The acceptance of evolution: A developmental view of Generation X in the United States

The public acceptance of evolution remains a contentious issue in the United States. Numerous investigations have used national cross-sectional studies to examine the factors associated with the acceptance or rejection of evolution. This analysis uses a 33-year longitudinal study that followed the same 5000 public-school students from grade 7 through midlife (ages 45-48) and is the first to do so in regard to evolution. A set of structural equation models demonstrate the complexity and changing nature of influences over these three decades. Parents and local influences are strong during the high school years. The combination of post-secondary education and occupational and family choices demonstrate that the 15 years after high school are the switchyards of life.

Reexamining the causes of age patterns in Black-White birth weight disparities: Evidence from U.S. cohorts

Black-White disparities in low birth weight (LBW) rise with maternal age. Why? The "weathering hypothesis" holds that the increasing disparity is due to the accumulation of adverse exposures leading to accelerated aging among Black compared to White mothers. Using US birth certificate data covering millions of births to successive cohorts of US women, this paper finds two sets of results that complicate this theory. Descriptively, I find that Black-White LBW disparities increase with age for some cohorts but not others. More causally, analyses exploiting a plausibly exogenous policy shock show that the effects of reducing adverse exposures were larger for older compared to younger mothers. This evidence points toward an alternative or complementary hypothesis: that LBW risks are more responsive to adverse exposures at older maternal ages than at younger ages. Emphasizing this pathway -- what I call "responsiveness" -- as opposed to accumulation has important implications for both research and policy.

How do life course events affect the accumulation of digital literacy?: Based on qualitative research of 16 medical university teachers of China

The purpose of this article is to examine the level of the accumulation of digital literacy in medical university of China. In this study, we argue that positive life events facilitate the formation of digital literacy. We review the development of research of life course and digital literacy since the 2010. From the perspective of life course theory, this article examines the significant impact of social changes in information technology on the accumulation of digital literacy of 16 medical university teachers, and understands the life course of medical university teachers as a sequence composed of multiple life events. The results show that the accumulation of medical university teachers' digital Literacy includes 4 types: linear accumulation, multi drive accumulation, parallel accumulation, and leading accumulation, of which multi drive accumulation and leading accumulation are the most conducive to the formation of medical university teachers' digital literacy. In addition, our findings reveal that subjective initiative plays an important role in the accumulation of medical university teachers' digital literacy. The accumulation of digital literacy is a dynamic and systematic process of the accumulation of individual life events of medical university teachers. This paper also discusses the relationship between order of life events and career outcomes.

Childhood Adversities and Caregiving for Older Parents: Building Capacity for a Caring Society

OBJECTIVES

This study investigates the relationships between childhood adversities and the provision of informal care for older parents in later life in China.

METHODS

The data came from 4 waves of the China Health and Retirement Longitudinal Study (N = 20,047). Using multilevel logistic regression models, we examined the relationships between adverse experiences in childhood and both the propensity and intensity of caregiving for older parents. Drawing on the regression results, we then estimated the total number of caregivers for older parents in China.

RESULTS

Experiencing 1 additional childhood adversity was associated with a decrease of 8% in the odds of providing informal care (p < .001). The association between childhood adversity and caregiving remained significant after sociodemographic factors and later-life outcomes were controlled for. We estimated that 58.3 million middle-aged adults in China were providing care for parents in 2020. Had people experienced 1 fewer adversity in their childhood, there would have been 2.2 million more caregivers in 2020. Had they experienced 2 fewer adversities, there would have been 3.4 million more caregivers.

DISCUSSION

The factors associated with informal caregiving can be traced back to early-life experiences. To address the shortage of informal care supply, it is crucial to foster a caring culture from the very beginning of human development.

For Whom Does Education Convey Health Benefits? A Two-Generation and Life Course Approach

Scholars of social determinants of health have long been interested in how parent's and own education influence health. However, the differing effects of parent's and own education on health-that is, for what socioeconomic group education conveys health benefits-are relatively less studied. Using multilevel marginal structural models, we estimate the heterogeneous effects of parent's and own education over the life course on two health measures. Our analysis considers both parent's and respondent's pre-education covariates, such as childhood health and socioeconomic conditions. We find that the protective effects of college completion against negative health outcomes are remarkably similar regardless of parent's (measured by father's or mother's) education. Meanwhile, parent's education has a larger effect when the average educational level is low in the population. Our results also reveal distinct life course patterns between health measures. We conclude by discussing the implications of our study for understanding the education-health relationship.

Multimorbid life expectancy across race, socio-economic status, and sex in South Africa

Multimorbidity is increasing globally as populations age. However, it is unclear how long individuals live with multimorbidity and how it varies by social and economic factors. We investigate this in South Africa, whose apartheid history further complicates race, socio-economic, and sex inequalities. We introduce the term 'multimorbid life expectancy' (MMLE) to describe the years lived with multimorbidity. Using data from the South African National Income Dynamics Study (2008-17) and incidence-based multistate Markov modelling, we find that females experience higher MMLE than males (17.3 vs 9.8 years), and this disparity is consistent across all race and education groups. MMLE is highest among Asian/Indian people and the post-secondary educated relative to other groups and lowest among African people. These findings suggest there are associations between structural inequalities and MMLE, highlighting the need for health-system and educational policies to be implemented in a way proportional to each group's level of need.

Social Determinants of Health and College Food Insecurity

In recent years, many students have faced economic hardship and experienced food insecurity, even as universities strive to create more equitable pathways to college. There is a need for a more holistic perspective that addresses the complexity of food insecurity amongst college students. To this end, we examined the relationship between the social determinants of health, including college food insecurity (CoFI) and childhood food insecurity (ChFI), and their relationship with well-being measures. The study sample was a convenience sample that included 372 students at a public university who responded to an online survey in fall 2021. Students were asked to report their food security status in the previous 30 days. We used the following analytical strategies: chi-square tests to determine differences between food secure (FS) and food insecure (FI) students; binary logistic regression of CoFI on student demographics and ChFI; and ordinal or binary logistic regression for well-being measures. Black students, off-campus students, first-generation students, in-state students, and humanities/behavioral/social/health sciences majors were more likely to report CoFI. FI students were more likely to have experienced ChFI and to have lower scores on all well-being measures. ChFI was associated with four well-being measures and its effects were mediated by CoFI. College student health initiatives would benefit from accounting for SDOH, including ChFI experiences and its subsequent cumulative disadvantages experienced during college.

Race/Ethnicity, Nativity, and Gender Disparities in Unmet Care Needs Among Older Adults in the United States

BACKGROUND AND OBJECTIVES

Although disparities in disability and the unequal distribution of care resources are widely discussed in the literature, there has been less research on disparities in experiencing unmet care needs among older adults. This study aims to investigate how unmet care needs are unevenly distributed across social groups with various intersecting identities, such as race/ethnicity, nativity, and gender, although considering their care needs and care networks, drawing on the conceptual framework of the pathway to unmet needs.

RESEARCH DESIGN AND METHODS

The data for this study came from the National Health and Aging Trends Study (2011-2018), and the study sample consisted of 7,061 Medicare beneficiaries who needed assistance with daily activities. Questions about unmet care needs were in the form of consequences related to difficulty or lack of help with daily activities. Mixed-effects negative binomial regression models were used to predict rates of unmet needs.

RESULTS

Older adults of color, especially women, experienced higher rates of unmet care needs compared with their White and male counterparts. Although Black-White and gender differences in unmet needs were mostly explained by unequal exposures to care needs and differential care networks, Hispanic women and foreign-born Hispanic men were still at a disadvantage even after adjusting for these covariates.

DISCUSSION AND IMPLICATIONS

These results emphasize the importance of adopting an intersectional approach to enhance the quality of long-term services and support for older adults facing social disadvantages.

When money and mental health problems pile up: The reciprocal relationship between income and psychological distress

Background

Longitudinal studies suggest that socioeconomic status (SES) and mental health have a bidirectional relationship such that SES declines lead to a deterioration of mental health (social causation), while worsening mental health leads to SES declines (social drift). However, the dynamic relationship between income and psychological distress has not been sufficiently studied.

Methods

We use cross-lagged panel models with unit fixed effects (FE-CLPM) and data from a five-wave representative panel (n = 3103) of working-age (18-64) New York City adults. Yearly measures include individual earnings, family income (income-to-needs), and psychological distress. We also examine effects by age, gender, education, and racial/ethnic identification.

Results

We find significant bidirectional effects between earnings and distress. Increases in past-year individual earnings decrease past-month psychological distress (social causation effect [SCE], standardized β= -0.07) and increases in psychological distress reduce next-year individual earnings (social drift effect [SDE], β= -0.03). Family income and distress only have a unidirectional relationship from past-year family income to distress (SCE, β= -.03). Strongest evidence of bidirectional effects between earnings and distress is for prime working-age individuals (SCE, β= -0.1; SDE, β= -0.03), those with less than bachelor's degrees (SCE, β= -0.08; SDE, β= -0.05), and Hispanics (SCE, β= -0.06; SDE, β= -0.08). We also find evidence of reciprocal effects between family income and distress for women (SCE, β= -0.03; SDE, β= -0.05), and Hispanics (SDE, β= -0.04; SDE, β= -0.08).

Conclusions

Individual earnings, which are labor market indicators, may be stronger social determinants of mental health than family income. However, important differences in social causation and social drift effects exist across groups by age, education, gender, and racial/ethnic identities. Future research should examine the types of policies that may buffer the mental health impact of negative income shocks and the declines in income associated with worsening mental health, especially among the most vulnerable.

Mattering and Self-Esteem as Bulwarks Against the Consequences of Financial Strain for Loneliness in Later Life: Differentiating Between- and Within-Person Processes

Financial strain likely constitutes a principal risk for loneliness in later-life, but a strong sense of mattering and self-esteem may mitigate these consequences by both offsetting and buffering the influence of financial strain. We test these arguments using data from a national longitudinal survey of older adults gathered between 2021 and 2022 (N = 2384), as nations emerged from the COVID-19 pandemic. Application of a within-between modelling strategy facilitates differentiation of inter-individual (i.e., between-person) and intra-individual (i.e., within-person) factors. Between-person financial strain is associated with greater loneliness, but within- and between-person mattering and self-esteem offset this association by forestalling loneliness. Between-person mattering buffers between-person financial strain, but between-person self-esteem buffers within-person financial strain. Consequently, within-person financial strain is associated with greater loneliness only at low levels of between-person self-esteem. In summary, accruing a strong sense of worth contributes to protecting older adults from the adverse consequences of financial strain for loneliness.

Older mothers and their difficult adult children: a life course exploration

Adult child to parent violence is a growing international social problem that needs to be better understood to develop clinical interventions. An exploratory study on the antecedents of early life adversity on adult child to parent violence/elder mistreatment was carried out using secondary analysis. Directed content analysis was used based on life course theory with a data set of older mothers all > 57 years old (J. R. Smith 2021, 2022). Measurement of instances of child abuse, domestic violence, and birth trauma among abused older mothers was conducted. All the older women had reported being negatively affected by their adult children's problems and 56% reported being physically attacked. A case example is presented to illustrate how repeated incidents of abuse or neglect in early life might explain an older woman's inability to take actions for her own safety.

Nonpharmacological interventions in dementia and diversity of samples: A scoping review

BACKGROUND

A public health priority is the increasing number of people with dementia (PwD), and nonpharmacological interventions (NPIs) might offer support. We sought to synthesize types of NPIs tested among PwD and explore sample characteristics.

METHODS

This study was a scoping literature review. Eligible articles were identified using the search terms "nonpharmacological intervention" and "dementia".

RESULTS

36 articles were included. Psychosocial NPIs were implemented the most (n=24) and music-based interventions were found to be the most effective. Gender, race, and ethnicity were not consistently reported (n=30, n=24, and n=6, respectively). White PwD had higher representation, with only 62.5% of studies including Black participants and 25% including Hispanic/Latino participants. Women made up a majority (>50%) of the sample in a greater number of studies (n=20).

CONCLUSION

Findings suggest that future studies need to be intentional about improving diversity of the sample, particularly with respect to including persons identifying as Black or Hispanic/Latino.

Income-Related Inequalities in Physical and Cognitive Health Domains Over the Later Life Course: Longitudinal Evidence From the U.S. (1992-2016)

This study aims to investigate changes in the income-health gradient over the later life course. We test the age-as-leveler, the cumulative advantage/disadvantage, and the persistent inequality pattern for physical and cognitive health domains, and analyze whether these patterns are gendered. We used HRS data (1992-2016) and Poisson growth curve models to predict multimorbidity (33,860 participants) as an indicator of physical health and memory (25,291 participants) as an indicator of cognitive health. We disentangled the within-participant from the between-participant effects. For multimorbidity, the income-health gradient weakened as individuals aged; whereas for memory, the income-health gradient strengthened as individuals aged. The cumulative advantage/disadvantage of higher/lower income on memory may be more pronounced among women than men. Findings were confirmed by sensitivity analyses. Findings suggest that the support for the age-as-leveler or cumulative advantage/disadvantage pattern may depend on health domains and the effect strength may depend on gender.

Mediators of Functional Disability at Mid- and Late-Life

As the number and proportion of older adults living in the U.S. increases, growing evidence shows that people are entering late life with more functional disability than in previous generations. Using data from the 2020 Behavioral Risk Factor Surveillance System survey, we sought to identify the contributions of demographic variables and health conditions to functional disability. Specifically, we tested the associations among age, sex, race, chronic physical health conditions, depression, and functional ability among 243,693 adults, ages 45 years and older. Model testing, implemented in AMOS 29.0.0, resulted in an acceptable fit of the model to the data, Χ2 (DF = 18, N = 243,693) = 19,512.64, p < .001; CFI = 0.909; TLI = 0.774; RMSEA = 0.066; R 2 Function = .267. The findings from the present study replicate previous research that age, sex, and racial background differences influence functional disability. We extend the literature to examine physical and emotional health as potential pathways to intervene in midlife.

Links between life-course SES and frailty trajectory moderated by community environment resources: Person-environment Fit perspective

INTRODUCTION

Drawing from the life course and person-environment fit perspectives, this study examined whether life-course SES disadvantages during childhood, adulthood and old- age influence frailty development in late- life and how community environment resources moderated the association between life-course SES disadvantages and frailty trajectories over a seven-year follow-up period.

METHODS

Data from 11,675 participants aged ≥ 50 years at baseline who participated in the four waves (2011-2018) of the China Health and Retirement Longitudinal Survey (CHARLS) were used. Life-course SES disadvantages were self-reported, and community environment resources (basic infrastructure and voluntary organizations) were ascertained from informed officials in the community. Frailty development was measured at each wave by the Frailty Index (FI) based on 39 potential deficits. Multilevel growth modeling was used to examine the interactive effect of life-course SES disadvantages and community environment resources on frailty development.

RESULTS

Life-course SES disadvantage exerted cumulatively negative effects on frailty trajectory, and individuals with SES disadvantages in two or three life stages reported higher initial levels of and faster increases in frailty scores. Community environmental resources (basic infrastructure and voluntary organizations) had a protective effect on frailty development and buffered the negative effects of SES vulnerability experiences accumulated over the life course. Community basic infrastructure resources played an important role in slowing the progression of frailty for individuals with cumulative SES disadvantage and downward mobility.

DISCUSSION

Our findings provided new evidence of person-environmental docility among older adults, documenting the role of community resources in buffering SES disparities in health during later-life.

Impact of adverse childhood experiences on life expectancy with depression in the U.K. population: The mitigating role of educational attainment

BACKGROUND

Adverse childhood experiences (ACEs) are associated with depression in later life.

OBJECTIVE

This study aimed to measure the impact of ACEs on life expectancy with depression (DLE) and to assess how educational attainment affected expectations.

PARTICIPANTS AND SETTING

The study used data on 5597 participants from the English Longitudinal Study of Aging (2006-2013).

METHODS

Depression was assessed through the eight-item short version of the Centre for Epidemiologic Studies Depression. We used discrete-multistate life table models to estimate total life expectancy and life expectancy with depression.

RESULTS

Older adults with ACEs had longer DLE and a higher proportion of remaining life with depression compared with those without ACEs. For example, men aged 60 years with ACEs could expect to live 5.2 (95 % confidence interval (CI): 4.2, 6.2) years with depression compared with 2.8 (95 % CI: 2.3, 3.3) years for men without ACEs. Women aged 60 years who reported ACEs could expect to live 9.4 (95 % CI: 7.6, 11.1) years with depression compared with 6.0 (95 % CI: 5.1, 7.0) years for women without ACEs. With a high level of educational attainment, older adults from younger cohorts with ACEs lived fewer depression years and spent a higher proportion of their life being free of depression than adults with ACEs and had a low level of educational attainment.

CONCLUSION

Our results indicated that ACEs may increase years of life with depression among U.K. adults. Meanwhile, high educational attainment could mitigate the mental health burden associated with ACEs.

Education and age trajectories of chronic conditions: Are tests of the cumulative advantage and disadvantage hypothesis biased by underreporting?

OBJECTIVE

This study examined the impact of underreporting on tests of the cumulative advantage and disadvantage hypothesis (CAD), which predicts age-related increases in health disparities between individuals with higher and lower education.

METHODS

Using the English Longitudinal Study of Ageing (ELSA), we identified underreporting by comparing self-reported hypertension and diabetes with biomedically measured hypertension (systolic blood pressure≥140 mm Hg and/or diastolic blood pressure≥90 mm Hg) and diabetes (fasting glucose level≥7 mmol/l and/or HbA1c≥6.5%). In a sample of 11,859 respondents aged 50 to 85 (54% women, 97% White), we assessed the associations between underreporting and the main analytic constructs in tests of the CAD (education, age, sex, and cohort).

RESULTS

The results showed that self-reported measures underestimated the prevalence of hypertension and diabetes. Underreporting showed weak to moderate associations with the main constructs in tests of the CAD, being more pronounced in individuals with lower education, in older age, in more recent cohorts, and among men. When correcting for underreporting using biomedical measures, the overall prevalence of hypertension and diabetes increased substantially, but education differences in age trajectories of both conditions remained similar.

CONCLUSIONS

Underreporting affected conclusions about the prevalence of hypertension and diabetes, but it did not affect conclusions about the CAD hypothesis for either condition.

Childhood abuse and opioid prescription use in adulthood: Differences between non-Hispanic Whites and non-Hispanic Blacks in the United States

Despite the rapid rise in opioid prescription medication usage, little research has examined the role of early life adversity, such as childhood abuse, particularly in the context of race, in opioid prescription usage in adulthood. Guided by the life course perspective, the current study investigates whether experiencing childhood abuse increases the risk of opioid prescription use in adulthood and whether this association varies by race. Data were sourced from the second wave of the Midlife in the United States (MIDUS) study (2004-2005). The analytic sample consisted of two groups: non-Hispanic Whites (n = 714) and non-Hispanic Blacks (n = 151). Opioid prescription use was identified from the participants' medication list using the MULTUM Lexicon Drug Database Classification System. Three types of childhood abuse-emotional, physical, and sexual-were assessed via summary scales derived from the Childhood Trauma Questionnaire. The results indicate a significant interaction between childhood physical abuse and race. Among non-Hispanic Whites, higher exposure to physical abuse during childhood was associated with greater odds of opioid prescription use in adulthood, even after adjusting for chronic pain, physical and mental health, and sociodemographic characteristics. However, the association between childhood physical abuse and opioid prescription use in adulthood was non-significant among non-Hispanic Black individuals. These findings underscore the long-term adverse health effects of physical abuse in childhood, particularly for non-Hispanic Whites, and suggest support for developing and implementing tailored intervention strategies.

Neighborhood Social Cohesion and Loneliness in Mid- and Later Life: Are Benefits Contingent on Race/Ethnicity or Neighborhood Disorder?

OBJECTIVES

Connections between social integration and health throughout the life span are well established, including at the neighborhood level and among older adults. Less explored is how pathways between neighborhood social cohesion and well-being may differ by race/ethnicity or by neighborhood disorder. This study investigates whether perceived neighborhood social cohesion is associated with loneliness in adults aged 50 and older, and whether this association is moderated by race/ethnicity or perceived neighborhood disorder.

METHODS

We used pooled cross-sectional data from the 2016 and 2018 waves of the Health and Retirement Study and respondents to the Leave-behind Questionnaire age 50 and older, living in the community (N = 10,713). Data were analyzed using multivariate ordinary least squares regression.

RESULTS

Perceived social cohesion was negatively associated with loneliness (B = -0.13, p < .001); however, this effect was strongest among White respondents, and significantly weaker for respondents who were Black (B = 0.02, p < .05), Hispanic (B = 0.03, p < .05), or of another race/ethnicity (B = 0.03, p < .05). Further, neighborhood disorder moderated the association between social cohesion and loneliness (B = 0.02, p < .001), reducing the strength of relationship for those in areas of high disorder. Inclusion of this interaction also attenuated the interaction between neighborhood cohesion and race for Black older adults.

DISCUSSION

Findings show that neighborhood social cohesion matters for midlife and older adults' loneliness, but that this relationship varies by race/ethnicity and neighborhood disorder. As such, neighborhood racial/ethnic makeup and both social and objective neighborhood characteristics should be considered when designing interventions to reduce loneliness.

Evolution of the income-related gap in health with old age: evidence from 20 countries in European and Chinese panel datasets

Some studies show that the protective effect of higher income on health weakens with old age (age-as-leveller pattern), whereas others show that it strengthens with old age (cumulative advantage/disadvantage pattern). Many existing studies are limited in that they use single-country and/or single-timepoint designs. To overcome these limitations and better understand how the income-health gradient evolves in older age, we used cross-national and longitudinal data of the Survey of Health, Ageing and Retirement in Europe (2004-2019, N = 73,407) and the China Health and Retirement Longitudinal Study (2011-2018, N = 10,067). We operationalised health using multimorbidity and three alternative indicators (functional disability, mobility disability, and memory). We performed Poisson growth curve modelling to capture the between-participant effects of age and the within-participant effects of aging. We obtained three consistent and robust findings for Europe (patterns were observed in most countries) and China. First, the protective effect of higher income on multimorbidity, functional disability, and mobility disability was weaker for older than for younger adults (between-participant age-as-leveller pattern). Second, only the protective effect of higher income on mobility disability weakened over the later life course (within-participant age-as-leveller pattern). Third, the protective effect of higher income on memory was stronger for older than for younger adults and strengthened over the later life course (between-participant and within-participant cumulative advantage/disadvantage pattern). Longitudinal data, growth curve modelling distinguishing the between-participant from within-participant effect, and adjustments for potential confounders based on the hypothesised causal structure enabled us to better navigate the landscape of causal inference. Findings suggest that the income-related gap in physical health but not in cognitive health narrows in old age for both Europe and China.

Associations between campus climate perceptions and food insecurity among undergraduates at a public university

Objective:Food-insecure college students have expressed frustration toward their academic institution for failing to meet students' needs. However, it is unclear whether campus climate perceptions are related to food insecurity status. We examined the association between campus climate surrounding health and food insecurity status among college students.Participants:Participants were undergraduate students (n = 1378) enrolled at a public university.Methods:We used secondary data from the American College Health Association-National College Health Assessment II (ACHA-NCHA-II) with campus-specific measures of campus climate and food insecurity status.Results:Findings showed that students with less favorable views of campus climate were between 1.85 and 1.74 times more likely to be food insecure, even after adjusting for demographics and financial hardship.Conclusions:Future research is needed to better understand how students' campus climate perceptions can inform programs that effectively address food insecurity on college campuses.

Early socioeconomic status, social mobility and cognitive trajectories in later life: A life course perspective

Using the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018 accompanied by the growth curve model, we examined the association between early socioeconomic status, social mobility, and divergent cognitive trajectories in later life within a society undergoing significant transformation. The study confirmed a positive relationship between socioeconomic status in early life and cognitive ability in later life. However, socioeconomic status in adulthood is associated with better cognitive ability in old age compared to that in childhood. Meanwhile, upward social mobility mitigates the negative correlation between socioeconomic disadvantage in early life and cognitive ability in later life. In addition, the inequality in socioeconomic status at earlier stages resulted in heterogeneous cognitive trajectories, with the double cumulative disadvantage effect resulting from education being particularly noteworthy. Thus, Chinese health policy should focus on the earlier stages of life, actively promoting inclusive family policies and improving the family's role in protecting childhood from an adverse environment. Simultaneously, education and employment fairness should be strengthened to accelerate social mobility and enhance the "Health Repair Mechanism" of the second life course.

Social contexts and cross-national differences in association between adverse childhood experiences and frailty index

Cross-national differences in the health implication of adverse childhood experiences have been documented. The differences may be shaped by macro- and micro-social context. However, previous studies failed to consider the role of micro-level social contexts, where adverse childhood experiences happen, in affecting the cross-national differences. The study aims to estimate the association between adverse childhood experiences and Frailty Index across countries and micro-social contexts, and then reveal how cross-national difference in the association between adverse childhood experiences and Frailty Index were shaped by social contexts. Adulthood information were collected from three waves of the Survey of Health, Ageing and Retirement in Europe in 2010, 2013, and 2015, and the China Health and Retirement Longitudinal Study data from in 2013, 2015 and 2018, respectively. Frailty index was measured based on 35 health measurements. Eleven adversities, including intrafamilial aggression and neglect, family dynamics, and socioeconomic status etc, were extracted from the life history survey of the two datasets, conducted in 2017 and 2014, respectively. Weighted Linear regression models and the smoothing-differencing method were applied. Experiencing three or more adversities was associated with increase in frailty index level in Europe and China. The effect size ranged from 0.015 (95%CI: 0.011-0.019) in China to 0.030 (95%CI: 0.025-0.034) in Germanic countries. Poor parent-child relationship, parental absence/death were ACEs in terms of frail in European countries but not in China. In a context where adversities were moderately likely to happen, the association between experiencing adverse childhood experiences and Frailty Index were greatest. Cross-national differences of adverse childhood experiences effects were most derived from this social context. These findings highlight the importance of micro-social contexts while mitigating early life stress to promote life-course health. Individuals who were moderately likely to experience adversity should be paid special attention in terms of health implication of adverse childhood experiences.

Social exclusion and critical transitions in later life: Trajectories, forms and mechanisms

Unequal ageing patterns are increasingly prevalent within the life courses of heterogeneous older populations. Critical transitions in later life may contribute to these patterns and to more multifaceted deep-rooted forms of social exclusion. Yet despite significant research in this area, knowledge gaps remain regarding the subjective experiences of these transitions, the trajectories and constituent events of these transitions, and the related mechanisms that may drive exclusion. With a focus on lived experience, this article aims to investigate the role of critical life transitions in older age in constructing multidimensional social exclusion. The onset of dementia, bereavement of a significant other, and forced migration are selected as three illustrative transitions in older age. Based on 39 in-depth life-course interviews and life-path analyses, the study sets out to illuminate common features of the transitional process that increases exclusion susceptibility, and the potential commonalities regarding transition-related exclusionary mechanisms. Transition trajectories related to each of the transitions are first described identifying shared exclusionary risk features. Transition-related mechanisms that can generate multidimensional social exclusion are then presented as arising from a transition's nature and character, its structural and management aspects, and its symbolic and normative positioning. Findings are discussed with reference to the international literature and future conceptualisation of social exclusion in later life.

Physical activity's impact on rural older adult health: The multiple mediating effects of education, income, and psychological capital

Introduction

This study aims to explore the influence mechanism of rural older adult health. By examining the mediating roles of education, income, and psychological capital in physical activity's impact on health, this study provides a reference for lifestyle interventions to improve the health level of rural older adults.

Methods

The analysis was conducted on a sample of 1778 rural older adults from CGSS2017, and data were analyzed using PROCESS V4.2 for multiple mediating effects.

Results

The findings indicate that physical activity impacts rural older adult health through multiple mediating pathways. The mediating role includes seven paths, comprising the independent effects of three mediating variables of income, education, and psychological capital, and the chain mediating effects generated together.

Discussion

Based on the influence mechanism of health on rural older adults, optimizing policy focus and developing a precise, interconnected, and sustainable health security system for older adults is necessary. These research results are of practical significance for advancing healthy aging in rural areas.

Ongoing Remote Work, Returning to Working at Work, or in between during COVID-19: What Promotes Subjective Well-Being?

The COVID-19 pandemic precipitated a massive turn to remote work, followed by subsequent shifts for many into hybrid or fully returning to the office. To understand the patterned dynamics of subjective well-being associated with shifting places of work, we conducted a nationally representative panel survey (October 2020 and April 2021) of U.S. employees who worked remotely at some point since the pandemic (N = 1,817). Cluster analysis identified four patterned constellations of well-being based on burnout, work-life conflict, and job and life satisfaction. A total return to office is generally more stressful, leading to significantly lower probabilities of being in the optimal low stress/high satisfaction constellation by Wave 2, especially for men and women without care obligations. Remote and hybrid arrangements have salutary effects; moving to hybrid is especially positive for minority men and less educated men, although it disadvantages White women's well-being.

Urbanization and Cognitive Function Among Middle-Aged and Old Adults in China

OBJECTIVES

Our study examined the effect of urbanization on cognitive function and its possible pathways among Chinese middle-aged and older adults independent of the influence of health-selective migration.

METHODS

Using data from the China Health and Retirement Longitudinal Study, we compared cognitive function among three groups (urbanized-rural residents, rural nonmigrants, and urban nonmigrants). Logistic regression and structural equation models were applied to explore the impact of urbanization on cognitive function and the potential mechanisms.

RESULTS

Compared with the urbanized-rural group, urban nonmigrants had better cognitive function, with a significant coefficient of 1.56 (95% CI: 1.22, 1.89) for global cognition scores and 0.37 (95% CI: 0.22, 0.53) for episodic memory scores. The rural nonmigrants had the worst cognitive function (β = -0.79, 95% CI: -1.04, -0.55) and lower scores of mental intactness (β = -0.65, 95% CI: -0.84, -0.57) and episodic memory (β = -0.14, 95% CI: -0.26, -0.03). The association between urbanization and cognitive function was mainly mediated by income and living conditions among middle-aged and older adults.

DISCUSSION

Rural people who experienced planned urbanization in China had higher cognitive scores than rural non-migrants. Urbanization could thus have a beneficial and cumulative effect on cognitive function. Improvements in living conditions and changes in income are the main drivers behind the relationship. However, urbanization could compensate for the negative impact on cognitive function from disadvantaged early-life conditions, but it cannot completely eliminate the gap between urbanized-rural people and urban nonmigrants.

Linking widowhood and later-life depressive symptoms: Do childhood socioeconomic circumstances matter?

Objectives: Widowhood and adverse childhood socioeconomic circumstances (CSC) have both been linked to increased levels of depressive symptoms in old age. Beyond their independent impact on depressive symptoms, experiencing adverse CSC may also trigger a cascade of cumulative adversity and secondary stressors across the life course that shapes how individuals weather stressful life events later on.Method: We examine whether exposure to adverse CSC moderates the relationship between later-life widowhood and depressive symptoms using data from the Survey of Health, Ageing and Retirement in Europe (2004-2017).Results: Mixed-effects models revealed that both widowhood and adverse CSC were associated with increased levels of depressive symptoms among men and women. Associations between widowhood and depressive symptoms, however, were not moderated by CSC for both genders.Conclusion: Persisting differences in the levels of mental health in response to later-life widowhood did not further widen in the presence of disparities experienced early in the life course. This may reflect the life-altering impact of this age-normative, yet stressful life event across the social strata.

Social Mobility and Sense of Purpose From Midlife to Old Age: Examining the Role of Major Life Events

Purpose in life (PIL) has been linked with numerous health benefits and adaptive aging, yet it diminishes with age, possibly due to loss of social or familial roles through life transitions. Drawing from the longitudinal surveys of the Midlife in the US study (n = 3418), we use time-varying coefficient models to investigate how the trajectory of PIL differs across cumulatively (dis)advantaged, upwardly mobile, and downwardly mobile groups and the role of major life events in shaping these trajectories. We found the upwardly mobile group exhibits higher PIL than the cumulatively disadvantaged and downwardly mobile groups. The consistently disadvantaged group experiences more adverse events at non-normative times. Socioeconomic status disparities in PIL during old age decrease after controlling for life events. We discuss how and why well-being changes and the role of structural and social factors in facilitating or impeding the development or maintenance of PIL over the life course.

Economic inequality in later life and imagination of the future

The personal futures of older adults are continually in mind, motivating goals, desires and plans. People approach the near and long term with differing agentic traits and dispositions, and they face forward, as well, from differing standpoints according to socio-economic position. This is a study of how persons who are economically privileged diverge in their future thought from persons of modest means, asking how income level qualifies the capacity to imagine, and foresee affecting, the future. We draw upon interviews conducted with 42 older, community-dwelling individuals in the Midwestern United States of America, a sample that was partitioned into two groups, one with below-median incomes versus one with incomes above 200 per cent of median. Interviews disclosed various foci of future thought with common contents among the two groups. Three foci, however, confirmed between-group differences in confidence about handling possible material and support needs, and also in enacting idealised norms of retirement. The underlying theme of these foci – financial security, long-term supports and services, and trips and travel – was the perceived affordability of the future. We conclude that there is indeed a material basis for imagination of and proactivity toward the future. When paradigms about later life set expectations that idealise lifestyle choice, consumption and prudential preparation for the future, these are prospects towards which some can reach more readily than others.

Life Course Pathways Into Intergenerational Caregiving

OBJECTIVES

We develop a framework for the analysis of pathways into intergenerational caregiving to older people provided by family members using life course concepts of key turning events in life, cumulative processes, and linked lives within the family realm.

METHODS

Using framework analysis, we analyze semistructured qualitative interviews from a sample of dyads (older cared-for adults and their main family carers comprised of children, children-in-law, and grandchildren) in Austria (N = 24) and Slovenia (N = 52). Data were collected in 2019 through purposive sampling, including dyads from a differentiated socioeconomic background and gender.

RESULTS

The analysis reveals 4 nonexclusive pathways into caregiving. One pathway is associated with single turning events occurring in family or work trajectories of carers that expanded the possibilities for caregiving later in life. A second pathway referred to cumulative processes that later influenced transitions into caregiving, such as personal biographies marked by weak labor market attachment. Another cumulative pathway, exclusive to caregiving, is characterized by continued and sustained exchanges of support within families that cement reciprocal ties that underpin caregiving at later stages. In the fourth pathway, life trajectories of siblings, but also family relationships and conflicts, constrained carers into their role.

DISCUSSION

Decisions regarding caregiving within families can be best understood as processes, linked to developments in other trajectories in carers' lives, as much as to internal family dynamics and relationships. Becoming a carer may be itself the result of intertwined accumulated vulnerabilities, as well as cumulative exchanges within families.

Affective Practices of Diabetes Self-Management Among Older Adults: Cumulative Effects of Childhood Adversity

BACKGROUND AND OBJECTIVES

A strong correlation exists between Type 2 diabetes mellitus and adverse childhood experiences. How adverse childhood experiences inform later-life diabetes management is less understood. This article examines diabetes management from the perspective of affective practice to explore the lingering impact of trauma biographies in diabetes management.

RESEARCH DESIGN AND METHODS

This secondary narrative analysis of 15 in-depth interviews with community-dwelling older adults with diabetes (subsample of the Subjective Experiences of Diabetes Study) focuses on the ways their reported childhood adversity affects perceptions of and responses to diabetes self-management.

RESULTS

The experiences of adversity in childhood accumulate, throughout the life course, in the affective practices informing diabetes self-management, from blood glucose testing, to food consumption, to the emotions invested in body size. We identify 3 thematic areas that emerged across participants: (a) undermining self-worth, (b) (over)eating and food as comfort, and (c) weight and body size.

DISCUSSION AND IMPLICATIONS

Our findings highlight affective practices as a mechanism through which adverse events accumulate and shape well-being over the life course. This analysis also suggests the potential for (de)accumulation of affective practices to improve diabetes management. The findings support recent calls for trauma-informed clinical care.

Friendship in Later Life: Thirty Years of Progress and Inequalities

Studies examining the impact of social change on individual development and aging postulate the growing importance of flexible relationships, such as friendship. Although friendship is well known as a factor of well-being in later life, the prevalence of friendship in older adult networks and its unequal distribution has been examined only in few studies. Through secondary data analysis of two cross-sectional surveys carried out in Switzerland in 1979 and 2011, respectively, the increasing presence of close friends was confirmed. Our results show that this trend was part of a broader lifestyle change after retirement, with increasing social engagements. However, this trend does not include a general decrease in social inequalities in friendship opportunities. Overall, friendship increase among older adults has contributed to a polarization of living conditions, with a majority of active, healthy persons contrasting with a minority of individuals who accumulate penalties.

Rural/urban dwelling across the life-course and late-life cognitive ability in Mexico

BACKGROUND

Urban advantages in older adults' cognitive function have been observed. Less is known about early-life urban dwelling and late-life cognition. We evaluate how rural/urban dwelling throughout life and rural to urban shifts in life relate with cognition in Mexico, a country experiencing aging and urbanization.

METHODS

Data came from the 2003 and 2012 Mexican Health and Aging Study (n = 12,238 adults age 50+). Early-life urban dwelling was self-reported. Late-life urban dwelling was based on population size of respondents' community of residence (community 2500+ people) at the time of survey. Cognitive function was measured across several cognitive tasks. We assess differences in baseline cognitive function and nine-year decline across groups using a latent change score model.

RESULTS

Cross-sectionally, compared to always rural dwellers, rural-urban transitions were associated with cognitive benefits, though individuals residing in urban areas continuously through life exhibited the highest levels of cognitive function (β = 0.89, 95% CI: 0.83, 0.96) even after adjusting for SES, health, and health behaviors (β = 0.28, 95% CI: 0.22, 0.35). Longitudinally, always urban dwellers exhibited slower decline than always rural dwellers when adjusting for baseline cognition (β = 0.11, 95% CI: 0.03, 0.18), though faster decline when baseline cognition was not adjusted (β = -0.11, 95% CI: -0.18, -0.04). No differences were observed for cognitive change across comparison groups after adjusting for potential mechanisms.

CONCLUSIONS

Early- and late-life urban dwelling may result in cognitive advantages for older Mexican adults. Clinicians should consider where individuals resided throughout life to better understand a patient's likelihood of experiencing poor cognitive outcomes.

Health after union dissolution(s): Cumulative and temporal dynamics

The number of individuals experiencing one or multiple union dissolutions in their lifetime is increasing. The literature has shown significant interactions with health disorders, in response to the crisis situation that affects the spouses. However, processes are still unclear, in particular regarding the timing of the affection. This study explored whether different health disorders are observed shortly after dissolution or are delayed, and whether they are short- or long-lasting. We used data from the two waves (2006 and 2010) of the French Health and Professional Lives Survey (SIP) among 8349 individuals aged 25-64 years. Based on three health disorders, we studied 1) their levels in relation to the retrospective histories of union dissolutions; 2) health changes associated with a dissolution occurring between the two waves. We found that individuals who experienced one or multiple union dissolutions had worse self-rated health, more depressive symptoms and sleep disorders. The two latter were more related with a recent dissolution than with distant ones, suggesting an immediate association, yet long-lasting. Self-rated health was related with distant dissolutions only, suggesting a lagged, however also long-lasting association. Experiencing union dissolution between the two waves was linked to a higher probability of the onset of sleep disorders and depressive mood, and of deterioration of self-rated health if it was not the first dissolution. Our study shows that union dissolutions are highly correlated with different poor health measures, in the short and the long run, depending on the health disorder, with cumulative and durable effects.

Marital Strain and Support and Subjective Well-Being in Later Life: Ascribing a Role to Childhood Adversity

Objectives: We integrate the life course perspective with the stress-process model to offer a framework for how childhood conditions moderate the relationship between marital support/strain and subjective well-being in older adulthood for men and women. Methods: Drawing on longitudinal data from the National Social Life, Health, and Aging Project (NSHAP), we use a series of lagged dependent-variable models and stratify the sample by gender. Results: Our results suggest that the benefits associated with greater marital support are stronger for those that did not live with both parents in childhood for men. Women raised in families that experienced financial hardship reported lower subjective well-being in the context of marital strain. Conclusion: Adverse experiences in childhood can be scarring or foster resilience related to well-being in the context of strained or supportive marriages.

Life course pathways from parental education to age-related decrements in kidney function among Black and white American adults

OBJECTIVE

Using cross-sectional data on Black and white adults, this analysis examined whether age-related decrements in kidney function across adulthood were associated with parental education, and whether the association was differentially influenced by race. Further, this study assessed racial differences in life course pathways from parental education to age-related decrements in kidney function, through current SES and health-related risk factors.

METHOD

Data from the main survey and the Biomarker Project of the Midlife in the United States (MIDUS) Wave 2 and Refresher samples were combined, resulting in 1861 adults (54.5% female; age 25-84, Mage = 53.37) who self-identified as non-Hispanic Black (n = 326) and non-Hispanic white (n = 1535). Estimated glomerular filtration rate (eGFR) was based on serum creatinine, calculated using the CKD-EPI formula. Adults SES was based on education, income, and financial strains. Health-related risk factors included obesity, elevated blood pressure (BP), and insulin resistance. Hypotheses were tested by utilizing multiple linear regression and regression-based moderated mediation analysis.

RESULTS

Lower parental education was associated with steeper age-related decrements in eGFR (B = 0.38, SE = 0.15, p = .013, 95%CI = 0.08, 0.68), due to higher eGFR among younger participants and lower eGFR among older participants. In addition, age-related decrements in kidney function were steeper among Black relative to white adults (B = 0.41, SE = 0.13, p < .01, 95%CI = 0.16, 0.66), driven by higher proportion of younger Black adults that met criterion for renal hyperfiltration. Furthermore, parental education and race were associated with age-related decrements in kidney function in an additive rather than interactive way. There were some racial differences in the life course pathways from parental education to age-related differences in eGFR, glucoregulation, and hypertension. Among Black adults, lower parental education was associated with elevated eGFR among younger participants through insulin resistance. Among white adults, lower parental education was linked to higher eGFR among younger adults and lower eGFR among older adults, and the association was mediated by current SES, elevated BP, and insulin resistance.

DISCUSSION

Early life SES can have a long-lasting influence on the preclinical renal senescence that is associated with the normal biology of aging for both Black and white adults.

Trajectories of middle-aged and elderly people's chronic diseases Disability Adjusted Life Years (DALYs): cohort, socio-economic status and gender disparities

BACKGROUND

The accelerated aging trend brought great chronic diseases burdens. Disabled Adjusted Life Years (DALYs) is a novel way to measure the chronic diseases burden. This study aimed to explore the cohort, socioeconomic status (SES), and gender disparities of the DALYs trajectories.

METHODS

A total of 15,062 participants (55,740 observations) comes from China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018. Mixed growth curve model was adopted to predict the DALYS trajectories in 45-90 years old people influenced by different birth cohorts and SES.

RESULTS

We find significant cohort, SES (resident place, education level and income) disparities differences in the chronic diseases DALYs. For individuals of earlier cohort, DALYs are developed in a late age but grow fast with age but reversed for most recent cohorts. Living in urban, having higher SES level will decrease the growth rate with age, but converges for most recent cohorts. Meanwhile, DALYs disparities of resident place and education level show gender differentials that those for female are narrowed across cohort but for male are not.

CONCLUSIONS

The cohort effects on chronic diseases DALYs are accumulated with China's unique social, and political settings. There are large inequalities in early experiences, SES and DALYs. Efforts of reducing these inequalities must focus on the lower SES individuals and those living in rural areas, which greatly benefit individuals from recent cohorts.

Social participation and life satisfaction among older adults: diversity of practices and social inequality in Switzerland

This paper examines the associations between social participation and individual life satisfaction among older adults. It specifically considers the diversity of the practices and social inequalities among this population. For analyses, we used a large survey of individuals of 65 years and older conducted in 2011 in Switzerland (N = 2,727). The first set of linear regression analyses examines Diener's Satisfaction with Life Scale and its association with various indicators of social participation. While the second set of logistic regression addresses the issue of social inequalities by evaluating the impacts of gender, age group, region and education on social participation indicators that are significantly associated with the satisfaction with life score. Our results stressed the importance of combining multiple forms of participation for life satisfaction and shows that some forms are particularly meaningful: in particular, the involvement in associations, visitation of family or visitation of friends/acquaintances and church attendance. When inequalities among older adults are considered, having rich and varied social participation, being involved in associations and maintaining private sociability with non-kin appear more elitist. While institutionalised and/or private sociability types of participation appear particularly significant for older adults’ life satisfaction, the most traditional integration forms – i.e. family and religions – are crucial for the more vulnerable. Implications for active ageing was equally discussed as well.

Impact of the 2008 Recession on Wealth-Adjusted Income and Inequality for US Cohorts

OBJECTIVE

To examine distributional effects of the 2008 recession and subsequent recovery across generational cohorts.

METHODS

Using data from the Survey of Consumer Finances (2007-2016), we constructed a measure of economic well-being accounting for income, household size and annuitized value of assets. We examine trajectories of adjusted income and inequality, using Gini coefficients and income shares by decile, for the overall population and by cohort during the recession and recovery.

RESULTS

Inequality declined temporarily during the recession, but reached new highs during the recovery. During recovery, population-level increases in economic resources were not reflected among below-median households, as the more concentrated financial assets rose while broader-based home equity and employment fell or remained stagnant. Inequality measures increased for cohorts in their primary working years (Generation-X and Baby Boomers), but not among the younger Millennials, who were at early stages of education, workforce entry and household formation.

DISCUSSION

The study illustrates an integrative approach to analyzing cumulative dis/advantage by considering interactions between historically consistent macro-level events, such as economic shocks or policy choices affecting all cohorts, and the persistent life-course processes that tend to increase heterogeneity and inequality as cohorts age over time. Although recovery policies led to rapid recovery of financial asset values, they did not proportionately reach those below the median or their economic resource-types. Results suggest that in a high-inequality environment, recovery policies from economic shocks may need tailoring to all levels of resources in order to achieve more equitable recovery outcomes and prevent exacerbating cohort inequality trajectories.

Volunteering and health: The role of social network change

OBJECTIVES

Levels of volunteering may differentially influence multiple dimensions of health among older adults. Further, increasing evidence indicates social networks represent critical bridging and bonding contexts for the volunteering-health link. This study examines two research questions: 1) does volunteering level (low, moderate, high) influence physical and mental health in the same ways? And 2) does social network change moderate this link?

METHODS

Data come from Waves 1 and 2 of the longitudinal Social Relations Study (n = 556) collected in 1992 and 2005 and the sub-sample of adults age 50 and older at Wave 2. Regression analyses predicting self-rated health and depressive symptoms were conducted to examine main effects of volunteering and moderating effects of social network change.

RESULTS

Volunteering at a moderate level (101-300 hours per year) was associated with fewer depressive symptoms compared to those not volunteering. Social network change moderated the association between volunteering and self-rated health. Among those reporting a decrease in the proportion of non-family in their network (decrease in bridging), a moderate level of volunteering was associated with better self-rated health.

CONCLUSION

While moderate levels of volunteering are associated with better mental health, the link to physical health is only present in the context of decreasing network bridging. Identifying specific circumstances under which volunteering is beneficial is critical for developing interventions to promote health for all, including those in mid and later life.