study of three generations of Swedish men and women. Soc Sci Med 2014; 120:199-207. [PMID: 25259658 DOI: 10.1016/j.socscimed.2014.09.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 09/09/2014] [Accepted: 09/11/2014] [Indexed: 01/29/2023]
Abstract
The objective of this study was to investigate the impact of grandparental and parental education and parental educational trajectory on their adult offspring's overweight/obesity. We used register data from the Uppsala Birth Cohort Multigenerational Study, based on a representative cohort born in Sweden 1915-1929 (G1). Our sample included 5122 women and 11,204 men who were grandchildren of G1 (G3), their parents (G2), and grandparents. G3's overweight/obesity (BMI≥25 kg/m2) was based on pre-pregnancy weight/height for women before their first birth (average age=26 years), and measured weight/height at conscription for men (average age=18 years). G1's, G2's, and G3's highest educational attainment was obtained from routine registers and classified as low, intermediate, or high based on respective sample distributions. Parental (G2) educational trajectory was defined as change in education between their own and their highest educated parent (G1), classified into 5 categories: always advantaged (AA), upward trajectory (UT), stable-intermediate (SI), downward trajectory (DT), and always disadvantaged (AD). We used hierarchical gender-stratified logistic regression models adjusted for G3's age, education, year of BMI collection, lineage and G2's year of birth and income. Grandparental and parental education were negatively associated with men's odds of overweight/obesity and parental education affected women's overweight/obesity risk. Furthermore, men and women whose parents belonged to the UT, SI, DT, and AD groups had greater odds of overweight/obesity compared to men and women whose parents belonged to the AA group (adjusted for G3's age, year of BMI collection, lineage, and G2's year of birth). These associations were attenuated when further adjusting for parental income and G3's own education. Socioeconomic inequalities can have long-term consequences and impact the health of future generations. For overweight/obesity in concurrent young cohorts, this inequality is not fully offset by upward educational trajectory in their parent's generation.
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Affiliation(s)
- M P Chaparro
- Centre for Health Equity Studies (CHESS), Stockholm University & Karolinska Institutet, Sveavägen 160, Floor 5, 106 91 Stockholm, Sweden.
| | - Ilona Koupil
- Centre for Health Equity Studies (CHESS), Stockholm University & Karolinska Institutet, Sveavägen 160, Floor 5, 106 91 Stockholm, Sweden.
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