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Schrempft S, Trofimova O, Künzi M, Ramponi C, Lutti A, Kherif F, Latypova A, Vollenweider P, Marques-Vidal P, Preisig M, Kliegel M, Stringhini S, Draganski B. The Neurobiology of Life Course Socioeconomic Conditions and Associated Cognitive Performance in Middle to Late Adulthood. J Neurosci 2024; 44:e1231232024. [PMID: 38499361 PMCID: PMC11044112 DOI: 10.1523/jneurosci.1231-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 03/20/2024] Open
Abstract
Despite major advances, our understanding of the neurobiology of life course socioeconomic conditions is still scarce. This study aimed to provide insight into the pathways linking socioeconomic exposures-household income, last known occupational position, and life course socioeconomic trajectories-with brain microstructure and cognitive performance in middle to late adulthood. We assessed socioeconomic conditions alongside quantitative relaxometry and diffusion-weighted magnetic resonance imaging indicators of brain tissue microstructure and cognitive performance in a sample of community-dwelling men and women (N = 751, aged 50-91 years). We adjusted the applied regression analyses and structural equation models for the linear and nonlinear effects of age, sex, education, cardiovascular risk factors, and the presence of depression, anxiety, and substance use disorders. Individuals from lower-income households showed signs of advanced brain white matter (WM) aging with greater mean diffusivity (MD), lower neurite density, lower myelination, and lower iron content. The association between household income and MD was mediated by neurite density (B = 0.084, p = 0.003) and myelination (B = 0.019, p = 0.009); MD partially mediated the association between household income and cognitive performance (B = 0.017, p < 0.05). Household income moderated the relation between WM microstructure and cognitive performance, such that greater MD, lower myelination, or lower neurite density was only associated with poorer cognitive performance among individuals from lower-income households. Individuals from higher-income households showed preserved cognitive performance even with greater MD, lower myelination, or lower neurite density. These findings provide novel mechanistic insights into the associations between socioeconomic conditions, brain anatomy, and cognitive performance in middle to late adulthood.
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Affiliation(s)
- Stephanie Schrempft
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva CH-1205, Switzerland
| | - Olga Trofimova
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
- Department of Computational Biology, University of Lausanne, Lausanne CH-1015, Switzerland
- Swiss Institute of Bioinformatics, Lausanne CH-1015, Switzerland
| | - Morgane Künzi
- Swiss National Centre of Competences in Research, "LIVES - Overcoming Vulnerability: Life Course Perspectives," University of Lausanne and University of Geneva, Lausanne CH-1015 and Carouge CH-1227, Switzerland
- Department of Psychology, University of Geneva, Geneva CH-1205, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Carouge CH-1227, Switzerland
| | - Cristina Ramponi
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Antoine Lutti
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Ferath Kherif
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Adeliya Latypova
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne CH-1008, Switzerland
| | - Matthias Kliegel
- Swiss National Centre of Competences in Research, "LIVES - Overcoming Vulnerability: Life Course Perspectives," University of Lausanne and University of Geneva, Lausanne CH-1015 and Carouge CH-1227, Switzerland
- Department of Psychology, University of Geneva, Geneva CH-1205, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Carouge CH-1227, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva CH-1205, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva CH-1211, Switzerland
- University Centre for General Medicine and Public Health, University of Lausanne, Lausanne CH-1005, Switzerland
| | - Bogdan Draganski
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
- Neurology Department, Max-Planck-Institute for Human Cognitive and Brain Sciences, D-04303 Leipzig, Germany
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Frank J, Mustard C, Smith P, Siddiqi A, Cheng Y, Burdorf A, Rugulies R. Work as a social determinant of health in high-income countries: past, present, and future. Lancet 2023; 402:1357-1367. [PMID: 37838441 DOI: 10.1016/s0140-6736(23)00871-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 01/17/2023] [Accepted: 04/27/2023] [Indexed: 10/16/2023]
Abstract
This paper, the first in a three-part Series on work and health, provides a narrative review of research into work as a social determinant of health over the past 25 years, the key emerging challenges in this field, and the implications of these challenges for future research. By use of a conceptual framework for work as a social determinant of health, we identified six emerging challenges: (1) the influence of technology on the nature of work in high-income countries, culminating in the sudden shift to telework during the COVID-19 pandemic; (2) the intersectionality of work with gender, sexual orientation, age, race, ethnicity, migrant status, and socioeconomic status as codeterminants of health disparities; (3) the arrival in many Organisation for Economic Co-operation and Development countries of large migrant labour workforces, who are often subject to adverse working conditions and social exclusion; (4) the development of precarious employment as a feature of many national labour markets; (5) the phenomenon of working long and irregular hours with potential health consequences; and (6) the looming threat of climate change's effects on work. We conclude that profound changes in the nature and availability of work over the past few decades have led to widespread new psychosocial and physical exposures that are associated with adverse health outcomes and contribute to increasing disparities in health. These new exposures at work will require novel and creative methods of data collection for monitoring of their potential health impacts to protect the workforce, and for new research into better means of occupational health promotion and protection. There is also an urgent need for a better integration of occupational health within public health, medicine, the life sciences, and the social sciences, with the work environment explicitly conceptualised as a major social determinant of health.
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Affiliation(s)
- John Frank
- Usher Institute, University of Edinburgh, Edinburgh, UK; Institute for Work & Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Cameron Mustard
- Institute for Work & Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Peter Smith
- Institute for Work & Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Yawen Cheng
- Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan
| | - Alex Burdorf
- Department of Public Health, Erasmus Medical Center, Rotterdam, Netherlands
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
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Lai R, Li R, Wang T, Ju J, Liu Q, Zhang J, Song L, Xu H. Short-term socioeconomic status shift and long-term cardiovascular outcomes in China: a population-based cohort study. J Epidemiol Community Health 2023; 77:152-159. [PMID: 36539279 PMCID: PMC9933156 DOI: 10.1136/jech-2022-219702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Limited studies have discussed the effect of socioeconomic status (SES) shift on cardiovascular outcomes, especially in less developed regions and countries. We; therefore, explored the association between short-term SES shift and long-term cardiovascular outcomes in China. METHODS In participants who had completed China Kadoorie Biobank study resurvey, 18 672 were included in the final analysis after excluding those who had cardiovascular diseases at baseline, and those who had a cardiovascular event before the resurvey. We used education, occupation, household income and healthcare cover as measurement of SES, and generated SES class for each individual at baseline and resurvey using latent class analysis. Outcomes of interest included cardiovascular death, major coronary event (MCE) and stroke. We used accelerated failure time model to obtain survival time ratio for each level of SES shift. RESULTS During a mean time gap of 2.6 years, 10 273 (55%) individuals remained stable in SES, 7763 (41.6%) shifted towards higher SES and 636 (3.4%) shifted towards lower SES. Participants were followed up for a mean of 9.8 years. After adjusting for baseline factors, sharp but not moderate SES downshift was significantly associated with shortened event-free survival time before cardiovascular deaths (p=0.02) and MCEs (p<0.001) occurred. Contrarily, moderate and sharp SES upshift was significantly associated with prolonged event-free survival time before cardiovascular deaths (p=0.0027 and p<0.001) and MCEs (p=0.0079 and p=0.009) occurred. CONCLUSION Short-term SES improvement is associated with better long-term cardiovascular outcome in China. High baseline SES might buffer out some unfavourable impact brought by moderate SES downshift. More comprehensive strategies should be considered in policy-making for socioeconomic development.
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Affiliation(s)
- Runmin Lai
- Department of Cardiology, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
| | - Ruiqi Li
- Department of Emergency, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Tong Wang
- Department of Cardiology, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Jianqing Ju
- Department of Cardiology, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
- National Research Center for Chinese Medicine Cardiology, Beijing, China
| | - Qiyu Liu
- Department of Cardiology, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
| | - Jie Zhang
- Department of Cardiology, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Luxia Song
- Department of Cardiology, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
| | - Hao Xu
- Department of Cardiology, China Academy of Chinese Medical Sciences Xiyuan Hospital, Beijing, China
- National Research Center for Chinese Medicine Cardiology, Beijing, China
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Dubnitskiy-Robin S, Laurent E, Herbert J, Fougère B, Guillon-Grammatico L. Elderly Outcomes After Hospitalization: The Hospital Frailty Risk Score Applied on the French Health Data Hub. J Aging Health 2022; 35:430-438. [PMID: 36342264 DOI: 10.1177/08982643221135318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objectives: To demonstrate the association between the Hospital Frailty Risk Score (HFRS) and 30-day mortality, 30-day hospital readmission and length of stay (LOS) in France. Methods: Logistic regressions were performed using data recorded in the French national health data system ( SNDS) for elderly patients (≥75 years old) hospitalized in France in 2017. Results: Over the 1,111,090 patients included, 30-day mortality was associated with the HFRS: adjusted OR (aOR) for an intermediate HFRS (5–15 points) was 1.91 [95% confidence interval (95% IC); 1.87–1.95] and aOR 2.57 [95% IC; 2.50–2.64] for high HFRS (>15 points), as compared to low HFRS (<5 points). LOS >10 days increased with the HFRS (aOR = 1.36 [95% IC; 1.34–1.38] for an intermediate HFRS and aOR 1.51 [95% IC; 1.48–1.54] for a high HFRS). A high HFRS was associated with 30-day hospital readmission (aOR = 1.06 [95% IC; 1.04–1.08]). Discussion: This real-life analysis of in- and out-patient healthcare pathways confirmed the HFRS’s ability to predict adverse outcomes, after adjustment on social deprivation.
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Affiliation(s)
- Sophie Dubnitskiy-Robin
- Division of Geriatric Medicine, Tours University Hospital, France
- Tours University, Nantes University, INSERM SPHERE, France
| | - Emeline Laurent
- Epidemiology Unit EpiDcliC, Service of Public Health, Tours University Hospital, France
- EA 7505 “Education, Ethics and Health”, Tours University, France
| | - Julien Herbert
- Epidemiology Unit EpiDcliC, Service of Public Health, Tours University Hospital, France
| | - Bertrand Fougère
- Division of Geriatric Medicine, Tours University Hospital, France
- EA 7505 “Education, Ethics and Health”, Tours University, France
| | - Leslie Guillon-Grammatico
- Epidemiology Unit EpiDcliC, Service of Public Health, Tours University Hospital, France
- MAVIVH, INSERM U1259, Tours University, France
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Hossin MZ, Heshmati A, Koupil I, Goodman A, Mishra GD. Latent class trajectories of socioeconomic position over four time points and mortality: the Uppsala Birth Cohort Study. Eur J Public Health 2022; 32:522-527. [PMID: 35788842 PMCID: PMC9341739 DOI: 10.1093/eurpub/ckac060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The study assessed socioeconomic position (SEP) over four time points and employed a latent class analysis (LCA) to explore the associations between longitudinal SEP trajectories and late-life mortality. METHODS We analyzed a cohort of 11 336 members born at the Uppsala University Hospital, Sweden during 1915-29 and followed up for mortality during 1980-2008. SEP was measured at birth, age 10, mid-adulthood and late adulthood. LCA was used to identify SEP trajectories, which were linked to all-cause and cause-specific mortality through Cox proportional hazard regression models. RESULTS The age and birth cohort adjusted hazard ratio (HR) of all-cause mortality among the upwardly mobile from middle vs. stable low SEP was 28% lower in men [HR: 0.72; 95% confidence interval (95% CI): 0.65, 0.81] and 30% lower in women (HR: 0.70; 95% CI: 0.62, 0.78). The corresponding HR of cardiovascular mortality was 30% lower in men (HR: 0.70; 95% CI: 0.60, 0.82) and 31% lower in women (HR: 0.69; 95% CI: 0.58, 0.83). Upward mobility was also associated with decreased HR of mortality from respiratory diseases and injuries among men and from cancer, respiratory diseases, injuries and mental disorders among women. The upwardly mobile were similar to the stable high group in terms of their HRs of mortality from all-causes and cardiovascular, cancer and mental diseases. CONCLUSIONS Upward mobility appeared to be protective of mortality from a wide range of causes. Interventions aiming to prevent deaths can benefit from creating optimal conditions earlier in the life course, letting disadvantaged children maximize their socioeconomic and health potentials.
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Affiliation(s)
- Muhammad Zakir Hossin
- Clinical Epidemiology Division, Department of Medicine (Solna), Karolinska Institute, Stockholm, Sweden.,Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Amy Heshmati
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Ilona Koupil
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.,Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Anna Goodman
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Herston, Australia
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6
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Zou X, Wang R, Yang Z, Wang Q, Fu W, Huo Z, Ge F, Zhong R, Jiang Y, Li J, Xiong S, Hong W, Liang W. Family Socioeconomic Position and Lung Cancer Risk: A Meta-Analysis and a Mendelian Randomization Study. Front Public Health 2022; 10:780538. [PMID: 35734761 PMCID: PMC9207765 DOI: 10.3389/fpubh.2022.780538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFamily socioeconomic position (SEP) in childhood is an important factor to predict some chronic diseases. However, the association between family SEP in childhood and the risk of lung cancer is not clear.MethodsA systematic search was performed to explore their relationship. We selected education level, socioeconomic positions of parents and childhood housing conditions to represent an individual family SEP. Hazard ratios (HRs) of lung cancer specific-mortality were synthesized using a random effects model. Two-sample Mendelian randomization (MR) was carried out with summary data from published genome-wide association studies of SEP to assess the possible causal relationship of SEP and risk of lung cancer.ResultsThrough meta-analysis of 13 studies, we observed that to compared with the better SEP, the poorer SEP in the childhood was associated with the increased lung cancer risk in the adulthood (HR: 1.25, 95% CI: 1.10 to 1.43). In addition, the dose-response analysis revealed a positive correlation between the poorer SEP and increased lung cancer risk. Same conclusion was reached in MR [(education level) OR 0.50, 95% CI: 0.39 to 0.63; P < 0.001].ConclusionThis study indicates that poor family socioeconomic position in childhood is causally correlated with lung cancer risk in adulthood.Systematic Review Registrationidentifier: 159082.
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Affiliation(s)
- Xusen Zou
- South China University of Technology, School of Public Administration, Guangzhou, China
| | - Runchen Wang
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Zhao Yang
- Peking University First Hospital, Beijing, China
| | - Qixia Wang
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Wenhai Fu
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- First Clinical School, Guangzhou Medical University, Guangzhou, China
| | - Zhenyu Huo
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Fan Ge
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- First Clinical School, Guangzhou Medical University, Guangzhou, China
| | - Ran Zhong
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yu Jiang
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Nanshan School, Guangzhou Medical University, Guangzhou, China
| | - Jiangfu Li
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shan Xiong
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wen Hong
- South China University of Technology, School of Public Administration, Guangzhou, China
- Wen Hong
| | - Wenhua Liang
- Department of Thoracic Oncology and Surgery, China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Wenhua Liang
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Post-Operative Cognitive Impairment: A Cognitive Epidemiology Perspective. J Intell 2022; 10:jintelligence10010018. [PMID: 35324574 PMCID: PMC8949407 DOI: 10.3390/jintelligence10010018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Cognitive epidemiology investigates cognitive predictors of health and disease outcomes. Post-operative cognitive impairment is a common complication of surgery but has been neglected as a health outcome in cognitive epidemiology research. This is despite the fact that knowledge of cognitive predictors of post-operative cognitive impairment can be utilized for risk stratification, informed decision-making (in elective surgery), and personalized care of patients during the postoperative period. In this narrative review, the current literature on cognitive predictors of post-operative cognitive impairment and gaps therein are summarized.
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Abstract
Health disparities by socioeconomic status (SES) have been extensively documented, but less is known about the physical health implications of achieving upward mobility. This article critically reviews the evolving literature in this area, concluding that upward mobility is associated with a trade-off, whereby economic success and positive mental health in adulthood can come at the expense of physical health, a pattern termed skin-deep resilience. We consider explanations for this phenomenon, including prolonged high striving, competing demands between the environments upwardly mobile individuals seek to enter and their environments of origin, cultural mismatches between adaptive strategies from their childhood environments and those that are valued in higher-SES environments, and the sense of alienation, lack of belonging, and discrimination that upwardly mobile individuals face as they move into spaces set up by and for high-SES groups. These stressors are hypothesized to lead to unhealthy behaviors and a dysregulation of biological systems, with implications for cardiometabolic health.
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Affiliation(s)
- Edith Chen
- Institute for Policy Research and Department of Psychology, Northwestern University, Evanston, Illinois 60208, USA;
| | - Gene H Brody
- Center for Family Research, University of Georgia, Athens, Georgia 30602, USA
| | - Gregory E Miller
- Institute for Policy Research and Department of Psychology, Northwestern University, Evanston, Illinois 60208, USA;
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Pool LR, Aguayo L, Brzezinski M, Perak AM, Davis MM, Greenland P, Hou L, Marino BS, Van Horn L, Wakschlag L, Labarthe D, Lloyd-Jones D, Allen NB. Childhood Risk Factors and Adulthood Cardiovascular Disease: A Systematic Review. J Pediatr 2021; 232:118-126.e23. [PMID: 33516680 DOI: 10.1016/j.jpeds.2021.01.053] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To conduct a comprehensive review of the literature on childhood risk factors and their associations with adulthood subclinical and clinical cardiovascular disease (CVD). STUDY DESIGN A systematic search was performed using the MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science databases to identify English-language articles published through June 2018. Articles were included if they were longitudinal studies in community-based populations, the primary exposure occurred during childhood, and the primary outcome was either a measure of subclinical CVD or a clinical CVD event occurring in adulthood. Two independent reviewers screened determined whether eligibility criteria were met. RESULTS There were 210 articles that met the predefined criteria. The greatest number of publications examined associations of clinical risk factors, including childhood adiposity, blood pressure, and cholesterol, with the development of adult CVD. Few studies examined childhood lifestyle factors including diet quality, physical activity, and tobacco exposure. Domains of risk beyond "traditional" cardiovascular risk factors, such as childhood psychosocial adversity, seemed to have strong published associations with the development of CVD. CONCLUSIONS Although the evidence was fairly consistent in direction and magnitude for exposures such as childhood adiposity, hypertension, and hyperlipidemia, significant gaps remain in the understanding of how childhood health and behaviors translate to the risk of adulthood CVD, particularly in lesser studied exposures like glycemic indicators, physical activity, diet quality, very early life course exposure, and population subgroups.
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Affiliation(s)
- Lindsay R Pool
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Liliana Aguayo
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Michal Brzezinski
- Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Amanda M Perak
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Matthew M Davis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Bradley S Marino
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lauren Wakschlag
- Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Darwin Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
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Brown HK. Invited Commentary: Biomarkers for Mortality Among Individuals With a History of Out-of-Home Care-Implications for Study Design and Conceptualizations of Risk. Am J Epidemiol 2021; 190:179-182. [PMID: 32476021 DOI: 10.1093/aje/kwaa077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/09/2020] [Accepted: 04/07/2020] [Indexed: 11/12/2022] Open
Abstract
Out-of-home care in childhood and adolescence has been shown to be associated with elevated risk for all-cause mortality in adulthood, with adverse socioeconomic, psychosocial, and health-related trajectories hypothesized to mediate this relationship. In the research letter by Batty and Hamer (Am J Epidemiol. 2021;190(1):176-178), the authors used data from the 1970 British birth cohort (n = 8,581) to examine risk of biomarkers for mortality in adults with a history of out-of-home care. While markers of inflammation, glucose metabolism, and lipids were less favorable in the exposed versus unexposed, differences between groups were small and were completely attenuated after adjustment. This study raises important issues regarding the design and conceptualization of future studies on the long-term outcomes of out-of-home care recipients. Such studies require more detailed information on duration of care, type of care setting, and reasons for care, all of which could affect outcome risk. Because the duration of follow-up is long, and attrition likely, authors should consider use of novel analytical techniques to account for selection bias, such as inverse probability weighting. Finally, a "chain-of-risk" approach to understanding outcomes might be warranted, given that risk is likely explained by accumulation of and prolonged exposure to adverse socioeconomic, psychosocial, and health risks.
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Intergenerational social mobility and body mass index trajectories - A follow-up study from Finland. SSM Popul Health 2021; 13:100723. [PMID: 33385060 PMCID: PMC7770483 DOI: 10.1016/j.ssmph.2020.100723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 01/22/2023] Open
Abstract
Evidence remains unclear on how intergenerational social mobility is associated with body mass index (BMI) and its long-term changes. Our study identified BMI trajectories from middle to older age by intergenerational social mobility groups and stratified the analyses by gender and two birth cohorts (birth years 1940‒1947 and 1950–1962). We used questionnaire-based cohort data that consists of four survey phases: 2000–2002, 2007, 2012, and 2017. In Phase 1, participants were 40–60-year-old employees of the City of Helsinki, Finland. Our analytical sample consisted of 6,971 women and 1,752 men. Intergenerational social mobility was constructed based on self-reported parental and own education—both divided into high and low—yielding four groups: stable high socioeconomic position (SEP) (high-high), upward social mobility (low-high), downward social mobility (high-low), and stable low SEP (low-low). BMI was calculated from self-reported height and weight from all four phases. Using mixed-effects linear regression, we found increasing BMI trajectories in all four social mobility groups until the age of 65. Women and men with stable high SEP had lower BMI trajectories compared to those with stable low SEP. In the younger birth cohort, women with upward social mobility had a lower BMI trajectory than women with stable low SEP. Additionally, women and men with downward social mobility had higher BMI trajectories than those with stable high SEP. In the older birth cohort, however, the BMI trajectories of upward and downward social mobility groups were somewhat similar and settled between the BMI trajectories of stable high and stable low SEP groups. Our results indicate that the associations between intergenerational social mobility and BMI may depend on gender and birth cohort. Nevertheless, to reduce socioeconomic inequalities in unhealthy weight gain, obesity prevention actions that focus on people who are likely to remain in low SEP might be worthwhile. Few studies exist on social mobility and long-term body mass index (BMI) changes. Rising BMI trajectories were found in all social mobility groups. Stable low socioeconomic position (SEP) was related to higher BMI trajectories. Stable high SEP and upward social mobility may protect from excessive weight gain. Social mobility–BMI associations differed by gender and birth cohort.
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Bricard D, Jusot F, Trannoy A, Tubeuf S. Inequality of opportunities in health and death: an investigation from birth to middle age in Great Britain. Int J Epidemiol 2020; 49:1739-1748. [PMID: 33011793 PMCID: PMC7746403 DOI: 10.1093/ije/dyaa130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2020] [Indexed: 11/23/2022] Open
Abstract
Objective We assess the existence of unfair inequalities in health and death using the normative framework of inequality of opportunities, from birth to middle age in Great Britain. Methods We use data from the 1958 National Child Development Study, which provides a unique opportunity to observe individual health from birth to the age of 54, including the occurrence of mortality. We measure health status combining self-assessed health and mortality. We compare and statistically test the differences between the cumulative distribution functions of health status at each age according to one childhood circumstance beyond people’s control: the father’s occupation. Results At all ages, individuals born to a ‘professional’, ‘senior manager or technician’ father report a better health status and have a lower mortality rate than individuals born to ‘skilled’, ‘partly skilled’ or ‘unskilled’ manual workers and individuals without a father at birth. The gap in the probability to report good health between individuals born into high social backgrounds compared with low, increases from 12 percentage points at age 23 to 26 at age 54. Health gaps are even more marked in health states at the bottom of the health distribution when mortality is combined with self-assessed health. Conclusions There is increasing inequality of opportunities in health over the lifespan in Great Britain. The tag of social background intensifies as individuals get older. Finally, there is added analytical value to combining mortality with self-assessed health when measuring health inequalities.
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Affiliation(s)
| | - Florence Jusot
- PSL, Université Paris-Dauphine, LEDA-LEGOS, Paris, France
| | - Alain Trannoy
- CNRS, EHESS, Centrale Marseille, AMSE, Aix-Marseille University, Marseille, France
| | - Sandy Tubeuf
- Institute of Health and Society (IRSS) and Institute of Economic and Social Research (IRES), Université catholique de Louvain, Brussels, Belgium
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Ozieh MN, Garacci E, Campbell JA, Walker RJ, Egede LE. Adverse Childhood Experiences and Decreased Renal Function: Impact on All-Cause Mortality in U.S. Adults. Am J Prev Med 2020; 59:e49-e57. [PMID: 32690202 PMCID: PMC7378887 DOI: 10.1016/j.amepre.2020.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/05/2020] [Accepted: 04/01/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Evidence suggests that individuals with a history of adverse childhood experiences have higher odds of developing kidney disease than individuals with no adverse childhood experiences. However, no study has examined the influence of coexisting adverse childhood experiences and kidney disease on mortality risk. This study uses a longitudinal survey of adults to examine the influence of coexisting adverse childhood experiences and decreased renal function on all-cause mortality in a sample of U.S. adults. METHODS A total of 1,205 adults participating in the Midlife Development in the United States series between 1995 and 2014 were used for this analysis performed in 2019. A total of 6 types of adverse childhood experiences were available in the data set, which were combined to create a dichotomous variable with any adverse experience counted as yes. Decreased renal function was defined as an estimated glomerular filtration rate <60 milliliter/minute/1.73 m2. The main outcome was all-cause mortality. Cox proportional hazards models were performed to examine 4 combinations of adverse childhood experiences and decreased renal function associated with overall survival (neither, adverse childhood experiences only, decreased renal function only, or both) controlling for covariables. RESULTS In fully adjusted models, adverse childhood experiences and decreased renal function were associated with increased all-cause mortality relative to neither (hazard ratio=2.85, 95% CI=1.30, 6.25). Decreased renal function only and adverse childhood experiences only were not significantly associated with all-cause mortality (hazard ratio=1.14, 95% CI=0.64, 2.04 and hazard ratio=1.55, 95% CI=0.44, 5.41, respectively). When using decreased renal function as the reference group, coexisting adverse childhood experiences and decreased renal function was associated with a 64% increased risk of all-cause mortality, though this relationship was not statistically significant. CONCLUSIONS Coexistence of adverse childhood experiences and decreased renal function is associated with higher all-cause mortality than seen in individuals with neither adverse childhood experiences nor decreased renal function and may be associated with higher all-cause mortality than seen in individuals with decreased renal function alone. Future research is needed to better understand this potential association.
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Affiliation(s)
- Mukoso N Ozieh
- Division of Nephrology, Department of Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Nephrology, Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin.
| | - Emma Garacci
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of General Internal Medicine, Department of Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Jennifer A Campbell
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of General Internal Medicine, Department of Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rebekah J Walker
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of General Internal Medicine, Department of Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Leonard E Egede
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of General Internal Medicine, Department of Medicine, The Medical College of Wisconsin, Milwaukee, Wisconsin
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Zemore SE, Lui C, Mulia N. The Downward Spiral: Socioeconomic Causes and Consequences of Alcohol Dependence among Men in Late Young Adulthood, and Relations to Racial/Ethnic Disparities. Alcohol Clin Exp Res 2020; 44:669-678. [PMID: 31984509 PMCID: PMC7081966 DOI: 10.1111/acer.14292] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 01/14/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND While young adults are generally at highest risk for alcohol problems, not all age out of problem drinking. Evidence suggests that Blacks and Latinos age out more slowly than Whites, particularly among men. Targeting men, we investigated whether differences in lifecourse SES might explain racial/ethnic disparities in alcohol dependence in late young adulthood, along with how experiencing alcohol dependence at that life stage relates to subsequent SES. METHODS We used longitudinal, national data to (i) describe racial/ethnic disparities in late young adult alcohol dependence criteria (LYADC), (ii) examine whether income trajectory in early young adulthood contributes to these racial/ethnic disparities, and (iii) test whether LYADC reciprocally predicts income trajectory in early midlife. Data were from the 1979 National Longitudinal Survey of Youth (N = 3,993), which measured LYADC in 1994 (mean age = 33). Income trajectory classes were derived for early young adulthood (mean ages = 21 to 31) and, separately, early midlife (mean ages = 35 to 45). Analyses included negative binomial regressions and multinomial regressions. RESULTS Both Black and US-born Latino men reported more LYADC than White men. Further, membership in the persistently low and slow increase (vs. stable middle) early young adult income trajectory classes was associated with more LYADC. Multivariate analyses suggested that Black-White disparities in LYADC were explained by early young adult income trajectories, whereas Latino-White disparities in the same were explained by both early young adult income trajectories and early education. In controlled models, more LYADC predicted a higher likelihood of membership in the persistently low (vs. stable middle) income trajectory class in early midlife. CONCLUSIONS This study found that poorer SES in early adulthood contributes to alcohol dependence, which reciprocally contributes to poorer SES in early midlife. This cycle appears particularly likely to affect Black and US-born Latino men. Results underline the need to address socioeconomic factors in addressing racial/ethnic disparities in alcohol problems.
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Affiliation(s)
- Sarah E Zemore
- From the, Alcohol Research Group, Emeryville, California
| | - Camillia Lui
- From the, Alcohol Research Group, Emeryville, California
| | - Nina Mulia
- From the, Alcohol Research Group, Emeryville, California
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Vieira LS, Bierhals IO, Vaz JDS, Meller FDO, Wehrmeister FC, Assunção MCF. Socioeconomic status throughout life and body mass index: a systematic review and meta-analysis. CAD SAUDE PUBLICA 2019; 35:e00125518. [PMID: 31618383 DOI: 10.1590/0102-311x00125518] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 04/12/2019] [Indexed: 01/27/2023] Open
Abstract
This article aimed to systematically review the association between socioeconomic status according to the life course models and the body mass index (BMI) in adults. A review was performed following the guidelines of the PRISMA. The studies were identified in the MEDLINE/PubMed, LILACS and Web of Science databases. The eligible articles investigated the association between at least one life course model (risk accumulation, critical period or social mobility) and BMI. In order to assess the quality of the selected articles, the NOS checklist was applied to each study. Eleven articles were selected for the systematic review, and seven articles were selected for the meta-analysis. The average score and the median in the NOS checklist were 6.4, within a maximum possible score of 8 points. The most used model was social mobility. Regarding meta-analysis, there was association between lower life course socioeconomic status and BMI among women. BMI mean difference (MD) was higher among those who remained with low socioeconomic status throughout life when compared with those who maintained a high socioeconomic status (MD: 2.17, 95%CI: 1.48; 2.86). Before that, the BMI MD was higher among those with upward mobility, compared with those who maintained a high socioeconomic status throughout life (MD: 1.20, 95%CI: 0.73; 1.68). The risk of overweight was also higher among women who maintained low socioeconomic status (summary RR: 1.70, 95%CI: 1.05; 2.74); however, according to the GRADE, the studies presented very low quality evidence. For men, no association was observed. Having low socioeconomic status sometime during life is associated with higher BMI in adulthood.
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Head J, Chungkham HS, Hyde M, Zaninotto P, Alexanderson K, Stenholm S, Salo P, Kivimäki M, Goldberg M, Zins M, Vahtera J, Westerlund H. Socioeconomic differences in healthy and disease-free life expectancy between ages 50 and 75: a multi-cohort study. Eur J Public Health 2019; 29:267-272. [PMID: 30307554 PMCID: PMC6426044 DOI: 10.1093/eurpub/cky215] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background There are striking socioeconomic differences in life expectancy, but less is known about inequalities in healthy life expectancy and disease-free life expectancy. We estimated socioeconomic differences in health expectancies in four studies in England, Finland, France and Sweden. Methods We estimated socioeconomic differences in health expectancies using data drawn from repeated waves of the four cohorts for two indicators: (i) self-rated health and (ii) chronic diseases (cardiovascular, cancer, respiratory and diabetes). Socioeconomic position was measured by occupational position. Multistate life table models were used to estimate healthy and chronic disease-free life expectancy from ages 50 to 75. Results In all cohorts, we found inequalities in healthy life expectancy according to socioeconomic position. In England, both women and men in the higher positions could expect 82–83% of their life between ages 50 and 75 to be in good health compared to 68% for those in lower positions. The figures were 75% compared to 47–50% for Finland; 85–87% compared to 77–79% for France and 80–83% compared to 72–75% for Sweden. Those in higher occupational positions could expect more years in good health (2.1–6.8 years) and without chronic diseases (0.5–2.3 years) from ages 50 to 75. Conclusion There are inequalities in healthy life expectancy between ages 50 and 75 according to occupational position. These results suggest that reducing socioeconomic inequalities would make an important contribution to extending healthy life expectancy and disease-free life expectancy.
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Affiliation(s)
- Jenny Head
- Department of Epidemiology and Public Health, University College London, London, UK
| | | | - Martin Hyde
- Centre for Innovative Ageing, University of Swansea, Swansea, UK
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sari Stenholm
- Department of Public Health, University of Turku and University Hospital Turku, Turku, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland
| | - Paula Salo
- Department of Psychology, University of Turku, Turku, Finland.,Finnish Institute of Occupational Health, Turku, Finland
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marcel Goldberg
- Inserm, Population-based Cohorts Unit-UMS 011, Villejuif, France
| | - Marie Zins
- Inserm, Population-based Cohorts Unit-UMS 011, Villejuif, France
| | - Jussi Vahtera
- Department of Public Health, University of Turku and University Hospital Turku, Turku, Finland
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
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Sung J, Song YM, Hong KP. Relationship between the shift of socioeconomic status and cardiovascular mortality. Eur J Prev Cardiol 2019; 27:749-757. [PMID: 31180761 DOI: 10.1177/2047487319856125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study is to investigate whether upward or downward shifts in socioeconomic status have an effect on cardiovascular mortality. DESIGN A retrospective cohort study. METHODS Among the Korean National Health Insurance Service National Sample Cohort, 178,812 subjects were selected who were over 20 years of age as of 2002, with available data on routine health check and free of a diagnosis of ischaemic heart disease, stroke, heart failure or cancer at baseline. Cause of death was identified by the death certificate. Stratification of socioeconomic status was done by income as low (lower 30th percentile), high (higher 30th percentile) and middle, which was reclassified annually. Shift in socioeconomic status was defined as any change in the income class from baseline. RESULTS During the follow-up of a median 10 years, cardiovascular mortality was significantly higher among middle and low socioeconomic status groups (hazard ratio and 95% confidence interval for middle 1.92 (1.68-2.19) and low 1.73 (1.50-2.00)) compared to the high socioeconomic status group after adjustment for age, gender, residence, blood pressure, fasting glucose, smoking and medications (statins and antiplatelet agents). In the same regression model, an upward shift of socioeconomic status was associated with a lower risk of cardiovascular death (hazard ratio 0.46, 95% confidence interval 0.40-0.52), while a downward shift was not a significant predictor. CONCLUSION An upward shift of socioeconomic status was associated with a lower risk of cardiovascular mortality after adjustment for baseline socioeconomic status, conventional risk factors and risk-reducing pharmacological treatments.
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Affiliation(s)
- Jidong Sung
- Department of Medicine, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Yun-Mi Song
- Department of Family Medicine, Sungkyunkwan University School of Medicine, Republic of Korea
| | - Kyung Pyo Hong
- Department of Medicine, Sungkyunkwan University School of Medicine, Republic of Korea
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18
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Almquist YB, Brännström L. Do trajectories of economic, work- and health-related disadvantages explain child welfare clients' increased mortality risk? A prospective cohort study. BMC Public Health 2019; 19:418. [PMID: 30999882 PMCID: PMC6472010 DOI: 10.1186/s12889-019-6752-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/05/2019] [Indexed: 11/10/2022] Open
Abstract
Background Past research has shown that individuals who have had experiences of out-of-home care (OHC) in childhood have increased risks of premature mortality. Prior studies also suggest that these individuals are more likely to follow long-term trajectories that are characterised by economic, work-, and health-related disadvantages, compared to majority population peers. Yet, we do not know the extent to which such trajectories may explain their elevated mortality risks. The aim of this study is therefore to examine whether trajectories of economic, work-, and health-related disadvantages in midlife mediate the association between OHC experience in childhood and subsequent all-cause mortality. Methods Utilising longitudinal Swedish data from a 1953 cohort (n = 14,294), followed from birth up until 2008 (age 55), this study applies gender-specific logistic regression analysis to analyse the association between OHC experience in childhood (ages 0–19; 1953–1972) and all-cause mortality (ages 47–55; 2000–2008). A decomposition method developed for non-linear regression models is used to estimate mediation by trajectories of economic, work-, and health-related disadvantages (ages 39–46; 1992–1999), as indicated by social welfare receipt, unemployment, and mental health problems. To account for selection processes underlying placement in OHC, an alternative comparison group of children who were investigated by the child welfare committee but not placed, is included. Results The results confirm that individuals with experience of OHC have more than a two-fold increased risk of all-cause mortality, for men (OR: 2.10, 95% CI: 1.42–3.11) and women (OR: 2.23, 95% CI: 1.39–3.59) alike. Approximately one-third (31.1%) of the association among men, and one-fourth (27.4%) of the association among women, is mediated by the long-term trajectories of economic, work-, and health-related disadvantages. The group who were investigated but not placed shows similar, yet overall weaker, associations. Conclusions Individuals who come to the attention of the child welfare services, regardless of whether they are placed in out-of-home care or not, continue to be at risk of adverse outcomes across the life course. Preventing them from following trajectories of economic, work-, and health-related disadvantages could potentially reduce their risk of premature death.
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Affiliation(s)
- Ylva B Almquist
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, SE-106 91, Stockholm, Sweden.
| | - Lars Brännström
- Department of Social Work, Stockholm University, SE-106 91, Stockholm, Sweden
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Hoven H, Siegrist J, Goldberg M, Ribet C, Zins M, Wahrendorf M. Intragenerational social mobility and depressive symptoms. Results from the French CONSTANCES cohort study. SSM Popul Health 2019; 7:100351. [PMID: 30705934 PMCID: PMC6349560 DOI: 10.1016/j.ssmph.2019.100351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/10/2018] [Accepted: 01/05/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND To further explain the association between low socioeconomic position and increased risk of poor health, research started to consider life course conditions, including previous occupational positions and patterns of social mobility in the analysis. We describe patterns of intragenerational social mobility and investigate their associations with depressive symptoms. METHODS We use data from the French CONSTANCES study, a population-based cohort and restrict the sample to people aged 45 to 60. Based on detailed retrospective data with annual information on respondents' occupational position, we assess the modal social class for two time periods - early adulthood (age 25-34) and mid-adulthood (age 35-44). Depressive symptoms are measured by the Centre for Epidemiologic Studies Depression Scale (CES-D), using sex-specific cut-points. RESULTS Our study reveals that most respondents remained in stable working careers, but these careers were less frequent amongst participants with lower socioeconomic positions compared with higher ones. In contrast to several earlier findings we observe no independent associations of intragenerational social mobility processes and health once the social positions of origin and destination are considered. However, our findings confirm a social gradient in the prevalence of depressive symptoms for stable working careers. CONCLUSIONS Our findings underline the importance of integrating data into analysis on starting and ending points of social mobility processes within entire histories of labor market participation.
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Affiliation(s)
- Hanno Hoven
- Centre for Health and Society, Institute of Medical Sociology, Medical Faculty, University of Düsseldorf, Universitätsstrasse 1, 40225 Düsseldorf, Germany
| | - Johannes Siegrist
- Senior professorship on work stress research, Medical Faculty, University of Düsseldorf, Germany
| | - Marcel Goldberg
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
- Paris Descartes University, France
| | - Céline Ribet
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
- Paris Descartes University, France
| | - Marie Zins
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
- Paris Descartes University, France
| | - Morten Wahrendorf
- Centre for Health and Society, Institute of Medical Sociology, Medical Faculty, University of Düsseldorf, Universitätsstrasse 1, 40225 Düsseldorf, Germany
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Stringhini S, Zaninotto P, Kumari M, Kivimäki M, Lassale C, Batty GD. Socio-economic trajectories and cardiovascular disease mortality in older people: the English Longitudinal Study of Ageing. Int J Epidemiol 2019; 47:36-46. [PMID: 29040623 PMCID: PMC5837467 DOI: 10.1093/ije/dyx106] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2017] [Indexed: 11/14/2022] Open
Abstract
Background Socio-economic status from early life has been linked to cardiovascular disease risk, but the impact of life-course socio-economic trajectories, as well as the mechanisms underlying social inequalities in cardiovascular disease risk, is uncertain. Objectives We assessed the role of behavioural, psychosocial and physiological (including inflammatory) factors in the association between life-course socio-economic status and cardiovascular disease mortality in older adults. Methods Participants were 7846 individuals (44% women) from the English Longitudinal Study of Ageing, a representative study of individuals aged ≥ 50 years, established in 2002-03. Comprising four indicators of socio-economic status (father's social class, own education, occupational position and wealth), we computed an index of socio-economic trajectory and a lifetime cumulative socio-economic score. Behavioural (smoking, physical activity, alcohol consumption, body mass index) and psychosocial (social relations, loneliness) factors, physiological (blood pressure, total cholesterol, triglycerides) and inflammatory markers (C-reactive protein, fibrinogen), measured repeatedly over time, were potential explanatory variables. Cardiovascular disease mortality was ascertained by linkage of study members to a national mortality register. Mediation was calculated using the traditional 'change-in-estimate method' and alternative approaches such as counterfactual mediation modelling could not be applied in this context. Results During the 8.4-year follow-up, 1301 study members died (438 from cardiovascular disease). A stable low-social-class trajectory was associated with around double the risk of cardiovascular disease mortality (hazard ratio; 95% confidence interval: 1.94, 1.37; 2.75) compared with a stable high social class across the life course. Individuals in the lowest relative to the highest life-course cumulative socio-economic status group were also more than twice as likely to die of cardiovascular disease (2.57, 1.81; 3.65). Behavioural factors and inflammatory markers contributed most to explaining this gradient, whereas the role of psychosocial and other physiological risk factors was modest. Conclusions In a population-based cohort of older individuals living in England, we provide evidence that disadvantage across the life course is linked to cardiovascular mortality. That behavioural factors and inflammatory markers partially explain this gradient may provide insights into the potential for intervention.
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Affiliation(s)
- Silvia Stringhini
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Meena Kumari
- Institute for Social and Economic Research, University of Essex, Essex, UK
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Camille Lassale
- Department of Epidemiology and Public Health, University College London, London, UK
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, UK
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Assari S, Gibbons FX, Simons R. Depression among Black Youth; Interaction of Class and Place. Brain Sci 2018; 8:E108. [PMID: 29895752 PMCID: PMC6025590 DOI: 10.3390/brainsci8060108] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/04/2018] [Accepted: 06/10/2018] [Indexed: 12/12/2022] Open
Abstract
Although high socioeconomic status (SES) is traditionally conceptualized as a health protective factor, recent literature has documented positive associations between SES (e.g., income) and depression among Blacks, including Black youth. To extend the results of this recent literature, the current study used the Family and Community Health Study (FACHS) data to examine the multiplicative effects of gender, place, and SES on average depressive symptoms of Black youth over a long period of time. FACHS, 1997⁻2017, followed 889 Black children aged 10⁻12 years old for up to 18 years. Depressive symptoms were measured in seven waves. The main predictors of interest were two SES indicators, parent education and family income measured at baseline (1997). Main outcome of interest was average depressive symptoms over the 18 year follow up period. Place of residence and gender were the focal moderators. Linear regression models were used for data analysis. In the pooled sample, living in a predominantly White area was associated with higher average depressive symptoms over time, however, this association was fully explained by higher perceived racial discrimination in the predominantly White areas. We found an interaction between income and place of residence on average depressive symptoms, suggesting that higher income is associated with more depressive symptoms in predominantly White compared to predominantly Black areas. Place did not interact with parent education on average depressive symptoms. Gender also did not interact with education or income on depressive symptoms. Findings suggest that place and SES may interact on depressive symptoms of Black youth, with high income becoming a risk factor for depressive symptoms in predominantly White areas. How SES indicators, such as income, protect or become a risk factor depend on other contextual factors, such as place of residence. There is a need to reduce discrimination experienced by Blacks, especially in predominantly White areas. Meanwhile, Black youth who live in predominantly White areas may require additional help that enhances their coping.
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Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Frederick X Gibbons
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Ronald Simons
- Department of Sociology, University of Georgia, Athens, GA 30602, USA.
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Assari S, Lankarani MM, Caldwell CH. Does Discrimination Explain High Risk of Depression among High-Income African American Men? Behav Sci (Basel) 2018; 8:bs8040040. [PMID: 29671796 PMCID: PMC5946099 DOI: 10.3390/bs8040040] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/22/2018] [Accepted: 03/28/2018] [Indexed: 12/28/2022] Open
Abstract
Background: Higher socioeconomic status is known to decrease the risk for poor mental health overall. However, African American males of higher socioeconomic status (SES) are at an increased risk for having a major depressive episode (MDE). It is not known whether perceived discrimination (PD) explains this risk. The current study used nationally representative data to explore the role of PD in explaining the association between high-SES and having MDE among African American men. Methods: The National Survey of American Life (NSAL), 2003, included 4461 American adults including 1271 African American men. SES indicators (i.e., household income, educational attainment, employment status, and marital status) were the independent variables. 12-month MDE measured using the Composite International Diagnostic Interview (CIDI) was the outcome. Age, gender, and region were the covariates. PD was the potential mediator. For data analysis, we used logistic regression. Results: Among African American men, household income was positively associated with odds of 12-month MDE. The positive association between household income and odds of MDE remained unchanged after adding PD to the model, suggesting that PD may not explain why high-income African American men are at a higher risk of MDE. Conclusions: Perceived discrimination does not explain the increased risk for depression among African American males of higher SES. Future research should explore the role of other potential mechanisms such as stress, coping, social isolation, and/or negative social interaction that may increase psychological costs of upward social mobility for African American males.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI 48109-2029, USA.
- Center for Research on Ethnicity, Culture, and Health (CRECH), University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
| | - Maryam Moghani Lankarani
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI 48109-2029, USA.
- Center for Research on Ethnicity, Culture, and Health (CRECH), University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
| | - Cleopatra Howard Caldwell
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI 48109-2029, USA.
- Department of Health Behaviors and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
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Karimi M, Rey G, Latouche A. A Joint modelling of socio-professional trajectories and cause-specific mortality. Comput Stat Data Anal 2018. [DOI: 10.1016/j.csda.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Association of Birthweight With Maternal Trajectories of Effort-Reward Imbalance and Demand-Control Across Pregnancy. J Occup Environ Med 2018; 59:169-176. [PMID: 28002356 DOI: 10.1097/jom.0000000000000932] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We assessed longitudinal patterns of effort-reward imbalance (ERI) and demand-control (DC) scores in pregnancy, and their association with newborn birthweight (BW). METHODS Sixty-one women were surveyed four times across pregnancy using the ERI and DC questionnaires. Trajectories of change in ERI and DC scores across pregnancy were constructed using growth mixture modeling, and their associations with BW were examined with generalized linear regression. RESULTS Declining ERI (diminishing effort with stable/increasing reward) was associated with higher BW (408 g; P = 0.015), and was robust to other work factors. DC trajectory was not significantly associated with BW. CONCLUSIONS Declining ERI may reflect improved work psychosocial climate across pregnancy, or a conscious reduction in effort. The ERI model may represent more flexible work characteristics, whereas job control may be less amenable to short-term alteration. Surveys in more diverse pregnant working populations could be recommended.
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The association of early life socioeconomic position on breast cancer incidence and mortality: a systematic review. Int J Public Health 2017; 63:787-797. [PMID: 29197969 DOI: 10.1007/s00038-017-1060-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 11/21/2017] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES We conducted a systematic review of the literature relating early life socioeconomic position (SEP) to breast cancer incidence and mortality from a critical period and life-course trajectory perspective. METHODS PubMed, EMBASE and Web of Science were searched to identify cohort studies that evaluated the impact of early life SEP indicators on the incidence and/or mortality from breast cancer in adulthood. RESULTS Nine distinct studies evaluated the relationship between early life SEP and breast cancer between 1990 and 2016. Five reports assessed breast cancer incidence and five assessed breast cancer mortality as outcomes; one study assessed both incidence and mortality. While lower early life SEP was associated with reduced breast cancer incidence and increased breast cancer mortality in the US, studies conducted in Europe were unable to establish a consistent association. CONCLUSIONS We found moderate support for the association between early life SEP and incidence and mortality from breast cancer. The impact of early life SEP on breast cancer incidence and mortality appeared to vary between countries. We urge further investigation of the role of lifelong SEP trajectories in breast cancer outcomes.
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Assari S. Social Determinants of Depression: The Intersections of Race, Gender, and Socioeconomic Status. Brain Sci 2017; 7:brainsci7120156. [PMID: 29186800 PMCID: PMC5742759 DOI: 10.3390/brainsci7120156] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 11/20/2017] [Accepted: 11/22/2017] [Indexed: 01/08/2023] Open
Abstract
Background: Despite the wealth of literature on social determinants of mental health, less is known about the intersection of these determinants. Using a nationally representative sample, this study aimed to study separate, additive, and multiplicative effects of race, gender, and SES on the risk of major depressive episode (MDE) among American adults. Methods: National Survey of American Life (NSAL) included 3570 African Americans and 891 Whites. Race, gender, socioeconomic status (SES, household income, education, employment, and marital status) were independent variables. Twelve-month MDE was measured by the Composite International Diagnostic Interview (CIDI). A series of logistic regressions were used to analyze the data. Results: In the pooled sample, race and household income, but not gender, education, employment, and marital status were associated with 12-month MDE. Gender interacted with the effects of income on MDE, suggesting that the association between household income and MDE is larger for women than men. In race by gender specific models that controlled for other SES indicators, high income was protective for White women, education was protective for African American women, and high income became a risk factor for African American men. High income did not show a risk effect for African American men in the absence of other SES indicators. Conclusions: Findings suggest that race, gender, and class interact on how SES indicators, such as education or income, become a protective or a risk factor for MDE among American Adults. When the outcome is MDE, White women benefit more from income, African American women gain from education, however, the residual effect of high income (above and beyond education, employment, and marital status) may become a risk factor for African American men.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; ; Tel.: +1-734-232-0445; Fax: +1-734-763-9265
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
- Institute for Healthcare Policy and Innovation (IHPI), University of Michigan, Ann Arbor, MI 48109, USA
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Guimarães JM, Clarke P, Tate D, Coeli CM, Griep RH, Fonseca MDJMD, Santos IS, Melo ECP, Chor D. Social mobility and subclinical atherosclerosis in a middle-income country: Association of intra- and inter-generational social mobility with carotid intima-media thickness in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Soc Sci Med 2016; 169:9-17. [DOI: 10.1016/j.socscimed.2016.09.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/16/2016] [Accepted: 09/13/2016] [Indexed: 10/21/2022]
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Toneti AN, Freitas D, Magnabosco P, Toneti BF, Lana DM, de Godoy S, Marchi-Alves LM. Use of noninvasive procedures in the cardiovascular risk assessment of hypertensive and normotensive individuals. JOURNAL OF VASCULAR NURSING 2016; 34:17-23. [PMID: 26897348 DOI: 10.1016/j.jvn.2015.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/22/2015] [Accepted: 10/26/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Arterial hypertension is associated with a high prevalence of vascular alterations. The use of noninvasive procedures to assess peripheral arterial diseases in the ranking of cardiovascular risks has been increasingly valued in clinical practice and should be adopted in nursing. OBJECTIVE To identify the cardiovascular risk of hypertensive and normotensive individuals through the use of different noninvasive procedures to assess the vascular function and integrity: ankle-brachial index, pulse pressure, and delta brachial-brachial and delta ankle-brachial indexes. METHODS Quantitative, descriptive, and cross-sectional study undertaken at a health service in a Brazilian city. The research variables were age, sex, blood pressure, abdominal circumference, body mass index, ankle-brachial index, pulse pressure, and delta brachial-brachial and delta ankle-brachial indexes. RESULTS Fifty-four (43.1%) normotensive and 69 (56.9%) hypertensive individuals participated in the study. Alterations were identified in ankle-brachial index, corresponding to mild and moderate arterial obstruction, among hypertensive individuals only (7.2%), with higher pulse pressure indices (P < 0.0001). The assessment of the correlation between the ankle-brachial index and pulse pressure showed no correlation in the normotensive group and a statistically significant correlation among hypertensive patients (Pearson's coefficient = -0.45, P < 0.0001, r(2) = 0.21). A statistically significant difference (P < 0.05) was found in the analysis of the mean delta brachial-brachial (6.2 ± 0.71 mm Hg for normotensive and 10.16 ± 1.45 mm Hg for hypertensive individuals) and delta ankle-brachial index (0.06 ± 0.01 for normotensive and 0.11 ± 0.01 for hypertensive individuals). CONCLUSIONS The use of the proposed cardiovascular risk predictors shows more frequent alterations among hypertensive than normotensive individuals.
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Affiliation(s)
- Adrielle Naiara Toneti
- University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, SP, Brazil
| | - Dayana Freitas
- University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, SP, Brazil
| | | | | | - Daniel Martinez Lana
- University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, SP, Brazil
| | - Simone de Godoy
- General and Specialized Nursing Department, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, SP, Brazil
| | - Leila Maria Marchi-Alves
- General and Specialized Nursing Department, University of São Paulo at Ribeirão Preto College of Nursing, Ribeirão Preto, SP, Brazil.
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Bihan H, Backholer K, Peeters A, Stevenson CE, Shaw JE, Magliano DJ. Socioeconomic Position and Premature Mortality in the AusDiab Cohort of Australian Adults. Am J Public Health 2016; 106:470-7. [PMID: 26794164 DOI: 10.2105/ajph.2015.302984] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine the association of socioeconomic position indicators with mortality, without and with adjustment for modifiable risk factors. METHODS We examined the relationships of 2 area-based indices and educational level with mortality among 9338 people (including 8094 younger than 70 years at baseline) of the Australian Diabetes Obesity and Lifestyle (AusDiab) from 1999-2000 until November 30, 2012. RESULTS Age- and gender-adjusted premature mortality (death before age 70 years) was more likely among those living in the most disadvantaged areas versus least disadvantaged (hazard ratio [HR] = 1.48; 95% confidence interval [CI] = 1.08, 2.01), living in inner regional versus major urban areas (HR = 1.36; 95% CI = 1.07, 1.73), or having the lowest educational level versus the highest (HR = 1.64; 95% CI = 1.17, 2.30). The contribution of modifiable risk factors (smoking status, diet quality, physical activity, stress, cardiovascular risk factors) in the relationship between 1 area-based index or educational level and mortality was more apparent as age of death decreased. CONCLUSIONS The relation of area-based socioeconomic position to premature mortality is partly mediated by behavioral and cardiovascular risk factors. Such results could influence public health policies.
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Affiliation(s)
- Hélène Bihan
- Hélène Bihan is with the Department of Endocrinology, Diabetology and Metabolic Diseases, Avicenne Hospital, Bobigny, France. Kathrin Backholer, Anna Peeters, Jonathan E. Shaw, and Dianna J. Magliano are with the Baker IDI Heart and Diabetes Institute, Melbourne, Australia. Christopher E. Stevenson is with the School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Melbourne
| | - Kathrin Backholer
- Hélène Bihan is with the Department of Endocrinology, Diabetology and Metabolic Diseases, Avicenne Hospital, Bobigny, France. Kathrin Backholer, Anna Peeters, Jonathan E. Shaw, and Dianna J. Magliano are with the Baker IDI Heart and Diabetes Institute, Melbourne, Australia. Christopher E. Stevenson is with the School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Melbourne
| | - Anna Peeters
- Hélène Bihan is with the Department of Endocrinology, Diabetology and Metabolic Diseases, Avicenne Hospital, Bobigny, France. Kathrin Backholer, Anna Peeters, Jonathan E. Shaw, and Dianna J. Magliano are with the Baker IDI Heart and Diabetes Institute, Melbourne, Australia. Christopher E. Stevenson is with the School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Melbourne
| | - Christopher E Stevenson
- Hélène Bihan is with the Department of Endocrinology, Diabetology and Metabolic Diseases, Avicenne Hospital, Bobigny, France. Kathrin Backholer, Anna Peeters, Jonathan E. Shaw, and Dianna J. Magliano are with the Baker IDI Heart and Diabetes Institute, Melbourne, Australia. Christopher E. Stevenson is with the School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Melbourne
| | - Jonathan E Shaw
- Hélène Bihan is with the Department of Endocrinology, Diabetology and Metabolic Diseases, Avicenne Hospital, Bobigny, France. Kathrin Backholer, Anna Peeters, Jonathan E. Shaw, and Dianna J. Magliano are with the Baker IDI Heart and Diabetes Institute, Melbourne, Australia. Christopher E. Stevenson is with the School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Melbourne
| | - Dianna J Magliano
- Hélène Bihan is with the Department of Endocrinology, Diabetology and Metabolic Diseases, Avicenne Hospital, Bobigny, France. Kathrin Backholer, Anna Peeters, Jonathan E. Shaw, and Dianna J. Magliano are with the Baker IDI Heart and Diabetes Institute, Melbourne, Australia. Christopher E. Stevenson is with the School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Melbourne
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Collins SE. Associations Between Socioeconomic Factors and Alcohol Outcomes. Alcohol Res 2016; 38:83-94. [PMID: 27159815 PMCID: PMC4872618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Socioeconomic status (SES) is one of the many factors influencing a person's alcohol use and related outcomes. Findings have indicated that people with higher SES may consume similar or greater amounts of alcohol compared with people with lower SES, although the latter group seems to bear a disproportionate burden of negative alcohol-related consequences. These associations are further complicated by a variety of moderating factors, such as race, ethnicity, and gender. Thus, among individuals with lower SES, members of further marginalized communities, such as racial and ethnic minorities and homeless individuals, experience greater alcohol-related consequences. Future studies are needed to more fully explore the underlying mechanisms of the relationship between SES and alcohol outcomes. This knowledge should be applied toward the development of multilevel interventions that address not only individual-level risks but also economic disparities that have precipitated and maintained a disproportionate level of alcohol-related consequences among more marginalized and vulnerable populations.
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Vohra J, Marmot MG, Bauld L, Hiatt RA. Socioeconomic position in childhood and cancer in adulthood: a rapid-review. J Epidemiol Community Health 2015; 70:629-34. [PMID: 26715591 PMCID: PMC4893135 DOI: 10.1136/jech-2015-206274] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 11/30/2015] [Indexed: 02/05/2023]
Abstract
Background The relationship of childhood socioeconomic position (SEP) to adult cancer has been inconsistent in the literature and there has been no review summarising the current evidence focused solely on cancer outcomes. Methods and results We performed a rapid review of the literature, which identified 22 publications from 13 studies, primarily in the UK and northern European countries that specifically analysed individual measures of SEP in childhood and cancer outcomes in adulthood. Most of these studies adjusted for adult SEP as a critical mediator of the relationship of interest. Conclusions Results confirm that childhood socioeconomic circumstances have a strong influence on stomach cancer and are likely to contribute, along with adult circumstances, to lung cancer through cumulative exposure to smoking. There was also some evidence of increased risk of colorectal, liver, cervical and pancreatic cancers with lower childhood SEP in large studies, but small numbers of cancer deaths made these estimates imprecise. Gaps in knowledge and potential policy implications are presented.
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Affiliation(s)
- Jyotsna Vohra
- Department of Cancer Prevention, Cancer Research UK, London, UK
| | - Michael G Marmot
- Department of Epidemiology and Public Health, UCL Institute of Health Equity, London, UK
| | - Linda Bauld
- Institute for Social Marketing, 3Y1, University of Stirling, Stirling, UK
| | - Robert A Hiatt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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Sabbath EL, Matz-Costa C, Rowe JW, Leclerc A, Zins M, Goldberg M, Berkman LF. Social Predictors of Active Life Engagement: A Time-Use Study of Young-Old French Adults. Res Aging 2015; 38:864-93. [PMID: 26449627 DOI: 10.1177/0164027515609408] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Active life engagement is important for successful aging of societies and individuals. We tested predictors of engagement in French adults aged 60-74 (the GAZEL cohort). METHODS Participants (n = 10,764) reported the previous day's activities in a time-use survey. We modeled concurrent social, demographic, and health predictors of participation incidence and intensity in paid work, volunteering, caregiving, community involvement, and informal social interaction. RESULTS Men were more active in volunteering/community activities and women in caregiving and informal social interaction. Participation varied inversely with socioeconomic status (SES). Paid work participation declined linearly with age and health status, but this relationship did not hold for other activities. CONCLUSIONS Men and those of higher SES were more likely to participate in certain activities than were women and those of low lifetime SES, potentially limiting the latter groups' future health and well-being benefits from such activities. Findings suggest groups that could benefit from interventions to increase engagement.
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Affiliation(s)
- Erika L Sabbath
- Boston College School of Social Work, Chestnut Hill, MA, USA Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | | | - John W Rowe
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Annette Leclerc
- INSERM, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France INSERM UMR-S 1168 VIMA, Villejuif, France Versailles St-Quentin University, UMS 011, F-94807, Villejuif, France
| | - Marie Zins
- INSERM, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France INSERM UMR-S 1168 VIMA, Villejuif, France Versailles St-Quentin University, UMS 011, F-94807, Villejuif, France
| | - Marcel Goldberg
- INSERM, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France INSERM UMR-S 1168 VIMA, Villejuif, France Versailles St-Quentin University, UMS 011, F-94807, Villejuif, France
| | - Lisa F Berkman
- Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
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de Quadros LDCM, Quevedo LDA, Motta JVDS, Carraro A, Ribeiro FG, Horta BL, Gigante DP. Social Mobility and Mental Disorders at 30 Years of Age in Participants of the 1982 Cohort, Pelotas, Rio Grande Do Sul - RS. PLoS One 2015; 10:e0136886. [PMID: 26448480 PMCID: PMC4598184 DOI: 10.1371/journal.pone.0136886] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 08/10/2015] [Indexed: 11/23/2022] Open
Abstract
This study aimed to evaluate the relationship between mental disorders at 30 years of age and social mobility by formally testing three hypotheses: Risk Accumulation; Critical Period; and Social Mobility. The study was performed using data from the 30-year follow-up of the Pelotas Birth Cohort Study, conducted in 1982, and data from previous follow-ups. The tool used to evaluate mental health was the Self Report Questionnaire (SRQ-20). For the statistical analysis, the chi-square test with the Yates correction was used to estimate the prevalence of mental disorder, and the Poisson regression with robust variance was used to formally test the hypotheses according to the Risk Accumulation, Critical Period and Social Mobility Models. The analyses were stratified by gender. The prevalence of Common Mental Disorders (CMDs) was 24.3% (95% CI 22.9–25.7) when the whole sample was considered. The highest prevalence, 27.1% (95% CI 25.1–29.2), was found in women, and the difference between genders was significant (p < 0.001). CMDs were more frequent in participants who remained “poor” in the three follow-ups. In both men and women, the best fit was obtained with the Risk Accumulation Model, with p = 0.6348 and p = 0.2105, respectively. The results indicate the need to rethink public income maintenance policies. Finally, we suggest further studies to investigate the role of different public policies in decreasing the prevalence of mental disorders and thus contribute proposals of new policies that may contribute to the prevention of these disorders.
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Affiliation(s)
- Lenice de Castro Muniz de Quadros
- Graduate Program in Epidemiology, Federal University of Pelotas (Universidade Federal de Pelotas - UFPEL), Rio Grande do Sul, Brazil
- * E-mail:
| | - Luciana de Avila Quevedo
- Graduate Program in Health and Behavior, Catholic University of Pelotas (Universidade Católica de Pelotas - UCPel), Rio Grande do Sul, Brazil
| | - Janaína Vieira dos Santos Motta
- Graduate Program in Health and Behavior, Catholic University of Pelotas (Universidade Católica de Pelotas - UCPel), Rio Grande do Sul, Brazil
| | - André Carraro
- Graduate Program in Organizations and Markets, Federal University of Pelotas (Universidade Federal de Pelotas - UFPEL), Rio Grande do Sul, Brazil
| | - Felipe Garcia Ribeiro
- Graduate Program in Organizations and Markets, Federal University of Pelotas (Universidade Federal de Pelotas - UFPEL), Rio Grande do Sul, Brazil
| | - Bernardo Lessa Horta
- Graduate Program in Epidemiology, Federal University of Pelotas (Universidade Federal de Pelotas - UFPEL), Rio Grande do Sul, Brazil
| | - Denise Petrucci Gigante
- Graduate Program in Epidemiology, Federal University of Pelotas (Universidade Federal de Pelotas - UFPEL), Rio Grande do Sul, Brazil
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Karimi M, Geoffroy-Perez B, Fouquet A, Latouche A, Rey G. Socioprofessional trajectories and mortality in France, 1976-2002: a longitudinal follow-up of administrative data. J Epidemiol Community Health 2014; 69:339-46. [PMID: 25516611 DOI: 10.1136/jech-2014-204615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Occupying a low socioeconomic position is associated with increased mortality risk. To disentangle this association, previous studies considered various dimensions of socioeconomic trajectories across the life course. However, they used a limited number of stages. We simultaneously examined various dimensions of the whole professional trajectory and its association with mortality. METHODS We used a large sample (337,706 men and 275,378 women) of the data obtained by linking individuals' annual occupation (collected in 1976-2002 from a representative panel of the French salaried population in the semipublic and private sectors) with causes of death obtained from registries. All-cause and cause-specific HRs were estimated using Cox's regression models adjusted for the occupational class at the beginning of the follow-up, the current occupational class, the transition rates between occupational categories and the duration of time spent in occupational categories. RESULTS An increase in the time spent in the clerk class increased men and women's cardiovascular mortality risk compared with that in the upper class (HRs=1.59 (1.14 to 2.20) and 2.65 (1.14 to 6.13) for 10 years increase, respectively, for men and women). Men with a high rate of transitions had about a 1.2-fold increased risk of all-cause and external-cause mortality compared with those without transitions during their professional life. This association was also observed for women's all-cause mortality. CONCLUSIONS Strong associations between professional trajectories and mortality from different causes of death were found. Long exposure to lower socioeconomic conditions was associated with increased mortality risk from various causes of death. The results also suggest gradual associations between transition rates and mortality.
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Affiliation(s)
| | | | - Aurélie Fouquet
- Département Santé-Travail, Institut de Veille Sanitaire, Saint-Maurice, France
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Abstract
The original GAZEL cohort was composed of 20 625 employees of the French national gas and electricity companies (15 011 male employees then aged 40 to 50 years and 5614 women between 35 and 50 years old) at its inception in 1989. A Cohort Profile article was published in 2007. By the end of 2013, participants were aged 60-75, and almost all of them retired during follow-up. Accordingly, the main focus of research in the past decade was devoted to the study of the persistent, long-term effects of occupational exposures after retirement; of the transition between professionally active life and retirement; and on determinants of early ageing. Accordingly, in addition to the health, behavioural and social data collected yearly since the beginning of the follow-up, new data were thus collected on cognitive complaints, cognitive and physical functioning, limitations in daily activities, time use and social relationships of retirees. This update presents the main findings of research within the GAZEL Cohort Study during the past 7 years. Any research group, in France or elsewhere, can submit a research proposal to work on the GAZEL cohort. To do this, interested researchers should contact one of the principal investigators of the GAZEL Cohort Study.
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Affiliation(s)
- Marcel Goldberg
- Population-based Epidemiological Cohorts Unit, UMS 011 Inserm-UVSQ, Villejuif, France and Versailles Saint Quentin en Yvelines University, Versailles, France Population-based Epidemiological Cohorts Unit, UMS 011 Inserm-UVSQ, Villejuif, France and Versailles Saint Quentin en Yvelines University, Versailles, France
| | - Annette Leclerc
- Population-based Epidemiological Cohorts Unit, UMS 011 Inserm-UVSQ, Villejuif, France and Versailles Saint Quentin en Yvelines University, Versailles, France Population-based Epidemiological Cohorts Unit, UMS 011 Inserm-UVSQ, Villejuif, France and Versailles Saint Quentin en Yvelines University, Versailles, France
| | - Marie Zins
- Population-based Epidemiological Cohorts Unit, UMS 011 Inserm-UVSQ, Villejuif, France and Versailles Saint Quentin en Yvelines University, Versailles, France Population-based Epidemiological Cohorts Unit, UMS 011 Inserm-UVSQ, Villejuif, France and Versailles Saint Quentin en Yvelines University, Versailles, France
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Bellis MA, Hughes K, Leckenby N, Hardcastle KA, Perkins C, Lowey H. Measuring mortality and the burden of adult disease associated with adverse childhood experiences in England: a national survey. J Public Health (Oxf) 2014; 37:445-54. [PMID: 25174044 PMCID: PMC4552010 DOI: 10.1093/pubmed/fdu065] [Citation(s) in RCA: 216] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND ACE (adverse childhood experience) studies typically examine the links between childhood stressors and adult health harming behaviours. Using an enhanced ACE survey methodology, we examine impacts of ACEs on non-communicable diseases and incorporate a proxy measure of premature mortality in England. METHODS A nationally representative survey was undertaken (n = 3885, aged 18-69, April-July 2013). Socio-demographically controlled proportional hazards analyses examined the associations between the number of ACE categories (<18 years; e.g. child abuse and family dysfunction such as domestic violence) and cancer, diabetes, stroke, respiratory, liver/digestive and cardiovascular disease. Sibling (n = 6983) mortality was similarly analysed as a measure of premature mortality. RESULTS Of the total, 46.4% of respondents reported ≥1 and 8.3% ≥4 ACEs. Disease development was strongly associated with increased ACEs (e.g. hazard ratios, HR, 0 versus ≥4 ACEs; cancer, 2.38 (1.48-3.83); diabetes, 2.99 (1.90-4.72); stroke, 5.79 (2.43-13.80, all P < 0.001). Individuals with ≥4 ACEs (versus no ACEs) had a 2.76 times higher rate of developing any disease before age 70 years. Adjusted HR for mortality was strongly linked to ACEs (≥4 versus 0 ACEs; HR, 1.97 (1.39-2.79), P < 0.001). CONCLUSIONS Radically different life-course trajectories are associated with exposure to increased ACEs. Interventions to prevent ACEs are available but rarely implemented at scale. Treating the resulting health costs across the life course is unsustainable.
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Affiliation(s)
- M A Bellis
- Centre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK Public Health Wales, Hadyn Ellis Building, Maindy Road, Cardiff CF24 4HQ, UK
| | - K Hughes
- Centre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK
| | - N Leckenby
- Centre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK
| | - K A Hardcastle
- Centre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University, 15-21 Webster Street, Liverpool L3 2ET, UK
| | - C Perkins
- Knowledge and Intelligence Team (North West), Public Health England, 15-21 Webster Street, Liverpool L3 2ET, UK
| | - H Lowey
- Blackburn with Darwin Borough Council, Specialist Public Health Directorate, 10 Duke Street, Blackburn BB2 1DH, UK
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Previous employment histories and quality of life in older ages: sequence analyses using SHARELIFE. AGEING & SOCIETY 2014. [DOI: 10.1017/s0144686x14000713] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTThis article summarizes previous employment histories and studies associations between types of histories and quality of life in older ages. Retrospective information from the Survey of Health, Ageing and Retirement in Europe (SHARE) was used and the occupational situation for each age between 30 and 65 of 4,808 men and 4,907 women aged 65 or older in Europe was considered. Similar histories were regrouped using sequence analyses, and multi-level modelling was applied to study associations with quality of life. To avoid reverse causality, individuals with poor health prior to or during their working life were excluded. Men's employment histories were dominated by long periods of paid employment that ended in retirement (‘regular’ histories). Women's histories were more diverse and also involved domestic work, either preceding regular careers (‘mixed’ histories) or dominating working life (‘home-maker’ histories). The highest quality of life was found among women with mixed histories and among men with regular histories and late retirement. In contrast, retirement between 55 and 60 (but not earlier) and regular histories ending in unemployment or domestic work (for men only) were related to lower quality of life, as well as home-maker histories in the case of women. Findings remain significant after controlling for social position, partnership and parental history, as well as income in older ages. Results point to the importance of continuous employment for health and wellbeing, not only during the working life, but also after labour market exit.
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Determinants of premature mortality in a city population: an eight-year observational study concerning subjects aged 18-64. Int J Occup Med Environ Health 2014; 26:724-41. [PMID: 24464538 DOI: 10.2478/s13382-013-0154-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 10/07/2013] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Premature deaths constitute 31.1% of all deaths in Łódź. Analysis of the causes of premature deaths may be helpful in the evaluation of health risk factors. Moreover, findings of this study may enhance prophylactic measures. MATERIAL AND METHODS In 2001, 1857 randomly selected citizens, aged 18-64, were included in the Countrywide Integrated Noncommunicable Diseases Intervention (CINDI) Programme. In 2009, a follow-up study was conducted and information on the subjects of the study was collected concerning their health status and if they continued to live in Łódź. The Cox proportional hazards model was used for evaluation of hazard coefficients. We adjusted our calculations for age and sex. The analysis revealed statistically significant associations between the number of premature deaths of the citizens of Łódź and the following variables: a negative self-evaluation of health - HR = 3.096 (95% CI: 1.729-5.543), poor financial situation - HR = 2.811 (95% CI: 1.183-6.672), occurring in the year preceding the study: coronary pain - HR = 2.754 (95% CI: 1.167-6.494), depression - HR = 2.001 (95% CI: 1.222-3.277) and insomnia - HR = 1.660 (95% CI: 1.029-2.678). Our research study also found a negative influence of smoking on the health status - HR = 2.782 (95% CI: 1.581-4.891). Moreover, we conducted survival analyses according to sex and age with Kaplan-Meier curves. CONCLUSIONS The risk factors leading to premature deaths were found to be highly significant but possible to reduce by modifying lifestyle-related health behaviours. The confirmed determinants of premature mortality indicate a need to spread and intensify prophylactic activities in Poland, which is a post-communist country, in particular, in the field of cardiovascular diseases.
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Charles MA. [Developmental origins of adult health and disease: an important concept for social inequalities in health]. Rev Epidemiol Sante Publique 2013; 61 Suppl 3:S133-8. [PMID: 23845205 DOI: 10.1016/j.respe.2013.05.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 05/24/2013] [Indexed: 11/15/2022] Open
Abstract
According to the theory of the developmental origins of adult health and disease, development in utero and in the first years of life are critical phases during which susceptibility to many chronic diseases is set. Diseases eventually occur only if the environment and lifestyle in later life is favorable. Exposure to chemicals (environmental or drug), to infectious agents, unbalanced nutrition, or psychosocial stress prenatally or in the first months/years of life are all factors which have been shown to impact long-term health of individuals. The consequences, however, are not limited to health. A demonstrative example was provided by the study of the influenza epidemic of 1918-1919 in the United States. Nationwide, it was estimated that the loss of income over a lifetime for individuals exposed during fetal life to this epidemic amounted to 14 billion dollars. This example demonstrates that an exposure during fetal life, which is not socially differentiated, may affect the social situation of individuals in adulthood. In many situations, it is much more difficult to separate the specific effect of a given exposure from the overall effect of the social environment. Indeed, it has been shown that socioeconomic status in childhood is associated with increased risk of mortality in adulthood, even after accounting for the socioeconomic status and risky behaviors in adulthood. Among the explanations, the theory of developmental origins of health credits of biological plausibility the model of critical periods early in which the individual is particularly vulnerable to certain exposures. Thus, ensuring the best conditions for the biological, physical, emotional and cognitive development of children in early life will enable them to reach their potential in terms of health and socioeconomic return to society. Investment in this period also brings the hope of reducing the perpetuation of social inequalities and health from generation to generation.
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Affiliation(s)
- M-A Charles
- Inserm U1018, centre de recherche en épidémiologie et santé des populations (CESP), équipe épidémiologie environnementale des cancers, Institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94807 Villejuif, France.
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Bowes L, Chollet A, Fombonne E, Galéra C, Melchior M. Lifecourse SEP and tobacco and cannabis use. Eur J Public Health 2013; 23:322-7. [PMID: 22645240 PMCID: PMC3610337 DOI: 10.1093/eurpub/cks065] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Social inequalities in substance use have been well-documented; however, the impact of changes in socio-economic position from childhood to adulthood is unclear. We examined the relationship between intergenerational trajectories of social position and tobacco and cannabis use among young adults. METHODS Data come from 1103 participants (mean age: 28.9 years) of the Trajectoires Epidémiologiques en Population (TEMPO) study and their parents, participants of the GAZEL study, France. Multinomial regression analyses were used to examine associations between lifecourse socio-economic position (SEP) assessed using the parent's reports of family income (1989 and 2002) and the participant's educational attainment, occupational grade and job stability in 2009, with self-reported tobacco and cannabis use in 2009. RESULTS Compared with participants with stable intermediate/high SEP, those with stable low SEP and those with declining SEP were more likely to use tobacco (age- and sex-adjusted ORs = 2.03 and 2.26). Participants who experienced declining SEP were also disproportionately likely to use and abuse cannabis (adjusted ORs = 2.22 and 2.73). Associations remained significant after adjusting for family (parental smoking, alcohol use, ill health, unemployment, depression and divorce) and individual (early tobacco and cannabis use, academic difficulties, juvenile internalizing and externalizing problems) risk factors. CONCLUSIONS Cross-sectional studies indicate social inequalities in substance use. Our longitudinal findings suggest that individuals who experienced declining SEP from childhood to adulthood may be twice as likely to use tobacco and cannabis compared with individuals with a stable/high trajectory. Interventions targeting substance abuse should take into account lifecourse determinants including the interplay between individuals' socio-economic origins and later attainment.
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Affiliation(s)
- Lucy Bowes
- 1 CESP, Inserm U1018, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France
- 4 Université de Versailles Saint-Quentin, Villejuif, France
| | - Aude Chollet
- 1 CESP, Inserm U1018, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France
- 4 Université de Versailles Saint-Quentin, Villejuif, France
| | - Eric Fombonne
- 2 Montreal Children’s Hospital, Department of Child Psychiatry, McGill University, Montreal, Canada
| | - Cédric Galéra
- 3 Child Psychiatry Department, Charles–Perrens Hospital, University Victor Segalen Bordeaux 2, Bordeaux, France
| | - Maria Melchior
- 1 CESP, Inserm U1018, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France
- 4 Université de Versailles Saint-Quentin, Villejuif, France
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Wahrendorf M, Blane D, Bartley M, Dragano N, Siegrist J. Working conditions in mid-life and mental health in older ages. ADVANCES IN LIFE COURSE RESEARCH 2013; 18:16-25. [PMID: 24797464 DOI: 10.1016/j.alcr.2012.10.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 10/20/2012] [Accepted: 10/22/2012] [Indexed: 06/03/2023]
Abstract
This article illustrates the importance of previous working conditions during mid-life (between 40 and 55) for mental health among older retired men and women (60 or older) across 13 European countries. We link information on health from the second wave (2006-2007) of the Survey of Health, Ageing and Retirement in Europe (SHARE) with information on respondents' working life collected retrospectively in the SHARELIFE interview (2008-2009). To measure working conditions, we rely on core assumptions of existing theoretical models of work stress (the demand-control-support and the effort-reward imbalance model) and distinguish four types of unhealthy working conditions: (1) a stressful psychosocial work environment (as assessed by the two work stress models) (2) a disadvantaged occupational position throughout the whole period of mid-life, (3) experience of involuntary job loss, and (4) exposure to job instability. Health after labour market exit is measured using depressive symptoms, as measured by the EURO-D depression scale. Main results show that men and women who experienced psychosocial stress at work or had low occupational positions during mid-life had significantly higher probabilities of high depressive symptoms during retirement. Additionally, men with unstable working careers and an involuntary job loss were at higher risks to report high depressive symptoms in later life. These associations remain significant after controlling for workers' health and social position prior mid-life. These findings support the assumption that mental health of retirees who experienced poor working conditions during mid-life is impaired.
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Affiliation(s)
- Morten Wahrendorf
- International Centre for Life Course Studies in Society and Health, Department of Primary Care and Public Health, Imperial College London, UK.
| | - David Blane
- International Centre for Life Course Studies in Society and Health, Department of Primary Care and Public Health, Imperial College London, UK
| | - Mel Bartley
- International Centre for Life Course Studies in Society and Health, Department of Epidemiology and Public Health, University College London, UK
| | - Nico Dragano
- Institute for Medical Sociology, University of Duesseldorf, University Clinic Duesseldorf, Germany
| | - Johannes Siegrist
- Institute for Medical Sociology, University of Duesseldorf, University Clinic Duesseldorf, Germany
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Melchior M, Chastang JF, Head J, Goldberg M, Zins M, Nabi H, Younès N. Socioeconomic position predicts long-term depression trajectory: a 13-year follow-up of the GAZEL cohort study. Mol Psychiatry 2013; 18:112-21. [PMID: 21931321 PMCID: PMC3526730 DOI: 10.1038/mp.2011.116] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Individuals with low socioeconomic position have high rates of depression; however, it is not clear whether this reflects higher incidence or longer persistence of disorder. Past research focused on high-risk samples, and risk factors of long-term depression in the population are less well known. Our aim was to test the hypothesis that socioeconomic position predicts depression trajectory over 13 years of follow-up in a community sample. We studied 12 650 individuals participating in the French GAZEL study. Depression was assessed by the Center for Epidemiological Studies-Depression scale in 1996, 1999, 2002, 2005 and 2008. These five assessments served to estimate longitudinal depression trajectories (no depression, decreasing depression, intermediate/increasing depression, persistent depression). Socioeconomic position was measured by occupational grade. Covariates included year of birth, marital status, tobacco smoking, alcohol consumption, body mass index, negative life events and preexisting psychological and non-psychological health problems. Data were analyzed using multinomial regression, separately in men and women. Overall, participants in intermediate and low occupational grades were significantly more likely than those in high grades to have an unfavorable depression trajectory and to experience persistent depression (age-adjusted ORs: respectively 1.40, 95% confidence interval (CI) 1.16-1.70 and 2.65, 95% CI 2.04-3.45 in men, 2.48, 95% CI 1.36-4.54 and 4.53, 95% CI 2.38-8.63 in women). In multivariate models, the socioeconomic gradient in long-term depression decreased by 21-59% in men and women. Long-term depression trajectories appear to follow a socioeconomic gradient; therefore, efforts aiming to reduce the burden of depression should address the needs of the whole population rather than exclusively focus on high-risk groups.
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Affiliation(s)
- M Melchior
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France.
| | - J-F Chastang
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France,Université de Versailles Saint-Quentin, Villejuif, France
| | - J Head
- International Institute for Society and Health, Department of Epidemiology and Public Health, University College London Medical School, London, UK
| | - M Goldberg
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France,Université de Versailles Saint-Quentin, Villejuif, France
| | - M Zins
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France,Université de Versailles Saint-Quentin, Villejuif, France
| | - H Nabi
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health, Villejuif, France,Université de Versailles Saint-Quentin, Villejuif, France
| | - N Younès
- Université de Versailles Saint-Quentin EA 4047, Centre Hospitalier de Versailles, Le Chesnay, France
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Hallal PC, Clark VL, Assunção MC, Araújo CLP, Gonçalves H, Menezes AMB, Barros FC. Socioeconomic trajectories from birth to adolescence and risk factors for noncommunicable disease: prospective analyses. J Adolesc Health 2012; 51:S32-7. [PMID: 23283158 PMCID: PMC3508416 DOI: 10.1016/j.jadohealth.2012.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 06/26/2012] [Accepted: 06/26/2012] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the associations between family socioeconomic trajectories from 0 to 11 years of age and risk factors for noncommunicable disease at 15 years. METHODS Individuals born in the city of Pelotas, Brazil, in 1993 are part of a birth cohort study. Socioeconomic position, collected at birth and at 11 years of age, was our main exposure. Risk factors for chronic disease were collected at 15 years. Body mass index was transformed into Z score using the World Health Organization standard. Transport and leisure-time physical activity, smoking, and alcohol consumption were assessed by self-report. Blood pressure was measured using a digital sphygmomanometer. RESULTS Of 5,249 cohort members, 85.7% were located at the 15-year follow-up visit. Rich adolescents were more likely to be overweight, be obese, and not use active modes of transport to school. Poor adolescents were more likely to smoke. In relation to socioeconomic trajectories, the odds of obesity were 46% higher among those who were "always rich" compared with those who were "always poor"; the odds of use of an inactive mode of transportation were 326% greater among the "always rich" than the "always poor," whereas the reverse was observed for smoking (odds of 200%). The "always rich" had one-half the odds of walking or cycling to school compared with those who became wealthy in the studied period. CONCLUSIONS Adolescent socioeconomic position is a stronger determinant of risk factors for noncommunicable diseases than socioeconomic trajectories. However, trajectories do matter, particularly in terms of use of active transportation to school.
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Affiliation(s)
- Pedro C Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
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Tiikkaja S, Olsson M, Malki N, Modin B, Sparén P. Familial risk of premature cardiovascular mortality and the impact of intergenerational occupational class mobility. Soc Sci Med 2012; 75:1883-90. [DOI: 10.1016/j.socscimed.2012.06.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 04/25/2012] [Accepted: 06/27/2012] [Indexed: 10/28/2022]
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Unfavourable life-course social gradient of coronary heart disease within Spain: a low-incidence welfare-state country. Int J Public Health 2012; 58:65-77. [PMID: 22674376 DOI: 10.1007/s00038-012-0374-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 04/19/2012] [Accepted: 05/21/2012] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Social position has yet to be established as a risk factor of coronary heart disease (CHD). Our aim was to investigate an individual life-course social position gradient link with CHD incidence in the EPIC-Spain cohort. METHODS 41,066 participants, mostly 30-65 years old, and free of cardiovascular disease at baseline (1992-1996) were followed up for a mean of 10.4 years. A combined score of paternal occupation in childhood and own adult education was used to assess individual life-course risk accumulation. Hazard ratios of CHD were estimated using Cox models, stratifying by centre, and age, and adjusting for cardiovascular risk factors. RESULTS 583 participants (80 % men) developed a definite CHD event. Paternal occupational class IV was associated with CHD in all models in men. The educational gradient remained significant after adjusting for diet and physical activity (p = 0.01). All adjusted risk of incident CHD rose by 23 % (95 % CI 6-42 %) per category increase of life-course social position score in men. No significant associations were found in women. CONCLUSIONS Individual life-course social position gradient was adversely related to incident CHD in Spanish men.
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Scodellaro C, Khlat M, Jusot F. Intergenerational financial transfers and health in a national sample from France. Soc Sci Med 2012; 75:1296-302. [PMID: 22742923 DOI: 10.1016/j.socscimed.2012.04.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 03/29/2012] [Accepted: 04/20/2012] [Indexed: 11/27/2022]
Abstract
Financial transfers from parents to their adult children are a growing trend in contemporary societies, and this study investigates the relation of those transfers to their beneficiaries' health in France. In the 2005 nationally representative Gender and Generation Survey, nearly 6% of the subjects aged 25-49 years reported having received financial transfers during the last 12 months. Subjects who had achieved intergenerational upward mobility as well as those who had remained in the upper class were more likely to receive transfers, suggesting that parents rewarded those of their children who achieved most social success. After adjusting for a wide range of socio-demographic factors, subjects who had been given large transfers were much more likely to report very good health than subjects who had not been given anything. Findings were interpreted within the framework of sociological research on intergenerational transfers and that of lifecourse epidemiology.
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Affiliation(s)
- Claire Scodellaro
- Université de Lorraine, Laboratoire Lorrain de Sciences Sociales, France.
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McKillop A, Crisp J, Walsh K. Barriers and enablers to implementation of a New Zealand-wide guideline for assessment and management of cardiovascular risk in primary health care: a template analysis. Worldviews Evid Based Nurs 2011; 9:159-71. [PMID: 22151788 DOI: 10.1111/j.1741-6787.2011.00233.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to identify the enablers and barriers to guideline implementation in a primary healthcare setting by employing the Promoting Action on Research Implementation in Health Services (PARIHS) framework as a template for data analysis and interpretation. BACKGROUND The use of clinical practice guidelines is pivotal to improving health outcomes. However, the implementation of guidelines into practice is complex, unpredictable, and, in spite of much investigation, remains resistant to explanation of what works and why. Optimising the enablers and minimising the barriers to implementation of a guideline for reducing cardiovascular disease risk has the potential to significantly reduce the burden of disease. The PARIHS framework has been successfully applied in a number of clinical contexts and has been found useful in illuminating the barriers and enablers to evidence implementation. APPROACH This qualitative study involved focus groups with 20 primary healthcare nurses, 4 general practitioners, 5 managers, and individual interviews with 3 funder/planners who discussed their contribution to the use of a guideline for the assessment and management of cardiovascular risk. Template analysis based on the PARIHS framework was applied to semi-structured narrative data to provide an in-depth analysis of the barriers and enablers to implementation of the guideline. CONCLUSIONS The lack of facilitation of the guideline into practice was a major barrier to implementation. Implementation plans that address the concerns and complexities of everyday practice are an essential aspect of guideline development. The PARIHS framework was found to be comprehensive and accommodating of the complexity of everyday practice associated with guideline implementation in primary health care. The pertinence of the framework confirms its usefulness as a tool to guide implementation.
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Affiliation(s)
- Ann McKillop
- School of Nursing, The University of Auckland, Auckland, New Zealand.
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Janicki-Deverts D, Cohen S, Matthews KA, Jacobs DR, Adler NE. Occupational mobility and carotid artery intima-media thickness: findings from the Coronary Artery Risk Development in Young Adults Study. Psychosom Med 2011; 73:795-802. [PMID: 22021461 PMCID: PMC3216404 DOI: 10.1097/psy.0b013e3182365539] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine whether a 10-year change in occupational standing is related to carotid artery intima-media thickness (IMT) 5 years later. METHODS Data were obtained from 2350 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Occupational standing was measured at the Year 5 and 15 CARDIA follow-up examinations when participants were 30.2 (standard deviation = 3.6) and 40.2 (standard deviation = 3.6) years of age, respectively. IMT (common carotid artery [CCA], internal carotid artery [ICA], and bulb) was measured at Year 20. Occupational mobility was defined as the change in occupational standing between Years 5 and 15 using two semicontinuous variables. Analyses controlled for demographics, CARDIA center, employment status, parents' medical history, own medical history, Year 5 Framingham Risk Score, physiological risk factors and health behaviors averaged across the follow-up, and sonography reader. RESULTS Occupational mobility was unrelated to IMT save for an unexpected association of downward mobility with less CCA-IMT (β = -0.04, p = .04). However, associations differed depending on initial standing (Year 5) and sex. For those with lower initial standings, upward mobility was associated with less CCA-IMT (β = -0.07, p = .003), and downward mobility was associated with greater CCA-IMT and bulb-ICA-IMT (β = 0.14, p = .01 and β = 0.14, p = .03, respectively); for those with higher standings, upward mobility was associated with greater CCA-IMT (β = 0.15, p = .008), but downward mobility was unrelated to either IMT measure (p values > .20). Sex-specific analyses revealed associations of upward mobility with less CCA-IMT and bulb-ICA-IMT among men only (p values < .02). CONCLUSIONS Occupational mobility may have implications for future cardiovascular health. Effects may differ depending on initial occupational standing and sex.
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Zins M, Guéguen A, Kivimaki M, Singh-Manoux A, Leclerc A, Vahtera J, Westerlund H, Ferrie JE, Goldberg M. Effect of retirement on alcohol consumption: longitudinal evidence from the French Gazel cohort study. PLoS One 2011; 6:e26531. [PMID: 22028898 PMCID: PMC3197660 DOI: 10.1371/journal.pone.0026531] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Accepted: 09/28/2011] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Little is known about the effect of retirement on alcohol consumption. The objectives were to examine changes in alcohol consumption following retirement, and whether these patterns differ by gender and socioeconomic status. METHODS AND FINDINGS We assessed alcohol consumption annually from 5 years before to 5 years after retirement among 10,023 men and 2,361 women of the French Gazel study. Data were analyzed separately for men and women, using repeated-measures logistic regression analysis with generalized estimating equations. Five years prior to retirement, the prevalence of heavy drinking was about 16% among men, and not patterned by socioeconomic status. Among women, this prevalence was 19.5% in managers, 14.7% in intermediate occupations, and 12.8% in clerical workers. Around retirement, the estimated prevalence of heavy drinking increased in both sexes. In men, this increase was 3.1 percentage points for managers, 3.2 in intermediate occupations, 4.6 in clerical workers, and 1.3 in manual workers. In women, this increase was 6.6 percentage points among managers, 4.3 in intermediate occupations, and 3.3 among clerical workers. In men the increase around retirement was followed by a decrease over the following four years, not significant among manual workers; among women such a decrease was also observed in the non-managerial occupations. It is difficult to assess the extent to which the results observed in this cohort would hold for other working populations, other conditions of employment, or in other cultural settings. A plausible explanation for the increase in heavy drinking around retirement could be that increased leisure time after retirement provides more opportunities for drinking, and not having to work during the day after may decrease constraints on drinking. CONCLUSIONS Our findings of increased consumption around retirement suggest that information about negative effects of alcohol consumption should be included in pre-retirement planning programs.
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Affiliation(s)
- Marie Zins
- Inserm U1018 Epidemiology of Occupational and Social Determinants of Health-Centre for Research in Epidemiology and Population Health, Vilejuif, France.
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