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Hunduma G, Dessie Y, Geda B, Yadeta TA, Deyessa N. Prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in eastern Ethiopia: a cross-sectional study. Sci Rep 2024; 14:3574. [PMID: 38347112 PMCID: PMC10861546 DOI: 10.1038/s41598-024-54145-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/08/2024] [Indexed: 02/15/2024] Open
Abstract
Adolescent's mental health issues are a major social burden and a significant public health issue, but they have not received enough attention in Ethiopia. Therefore, this study aimed to determine the prevalence and correlates of internalizing and externalizing mental health problems among in-school adolescents in the Harari region, eastern Ethiopia. A cross-sectional study was conducted among 3227 in-school adolescents. Multistage sampling was used to select schools and eligible students to participate in the study. A guided, self-administered strength and difficulty questionnaire measured mental health problems. Data were double-entered, validated, and cleaned using EpiData 3.1 and analyzed using STATA version 17. Ordinal logistic regression analysis was performed to estimate the adjusted odds ratio between mental health problems and their correlates. Statistical significance was set at p-value < 0.05. The magnitudes of mental health problems among in-school adolescents by subscale was 24.17% (95% CI 22.72; 25.67) for internalizing and 11.93% (95% CI 10.85; 13.09) for externalizing problems. A high internalizing problem score was associated with females, rural residents, alcohol users, attending public schools, those bullied at school, and those in the lowest wealth index. Likewise, the likelihood of a high externalizing problem score was high among alcohol users, adolescents whose fathers are uneducated, rural, and bullied at school. The study suggests that mental health problems are prevalent among in-school adolescents in Ethiopia, especially internalizing problems. The study also identifies several risk factors associated with internalizing and externalizing problems, such as wealth index, school types, alcohol use, bullying, and rural residence. These factors may indicate the need for more mental health awareness and support programs for adolescents in Ethiopia. This highlights that schools and communities should prioritize mental health awareness and support programs for adolescents. These programs should be tailored to address the specific needs of the population, such as rural residents, those in the lowest wealth index, and those who have experienced bullying.
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Affiliation(s)
- Gari Hunduma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- School of Nursing and Midwifery, College of Health and Medical Sciences, Madda Walabu University, Shashamene, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Negussie Deyessa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Islam S, Jaffee SR. Social mobility and mental health: A systematic review and meta-analysis. Soc Sci Med 2024; 340:116340. [PMID: 38006845 DOI: 10.1016/j.socscimed.2023.116340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/05/2023] [Accepted: 10/12/2023] [Indexed: 11/27/2023]
Abstract
Socioeconomic status (SES) is a robust correlate of mental health, and emerging research indicates that life course trajectories of SES (i.e., social mobility) may be more predictive for health outcomes than point-in-time SES assessments. This paper presents five primary meta-analyses to determine how mental health differs between social mobility groups. We conducted a systematic review of PsycINFO, Web of Science, and PubMed for studies of social mobility and mental health. We used random-effects multilevel meta-analyses to compare mental health problems between individuals who experienced upward mobility, downward mobility, stable high SES, and stable low SES. We included data from 21 studies and 157,763 unique participants yielding 105 effect sizes. Upwardly mobile participants experienced more mental health problems than stable high SES participants (d = 0.11), fewer mental health problems than stable low SES participants (d = -0.24), and fewer mental health problems than downwardly mobile participants (d = -0.17). Downwardly mobile individuals experienced more mental health problems than stable high SES participants (d = 0.26) and fewer mental health problems than stable low SES participants (d = -0.10). Subgroup analyses revealed that the magnitude of effects did not differ by continent of study, type of generational mobility (intergenerational vs. intragenerational), or SES indicator. Meta-regressions with continuous moderators (age, gender, race, study quality) were also non-significant. Taken together, these results indicate that both upwardly and downwardly mobile individuals experience more mental health problems than those who are persistently advantaged, and they both experience fewer mental health problems than those who are persistently disadvantaged. Our findings suggest that while current SES has a stronger association with adult mental health than childhood SES, it is important to also consider the impact of early life and prior generation SES to account for lingering effects of early disadvantage.
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Affiliation(s)
- Samiha Islam
- Department of Psychology, University of Pennsylvania, 425 S. University Ave, Philadelphia, PA, USA.
| | - Sara R Jaffee
- Department of Psychology, University of Pennsylvania, 425 S. University Ave, Philadelphia, PA, USA.
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Patel OP, Quist A, Martin CL, Wegienka G, Baird DD, Wise LA, Vines AI. Life-Course Mobility in Socioeconomic Position and High Depressive Symptoms Among Young Black Women: The SELF Study. Womens Health Issues 2023; 33:266-272. [PMID: 36588050 PMCID: PMC10213084 DOI: 10.1016/j.whi.2022.11.010] [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: 04/07/2022] [Revised: 11/04/2022] [Accepted: 11/28/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Current literature on the association between mobility in socioeconomic position (SEP) and depression demonstrates mixed findings, with variation in the benefits of upward SEP by racial group and ethnic background. No study has examined life-course SEP mobility and depressive symptoms among Black women in the United States. METHODS Our cohort included 1,612 Black women enrolled in the Study of Environment, Lifestyle and Fibroids between 2010 and 2012 and followed for 5 years. We used data on socioeconomic indicators at childhood and adulthood and used latent class analysis to create a life-course SEP mobility measure (persistently low, downward, upward, and persistently high). Using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D), we assessed high (≥9) versus low depressive symptoms. Multivariable log risk models were used to produce risk ratios (RRs) and 95% confidence intervals (CIs). RESULTS Of the participants, 37% had high depressive symptoms. Persistently low (RR, 1.56; 95% CI, 1.31-1.86) and downward (RR, 1.36; 95% CI, 1.14-1.63) SEP mobility was associated with high depressive symptoms after adjustment for age, adult social support, and marital status. There was evidence of an effect measure modification by adult social support, with a stronger association among those who reported high adult social support compared with low adult social support. CONCLUSIONS These findings suggest directing mental health resources to people experiencing low SEP at any stage in life, especially those with low SEP in adulthood, to aid in the management of depressive symptoms.
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Affiliation(s)
- Opal P Patel
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Arbor Quist
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Chantel L Martin
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
| | - Donna D Baird
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Anissa I Vines
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina.
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Best JR, Gan DRY, Wister AV, Cosco TD. Age and sex trends in depressive symptoms across middle and older adulthood: Comparison of the Canadian Longitudinal Study on Aging to American and European cohorts. J Affect Disord 2021; 295:1169-1176. [PMID: 34706430 DOI: 10.1016/j.jad.2021.08.109] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/27/2021] [Accepted: 08/28/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The literature suggests depressive symptoms differ in a non-linear fashion across adulthood and are more commonly reported in women as compared to men. Whether these trends are observed across countries in population-based cohorts is unclear. METHODS Cross-sectional observational study of approximately 138,000 women and men between the ages of 45 and 95 from three population-based cohorts representing Canadian, European, and American populations. Age, gender, educational attainment and annual income were assessed in each cohort. Depressive symptoms were assessed by the Center for Epidemiological Studies Depression Scale in the US and Canadian cohorts, and by the EURO-D in the European cohort. RESULTS Across all three cohorts, non-linear age trends and gender differences were observed in the report of depressive symptoms, independent from educational attainment and annual income effects. The non-linear age trends reflected a negative association between depressive symptoms and age during midlife and then a positive association in late life. Females reported greater depressive symptoms than males; however, an interaction between gender and age was also observed in the Canadian and European cohorts. Among Canadians, the gender differences were largest after age 70, whereas among Europeans, gender differences where largest among those approximately aged 60. LIMITATIONS Limitations include: 1) the cross-sectional nature of the study, resulting in age differences potentially reflecting cohort effects rather than a developmental process; and 2) the use of different depressive symptoms measures across cohorts. CONCLUSIONS Characterization of depressive symptoms over mid and late adulthood in women and men provides insights into potential focal points for intervention and allocation of resources.
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Affiliation(s)
- John R Best
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Daniel R Y Gan
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Andrew V Wister
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Theodore D Cosco
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada; Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada; Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
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Simanek AM, Meier HCS, D'Aloisio AA, Sandler DP. Objective and subjective childhood socioeconomic disadvantage and incident depression in adulthood: a longitudinal analysis in the Sister Study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1201-1210. [PMID: 33881563 PMCID: PMC8580191 DOI: 10.1007/s00127-020-02013-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 12/08/2020] [Indexed: 01/04/2023]
Abstract
Understanding of the role of objective versus subjective childhood socioeconomic disadvantage (SD) in depression onset in adulthood among women, independent of later life SD, and across birth cohorts, is limited. We examined the association between objective (i.e., household education level) and subjective (i.e., rank of family income and report of not enough food to eat) SD during childhood and diagnosis of clinical depression after age 30 among 47,055 women in the Sister Study. We used Cox proportional hazard models adjusting for women's race/ethnicity, childhood household composition, mother's age at her birth adulthood educational attainment, and calendar year of birth. Analyses were repeated stratified by 10-year birth group. A total of 8036 (17.1%) women were diagnosed with clinical depression over a mean follow-up of 24.0 (± 9.9) years. Those reporting being poor (versus well-off) or not having enough food to eat in childhood had a 1.28 (95% confidence interval (CI) 1.13, 1.44) and 1.30 (95% CI 1.21, 1.41) times higher rate of depression diagnosis, respectively, with consistent associations observed across birth year groups. An inverse association between low household education level and incident depression was observed at baseline (i.e., age 30) becoming positive over time in the total sample but only among women born between 1935-1954 in analyses stratified by 10-year birth group. Our findings suggest that subjective SD in childhood is a largely consistent predictor of depression onset among women in adulthood whereas the effects of household education level in childhood may vary across women born into different birth cohorts, and for some, across the lifecourse.
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Affiliation(s)
- Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St, Milwaukee, WI, 53205, USA.
| | - Helen C S Meier
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St, Milwaukee, WI, 53205, USA
| | | | - Dale P Sandler
- National Institute of Environmental Health Sciences, Epidemiology Branch, Research Triangle Park, NC, USA
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Kim Y, Woo H, Withers E. Low income dynamics and depression over the life course in South Korea. ADVANCES IN LIFE COURSE RESEARCH 2021; 48:100400. [PMID: 36695140 DOI: 10.1016/j.alcr.2020.100400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/18/2020] [Accepted: 12/22/2020] [Indexed: 06/17/2023]
Abstract
OBJECTIVES We examined how experiencing low income multiple times is associated with depressive symptoms over the life course to better understand the influence of low income experience on psychological well-being. METHODS We employed fixed effects models to estimate the association between low income experience and depressive symptoms using data from a longitudinal survey of a representative sample of adults in Korea (N=6,930). We also considered age variations given different perspectives and social circumstances related to different ages and family stages over the life course that potentially modify the association. RESULTS Our results revealed that the detrimental influence of low income experience on depressive symptoms slowly declines with additional increments in the number of the exposures. Additionally, although older adults have a higher risk of experiencing low income more than once, the detrimental influence appears more salient among younger adults compared to older individuals. DISCUSSION We offered some explanations for the diminishing effects of additional experiences of low income on depressive symptoms, and the age group variations in the association in Korea. We also discussued policy implications of our findings.
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Affiliation(s)
- Yujin Kim
- Department of Sociology, Kangwon National University, 1 Gangwondaehak-gil, Seoksa-dong, Chuncheon-si, Gangwon-do, 24341, Republic of Korea.
| | - Hyeyoung Woo
- Department of Sociology, Portland State University, 1721 SW Broadway, Portland, OR, 97207-0751, United States.
| | - Elizabeth Withers
- Department of Sociology, Portland State University, 1721 SW Broadway, Portland, OR, 97207-0751, United States.
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Turuba R, Pirkle C, Bélanger E, Ylli A, Gomez Montes F, Vafaei A. Assessing the relationship between multimorbidity and depression in older men and women: the International Mobility in Aging Study (IMIAS). Aging Ment Health 2020; 24:747-757. [PMID: 30724575 DOI: 10.1080/13607863.2019.1571018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objectives: Our study aims to assess whether multimorbidity is an independent risk factor for the development of depression in older adults living in Canada, Brazil, Colombia, and Albania and examines differences in incidence of depression regarding social and psychosocial characteristics.Methods: The longitudinal International Mobility Aging Study (IMIAS) collected information from adults between 65-74 years old. Depression was defined by a 16 or higher score assessed by the Centre for Epidemiological Studies Depression (CES-D) Scale. Multimorbidity was defined as having two or more chronic conditions, which were self-reported by participants using a list of eight physical chronic conditions. Poisson regression was performed to estimate the relative risk of depression in older adults with multimorbidity compared to those living with 0-1 chronic conditions, adjusting for sex, age, education, number of doctor visits, degree of assistance needed, social support, and smoking status. The analysis was stratified by study region (Canada; Latin America; Albania).Results: Crude and adjusted models showed no statistically significant associations between multimorbidity and the incidence of depression in any of the study regions, confirmed by sensitivity analyses. However, the incidence of depression varied across study region, confirmed by the intra-class correlation coefficient which indicated that 13% of variations in depression incidence were due to geographic differences.Conclusion: Multimorbidity does not appear to increase the risk of developing depression in older adults between 65-74. Higher rates of depression in Latin America and Albania (compared to Canada) may be attributed to lifecourse exposures to social and economic adversity in these regions.
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Affiliation(s)
- Roxanne Turuba
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
| | - Catherine Pirkle
- Office of Public Health Studies, University of Hawaii, Honolulu, HI, USA
| | - Emmanuelle Bélanger
- Center for Gerontology and Healthcare Research, Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA
| | - Alban Ylli
- Institute of Public Health, Tirana, Albania
| | - Fernando Gomez Montes
- Research Group on Geriatrics and Gerontology, Faculty of Health Sciences, Universidad de Caldas, Manizales, Colombia
| | - Afshin Vafaei
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
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Peristera P, Platts LG, Magnusson Hanson LL, Westerlund H. A comparison of the B-spline group-based trajectory model with the polynomial group-based trajectory model for identifying trajectories of depressive symptoms around old-age retirement. Aging Ment Health 2020; 24:445-452. [PMID: 30499331 DOI: 10.1080/13607863.2018.1531371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: The life event of retirement may be associated with changes in levels of depressive symptoms. The use of polynomial group-based trajectory modelling allows any changes to vary between different groups in a sample. A new approach, estimating these models using B-splines rather than polynomials, may improve modelling of complex changes in depressive symptoms at retirement.Methods: The sample contained 1497 participants from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Polynomial and B-spline approaches to estimating group-based trajectory models were compared.Results: Polynomial group-based trajectory models produced unexpected changes in direction of trajectories unsupported by the data. In contrast, B-splines provided improved insights into trajectory shapes and more homogeneous groups. While retirement was associated with reductions in depressive symptoms in the sample as a whole, the nature of changes at retirement varied between groups.Conclusions: Depressive symptoms trajectories around old age retirement changed in complex ways that were modelled more accurately by the use of B-splines. We recommend estimation of group-based trajectory models with B-splines, particularly where abrupt changes might occur. Improved trajectory modelling may support research into risk factors and consequences of major depressive disorder, ultimately assisting with identification of groups which may benefit from treatment.
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Affiliation(s)
| | - Loretta G Platts
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | | | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
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Schweizer S, Stretton J, Van Belle J, Price D, Calder AJ, Dalgleish T. Age-related decline in positive emotional reactivity and emotion regulation in a population-derived cohort. Soc Cogn Affect Neurosci 2019; 14:623-631. [PMID: 31119296 PMCID: PMC6688446 DOI: 10.1093/scan/nsz036] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/20/2019] [Accepted: 05/09/2019] [Indexed: 01/08/2023] Open
Abstract
Human older age ushers in functional decline across the majority of cognitive domains. A notable exception seems to be affective processing, with older people reporting higher levels of emotional well-being. Here we evaluated age-related changes in emotional reactivity and regulation in a representative subsample (N = 104; age range: 23-88 years) of the population-derived Cambridge Centre for Ageing and Neuroscience cohort. Performance on a film-based emotion reactivity and regulation task in the magnetic resonance imaging scanner showed an age-related decline in positive reactivity, alongside a similar decline in the capacity to down-regulate negative affect. Decreased positivity with age was associated with reduced activation in the middle frontal gyrus. These findings, from the largest neuroimaging investigation to-date, provide no support for age-related increases in positive emotional reactivity.
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Affiliation(s)
- Susanne Schweizer
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
- Institute of Cognitive Neuroscience, University College London, London, WC1N 3AZ, UK
| | - Jason Stretton
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - Janna Van Belle
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - Darren Price
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | - Andrew J Calder
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
| | | | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
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Kwon E, Park S. Heterogeneous Trajectories of Physical and Mental Health in Late Middle Age: Importance of Life-Course Socioeconomic Positions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060582. [PMID: 28556801 PMCID: PMC5486268 DOI: 10.3390/ijerph14060582] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/24/2017] [Accepted: 05/26/2017] [Indexed: 11/16/2022]
Abstract
Drawing on life course and cumulative disadvantage theory, this study examines heterogeneous trajectories of functional limitations and depressive symptoms among late middle-aged individuals. This study used prospective data from 6010 adults, 51 to 64 years old, collected over a 12-year-period from the Health and Retirement Study. Considering the empirical proposition that several physical and mental trajectories may exist, Latent Class Growth Modeling was used. Five heterogeneous patterns of joint trajectories (Relatively healthy, Moderately improving, Steadily deteriorating, Steeply deteriorating, and Persistently high comorbid) were identified. Early life adversity was related to an increasing risk of declines in physical and mental health. The Persistently high comorbid class was characterized by a concentration of disadvantages over the life course. The development of public health interventions could help reduce co-existing physical and mental health problems, especially during late middle-age.
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Affiliation(s)
- Eunsun Kwon
- Center for Social Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea.
| | - Sojung Park
- George Warren Brown School of Social Work at Washington University in One Brookings Drive, Saint Louis, MO 63105, USA.
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