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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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Letarte L, Samadoulougou S, McKay R, Quesnel-Vallée A, Waygood EOD, Lebel A. Neighborhood deprivation and obesity: Sex-specific effects of cross-sectional, cumulative and residential trajectory indicators. Soc Sci Med 2022; 306:115049. [PMID: 35724583 DOI: 10.1016/j.socscimed.2022.115049] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 04/09/2022] [Accepted: 05/15/2022] [Indexed: 11/29/2022]
Abstract
Obesity is a long-term health issue that is becoming increasingly prevalent. Very few studies have considered the life course effects of neighborhood characteristics on obesity. In a sample of 35,856 adult participants (representative of the population of the Province of Quebec in Canada), we measured the association between neighborhood deprivation and obesity using logistic modelling on indicators of cross-sectional neighborhood deprivation, cumulative neighborhood deprivation and trajectories of neighborhood deprivation. For cross-sectional exposure, we found that females in our sample had higher odds of being affected by obesity when living in high-deprivation (OR 1.73, CI 1.41-2.13) or medium-deprivation neighborhoods (OR 1.27, CI 1.07-1.51) compared to females living in low-deprivation neighborhoods. Males also had higher odds of being affected by obesity when living in medium or high deprivation. For cumulative exposure to neighborhood deprivation, only females in the second highest category for longitudinal exposure to deprived neighborhoods had significantly higher odds of living with obesity (OR 1.89 CI 1.12-3.19) compared to females in the low cumulative exposure category. Using sequence analysis to determine neighborhood deprivation trajectories for up to 17 years, we found that females with a Deprived upward (OR 1.75 CI 1.10-2.78), an Average downward (OR 1.75 CI 1.08-2.84) or a Deprived trajectory (OR 1.81 CI 1.45-2.86) had higher odds of living with obesity compared to the Privileged trajectory. For males, there were no significant associations. Using trajectory indicators was beneficial to our analyses because this method shows that not only are individuals in low socioeconomic status neighborhoods at the end of their trajectory more susceptible to living with obesity, but so are those exposed to neighborhood deprivation at the beginning of their trajectory. These results could help to more precisely identify individuals at higher risk of developing obesity-related health issues.
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Affiliation(s)
- Laurence Letarte
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada.
| | - Sekou Samadoulougou
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
| | - Rachel McKay
- McGill Observatory on Health and Social Services Reforms, McGill University, Montreal, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Canada
| | - Amélie Quesnel-Vallée
- McGill Observatory on Health and Social Services Reforms, McGill University, Montreal, Canada; Department of Sociology, McGill University, Montreal, Canada
| | | | - Alexandre Lebel
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
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Lopes JAS, Giatti L, Griep RH, Lopes AADS, Matos SMA, Chor D, Fonseca MDJM, Barreto SM. Life Course Socioeconomic Position, Intergenerational Social Mobility, and Hypertension Incidence in ELSA-Brasil. Am J Hypertens 2021; 34:801-809. [PMID: 33544821 DOI: 10.1093/ajh/hpab029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Life course epidemiology is a powerful framework to unravel the role of socioeconomic position (SEP) disparities in hypertension (HTN). This study investigated whether life course SEP is associated with HTN incidence. Specifically, to test whether cumulative low SEP throughout life and unfavorable intergenerational social mobility increased HTN incidence. METHODS Longitudinal analysis of 8,754 ELSA-Brasil participants without HTN or cardiovascular in visit 1 (2008-2010). The response variable was the incidence of HTN between visits 1 and 2 (2012-2014). The explanatory variables were childhood, youth, and adulthood SEP, cumulative low SEP, and intergenerational social mobility. Associations were estimated by incidence rate ratios (IRRs) obtained by generalized linear models, with Poisson distribution and logarithmic link function, after adjustment for sociodemographic, behavioral, and health factors. RESULTS The incidence of HTN was 43.2/1,000 person-years, being higher in males, elderly (70-74 years), self-declared black, and low SEP individuals. After considering sociodemographic factors, low SEP in childhood, youth, and adulthood remained statistically associated with increased HTN incidence. Individuals in the third (IRR: 1.26; 95% confidence interval (CI): 1.11-1.44) and fourth top quartiles (IRR: 1.29; 95% CI: 1.11-1.49) of cumulative low SEP, vs. first, as well as those with low stable intergenerational trajectory (IRR: 1.29; 95% CI: 1.16-1.43), vs. high stable, also had increased HTN incidence rates. CONCLUSIONS Socioeconomic disparities at all phases of the life cycle appear to raise HTN incidence rates, being the individuals with greater accumulation of exposure to low SEP and with more unfavorable intergenerational mobility at greatest risk, even in a short follow-up time.
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Affiliation(s)
- José Aparecido Soares Lopes
- Department of Student and Community Affairs, Instituto Federal do Norte de Minas Gerais, Januária, Brazil
- Social and Preventive Department, Faculty of Medicine & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luana Giatti
- Social and Preventive Department, Faculty of Medicine & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Rosane Harter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Sheila Maria Alvim Matos
- Department of Collective Health, Institute of Collective Health, Universidade Federal da Bahia, Salvador, Brazil
| | - Dora Chor
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Maria de Jesus M Fonseca
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Sandhi Maria Barreto
- Social and Preventive Department, Faculty of Medicine & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Letarte L, Gagnon P, McKay R, Quesnel-Vallée A, Waygood EOD, Lebel A. Examining longitudinal patterns of individual neighborhood deprivation trajectories in the province of Quebec: A sequence analysis application. Soc Sci Med 2021; 288:113695. [PMID: 33546938 DOI: 10.1016/j.socscimed.2021.113695] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/26/2020] [Accepted: 01/07/2021] [Indexed: 12/14/2022]
Abstract
Exposure to neighborhood deprivation has been associated with a number of health, behavioral and sociological outcomes. However, many negative outcomes associated with deprivation have a long latency and may be influenced by varying exposure to neighborhoods throughout time. Capturing the longitudinal exposure to neighborhood deprivation is methodologically complex when one wishes to include life course notions of order, duration and timing. In a sample of 60,555 participants, aged 12 years and older (representative of the population of the Province of Quebec in Canada) our objectives were to: 1) Create an indicator for neighborhood deprivation trajectories; 2) compare trajectories with cross-sectional and cumulative neighborhood deprivation; 3) identify individual socioeconomic determinants of membership to a trajectory cluster. Using sequence analysis based on optimal matching and clustering around theoretical types, we grouped sequences in nine neighborhood deprivation trajectory clusters. We found that half (50%) of the participants were in a stable trajectory and did not transition significantly from one deprivation tertile to another during their sequence. A comparison between a cross-sectional indicator of neighborhood deprivation and the trajectories showed that only 42.2% of the participants had a cross-sectional deprivation at the index date representative of their whole trajectory. We also found, using logistic regression (adjusted for age, sex, number of residential moves) that having no high school diploma, living in a rural area and being an immigrant was strongly associated with a deprived stable trajectory. Sequence analysis is an effective tool to describe neighborhood deprivation trajectories in a sample representative of the Quebec population. Trajectories are a useful addition to a better understanding of the distribution of health outcomes because they provide information about the order and accumulation of longitudinal exposures to neighborhood and seem to be associated with specific individual socioeconomic characteristics such as education, urbanity, and immigration status.
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Affiliation(s)
- Laurence Letarte
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada.
| | - Pierre Gagnon
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
| | - Rachel McKay
- McGill Observatory on Health and Social Services Reforms, McGill University, Montreal, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Amélie Quesnel-Vallée
- McGill Observatory on Health and Social Services Reforms, McGill University, Montreal, Canada; Department of Sociology, McGill University, Montreal, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | | | - Alexandre Lebel
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
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Morrissey K, Kinderman P. The impact of financial hardship in childhood on depression and anxiety in adult life: Testing the accumulation, critical period and social mobility hypotheses. SSM Popul Health 2020; 11:100592. [PMID: 32642546 PMCID: PMC7334602 DOI: 10.1016/j.ssmph.2020.100592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 11/28/2022] Open
Abstract
This paper examines the association between financial hardship in childhood and adulthood, and depression and anxiety in adulthood with reference to the accumulation, critical period and social mobility hypotheses in lifecourse epidemiology. Using the BBC Stress test, linear regression models were used to investigate the associations for the whole population and stratifying by gender and adjusting for age and highest education attainment. The critical period hypothesis was not confirmed. The accumulation hypothesis was confirmed and stratifying by gender women had a higher estimated mean GAD score if they were poor in both childhood and adulthood compared to men. Our findings do not support the social mobility hypothesis. However, stratifying by gender, a clear difference emerged with upward mobility having a favourable impact (lower) on women's mean GAD scores, while upward social mobility in adulthood did not attenuate the impact of financial hardship in childhood or men. The impact of financial hardship in childhood on later mental health outcomes is particularly concerning for future health outcomes as current levels of child poverty increases in the UK. The association between financial hardship in childhood and adulthood, and depression and anxiety in adulthood was tested. A lifecourse approach was used. Two episodes of financial hardship had a greater impact on women’s Goldberg Anxiety & Depression score compared to men. Upward mobility had a favourable impact on women's mean Goldberg Anxiety & Depression scores, but not for men.
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Affiliation(s)
- Karyn Morrissey
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Truro, TR1 3HD, UK
| | - Peter Kinderman
- Psychological Sciences, University of Liverpool, Liverpool, UK
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The impact of childhood socioeconomic status on depression and anxiety in adult life: Testing the accumulation, critical period and social mobility hypotheses. SSM Popul Health 2020; 11:100576. [PMID: 32346597 PMCID: PMC7178545 DOI: 10.1016/j.ssmph.2020.100576] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 11/22/2022] Open
Abstract
This paper examines the association between financial hardship in childhood and adulthood, and depression and anxiety in adulthood with reference to the accumulation, critical period and social mobility hypotheses in lifecourse epidemiology. Using the BBC Stress test, linear regression models were used to investigate the associations for the whole population and stratifying by sex and adjusting for age and highest education attainment. The critical period hypothesis was not confirmed. The accumulation hypothesis was confirmed and stratifying by sex women had a higher estimated mean GAD score if they were poor in both childhood and adulthood compared to men. Our findings do not support the social mobility hypothesis. However, stratifying by sex, a clear difference emerged with upward mobility having a favourable impact (lower) on women's mean GAD scores, while upward social mobility in adulthood did not attenuate the impact of financial hardship in childhood or men. The impact of financial hardship in childhood on later mental health outcomes is particularly concerning for future health outcomes as current levels of child poverty increases in the UK. The association between socioeconomic status in childhood and adulthood, and depression and anxiety in adulthood was tested. A lifecourse approach was used. Two episodes of financial hardship had a greater impact on women’s Goldberg Anxiety & Depression score compared to men. Upward mobility had a favourable impact on women's mean Goldberg Anxiety & Depression scores, but not for men.
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Billingsley S. Sick leave absence and the relationship between intra-generational social mobility and mortality: health selection in Sweden. BMC Public Health 2020; 20:8. [PMID: 31907012 PMCID: PMC6945420 DOI: 10.1186/s12889-019-8103-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/17/2019] [Indexed: 01/08/2023] Open
Abstract
Background Poor health could influence how individuals are sorted into occupational classes. Health selection has therefore been considered a potential modifier to the mortality class gradient through differences in social mobility. Direct health selection in particular may operate in the short-term as poor health may lead to reduced work hours or achievement, downward social mobility, unemployment or restricted upward mobility, and death. In this study, the relationship between social mobility and mortality (all-cause, cancer-related, cardiovascular disease-related (CVD), and suicide) is explored when the relationship is adjusted for poor health. Methods Using Swedish register data (1996–2012) and discrete time event-history analysis, odds ratios and average marginal effects (AME) of social mobility and unemployment on mortality are observed before and after accounting for sickness absence in the previous year. Results After adjusting for sickness absence, all-cause mortality remained lower for men after upward mobility in comparison to not being mobile (OR 0.82, AME -0.0003, CI − 0.0003 to − 0.0002). Similarly, upward mobility continued to be associated with lower cancer-related mortality for men (OR 0.85, AME -0.00008, CI − 0.00002 to − 0.0002), CVD-related mortality for men (OR 0.76, AME -0.0001, CI − 0.00006 to − 0.0002) and suicide for women (OR 0.67, AME -0.00002, CI − 0.000002 to − 0.00003). The relationship between unemployment and mortality also persisted across most causes of death for both men and women after controlling for previous sickness absence. In contrast, adjusting for sickness absence renders the relationship between downward mobility and cancer-related mortality not statistically different from the non-mobile. Conclusions Health selection plays a role in how downward mobility is linked to cancer related deaths. It additionally accounts for a portion of why upward mobility is associated with lower mortality. That health selection plays a role in how social mobility and mortality are related may be unexpected in a context with strong job protection. Job protection does not, however, equalize opportunities for upward mobility, which may be limited for those who have been ill. Because intra-generational upward mobility and mortality remained related after adjusting for sickness absence, other important mechanisms such as indirect selection or social causation should be explored.
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Affiliation(s)
- Sunnee Billingsley
- Department of Sociology and Demography Unit, Stockholm University, S-106 91, Stockholm, Sweden.
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Lee H. A life course approach to total tooth loss: Testing the sensitive period, accumulation, and social mobility models in the Health and Retirement Study. Community Dent Oral Epidemiol 2019; 47:333-339. [PMID: 31115080 DOI: 10.1111/cdoe.12463] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 02/22/2019] [Accepted: 04/09/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Childhood socio-economic status (SES) has long been associated with later-life oral health, suggesting that childhood is a sensitive period for oral health. Far less attention has been given to the long-term impact of childhood trauma, abuse, and smoking on later-life oral health. This study fills the gap in the literature by examining how adverse childhood experiences-social, psychological, and behavioral-shape total tooth loss over the life course, with an assessment of the sensitive period, accumulation, and social mobility models from life course research. METHODS Data are drawn from the 2012 Health and Retirement Study (HRS) merged with multiple HRS data sources to obtain childhood information (N = 6,427; age > 50). Adverse childhood experiences include childhood financial hardship, trauma, abuse, and smoking. Total tooth loss is measured to assess poor oral health in later life. Educational attainment and poverty status (since age 51) are measured as adult adversity. Current health conditions and health behaviors are assessed to reflect the correlates of oral health in later life. RESULTS The sensitive period model indicates that childhood trauma such as parental death or divorce (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.04, 1.80), physical abuse (OR = 1.17, 95% CI = 1.03, 1.34), and low educational attainment (≤ high school; OR = 1.52, 95% CI = 1.04, 2.22) are associated with higher odds of total tooth loss in later life. Poverty status was not associated with the outcome. There was a clear graded relationship between accumulation of adverse experiences and oral health, which supports the accumulation model. In the social mobility model, older adults who occupied a stable disadvantageous position were more likely to be toothless (OR = 1.77, 95% CI = 1.08, 2.90) compared to those who did not face adversity in any case. Neither upward nor downward mobility mattered. CONCLUSIONS Failing oral health in older adults, especially total tooth loss, may have its roots in adverse experiences such as childhood trauma, abuse, and low educational attainment. Findings also suggest that oral health in later life may be more influenced by accumulation of adversity rather than changes in social and economic position over the life course.
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Affiliation(s)
- Haena Lee
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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Günther S, Moor I, Knöchelmann A, Richter M. [Intergenerational mobility and health inequalities in East and West Germany : A trend analysis from 1992 to 2012]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 61:78-88. [PMID: 29138900 DOI: 10.1007/s00103-017-2655-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Social mobility processes, i. e. the movement of a person from one social position to another, are central mechanisms for explaining health inequalities. Social differences in health status or behaviour may also change with changes in social status. This article examines the importance of intergenerational mobility, i. e. the rise and fall of social status in relation to parental social position, for subjective health in East and West Germany and whether this relationship has changed over 20 years. MATERIAL AND METHODS The data basis is the socio-economic panel from 1992-2012. Employees aged between 25 and 59 were taken into account. Different mobility paths were determined by comparing their current occupational positions with those of their parents. For these, prevalence and logistic regression of subjective health were calculated. RESULTS Those in low occupational positions rated their health more often as being worse in all periods. Upwardly mobile individuals had a lower risk of poorer health (OR 0.72) compared to those who remained in their original position. Persons affected by downward mobility had a similarly worse self-rated health (OR 1.55 or OR 1.86). Significant differences in gender or region of origin (East-West Germany) could not be determined. Education and income contribute to explaining the relationship. CONCLUSION The results suggest that social advancement has a positive effect on health, whereas social decline is negative - regardless of gender, region of origin or time. It is therefore important to reinforce political efforts aimed at increasing the mobility opportunities of all social groups in a positive sense and thus reducing social inequalities.
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Affiliation(s)
- Sebastian Günther
- Medizinische Fakultät, Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Deutschland.
| | - Irene Moor
- Medizinische Fakultät, Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Deutschland
| | - Anja Knöchelmann
- Medizinische Fakultät, Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Deutschland
| | - Matthias Richter
- Medizinische Fakultät, Institut für Medizinische Soziologie, Martin-Luther-Universität Halle-Wittenberg, Magdeburger Straße 8, 06097, Halle (Saale), Deutschland
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Billingsley S. Intragenerational social mobility and cause-specific premature mortality. PLoS One 2019; 14:e0211977. [PMID: 30735550 PMCID: PMC6368327 DOI: 10.1371/journal.pone.0211977] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/24/2019] [Indexed: 12/02/2022] Open
Abstract
This study explores whether there is a short-term relationship between intragenerational social mobility and mortality while individuals are working and whether it is widespread across different causes of death. Net of accumulated advantages and disadvantages, social mobility may influence mortality through health selection or changes in well-being. Men and women working in 1996 up to age 65 are observed annually until 2012 in Swedish register data. Time-varying covariates and origin and destination status are controlled for in discrete time event-history analyses. Results show that when men were upwardly mobile, mortality was lower due to cancer, CVD, IHD, and suicide. Upward mobility was only associated with lower odds of suicide for women. When downwardly mobile, cancer mortality was higher for both men and women and smoking-related cancer mortality was higher for men. Social mobility was not linked to deaths related to accidents and poisoning or alcohol-related mortality. The results may support a relationship between social mobility and mortality characterized by health selection: Only in the case of a chronic illness (cancer) was downward mobility associated with higher mortality. The widespread relationship between upward mobility and lower mortality for men may also indicate positive health selection into attaining a higher class and that individuals with poor health may be less likely to search for better positions or receive promotions.
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Affiliation(s)
- Sunnee Billingsley
- Department of Sociology, Stockholm University, Stockholm, Sweden
- * E-mail:
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Willson AE, Shuey KM. A Longitudinal Analysis of the Intergenerational Transmission of Health Inequality. J Gerontol B Psychol Sci Soc Sci 2019; 74:181-191. [PMID: 29762741 DOI: 10.1093/geronb/gby059] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Indexed: 02/01/2023] Open
Abstract
Objectives Empirical investigations of cumulative dis/advantage typically treat health inequality as an intraindividual process rooted in early-life conditions and operating within the span of the individual life course, while literature on processes of intergenerational transmission has historically focused on socioeconomic mobility, largely overlooking health. The current study examines the persistence of work disability across generations and multiple explanations for this relationship, including the role of early-life disadvantage, childhood health, educational attainment, and social mobility. Methods We model latent classes of midlife work disability characterized by timing and stability using longitudinal data from the intergenerational component of the U.S. Panel Study of Income Dynamics (N = 3,328). Latent class analysis captures the initial risk of experiencing a work disability and how this risk changes across mid-life as a function of early-life conditions, childhood health, educational attainment, mobility, and parent's work disability. Results Early disadvantage, childhood health, and educational attainment were associated with patterns of midlife work disability, and although upward mobility provided some protection, intergenerational continuity in health remained net of all of these factors. Discussion Findings support the importance of looking beyond the individual life course to the transmission of health inequality across generations within families.
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Affiliation(s)
- Andrea E Willson
- Department of Sociology, University of Western Ontario, London, Canada
| | - Kim M Shuey
- Department of Sociology, University of Western Ontario, London, Canada
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The influence of lifecourse financial strains on the later-life health of the Japanese as assessed by four models based on different health indicators. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractIn this study, four models used for assessing the influence of lifecourse financial strains on later-life health (the latent period effects, pathway, social mobility and accumulative effects models) were tested in the context of Japan by using different types of health indicators: comorbidity, disabled activities of daily living, disabled cognitive function, self-rated health and depressive symptoms. We hypothesised that suitable models for describing the influence of financial strain would differ according to the type of health indicator used. Participants aged 60–92 years (N = 2,500) were obtained in 2012 by using a two-stage stratified random sampling method. The final number of participants in the sample was 1,324. The results indicate that three models – pathway, accumulative effects and social mobility – describe the influence of a person's lifecourse financial strain on comorbidity, cognitive function, self-rated health and depressive symptoms. In turn, the latent period effects model explains the influence of lifecourse financial strain on comorbidity. However, only the pathway model described the influence of lifecourse financial strain on activities of daily living. These results suggest that disadvantages in lifecourse socio-economic status influence the decline of health in elderly Japanese people, similar to people in Western countries. However, the finding that suitable models for describing the influence of socio-economic status on health will differ according to the type of health indicator is an original contribution of this study.
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Linking financial hardship throughout the life-course with psychological distress in old age: Sensitive period, accumulation of risks, and chain of risks hypotheses. Soc Sci Med 2018; 201:111-119. [DOI: 10.1016/j.socscimed.2018.02.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 02/12/2018] [Accepted: 02/14/2018] [Indexed: 11/20/2022]
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Life course indices for social determinants of self-rated health trajectory in Korean elderly. Arch Gerontol Geriatr 2017; 70:186-194. [PMID: 28192754 DOI: 10.1016/j.archger.2017.02.003] [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: 02/04/2016] [Revised: 12/21/2016] [Accepted: 02/01/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This study investigated the self-rated health trajectories of the Korean older population and revealed life-course factors that affect the trajectories over the life course. METHODS Around 1000 older adults were randomly allocated by stratified multi-stage sampling based on the population census, and underwent face-to-face interviews. Self-rated health status, socioeconomic variables over the life course, and demographic variables were included in the analysis. A group-based trajectory model was used to investigate the association between self-rated health and explanatory variables. RESULTS The enrolled men and women were divided into three groups by trajectory analysis, which showed marked differences in self-rated health trajectories from childhood to senescence. Among older men, those who experienced skipping meals in childhood and those with chronic disease conditions were more likely to be in the lower trajectory groups. Compared to the older men, the likelihood of being in the lower trajectory groups in older women was increased by experience of skipping meals, lower household income, housekeeping labor, receiving Basic Livelihood Security and chronic disease conditions. CONCLUSION Various self-rated health trajectories of the Korean older population were identified, and differed according to socioeconomic variables during their life course. Therefore, socioeconomic variables during the life course should be monitored, and health policies directed at the elderly should focus on initial health status from the perspective of a life-course approach.
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Jonsson F, Sebastian MS, Hammarström A, Gustafsson PE. Intragenerational social mobility and functional somatic symptoms in a northern Swedish context: analyses of diagonal reference models. Int J Equity Health 2017; 16:1. [PMID: 28057005 PMCID: PMC5217297 DOI: 10.1186/s12939-016-0499-1] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 12/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research indicate that social class mobility could be potentially important for health, but whether this is due to the movement itself or a result of people having been integrated in different class contexts is, to date, difficult to infer. In addition, although several theories suggest that transitions between classes in the social hierarchy can be stressful experiences, few studies have empirically examined whether such movements may have health effects, over and above the implications of "being" in these classes. In an attempt to investigate whether intragenerational social mobility is associated with functional somatic symptoms in mid-adulthood, the current study tests three partially contrasting theories. METHOD The dissociative theory suggests that mobility in general and upward mobility in particular may be linked to psychological distress, while the falling from grace theory indicates that downward mobility is especially stressful. In contrast, the acculturation theory holds that the health implications of social mobility is not due to the movement itself but attributed to the class contexts in which people find themselves. Diagonal Reference Models were used on a sample of 924 individuals who in 1981 graduated from 9th grade in the municipality of Luleå, Sweden. Social mobility was operationalized as change in occupational class between age 30 and 42 (measured in 1995 and 2007). The health outcome was functional somatic symptoms at age 42, defined as a clustering self-reported physical symptoms, palpitation and sleeping difficulties during the last 12 months. RESULTS Overall mobility was not associated with higher levels of functional somatic symptoms compared to being immobile (p = 0.653). After controlling for prior and current class, sex, parental social position, general health, civil status, education and unemployment, the association between downward mobility was borderline significant (p = 0.055) while upward mobility was associated with lower levels of functional somatic symptoms (p = 0.03). CONCLUSION The current study did not find unanimous support for any of the theories. Nevertheless, it sheds light on the possibility that upward mobility may be beneficial to reduce stress-related health problems in mid-life over and above the exposure to prior and current class, while downward mobility can be of less importance for middle-age health complaints.
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Affiliation(s)
- Frida Jonsson
- Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Umeå, SE-901 85, Sweden.
| | - Miguel San Sebastian
- Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Umeå, SE-901 85, Sweden
| | - Anne Hammarström
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Per E Gustafsson
- Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Umeå, SE-901 85, Sweden
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Falconi A. Sex-Based Differences in the Determinants of Old Age Life Expectancy: The Influence of Perimenopause. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2017; 63:54-70. [PMID: 28287306 PMCID: PMC5656253 DOI: 10.1080/19485565.2016.1273755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Studies using the sensitive periods framework typically examine the effects of early life exposures on later life health, due to the significant growth and development occurring during the first few years of life. The menopausal transition (i.e., perimenopause) is similarly characterized by rapid physiological change, yet rarely has been tested as a sensitive window in adulthood. Cohort mortality data drawn from three historic populations, Sweden (1751-1919), France (1816-1919), and England and Wales (1841-1919), were analyzed using time series methods to assess whether conditions at midlife significantly influenced or "programmed" later life longevity. Results indicated a significant inverse association between mortality at ages 45-49, the average age range in which perimenopause occurred, and life expectancy at age 60 among females in all three countries. Study findings suggest a degree of plasticity associated with women's aging and, in particular, the age group correlated with perimenopause.
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Affiliation(s)
- April Falconi
- University of California, Berkeley, School of Public Health
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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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18
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Han DH, Khang YH. Lifecourse socioeconomic position indicators and tooth loss in Korean adults. Community Dent Oral Epidemiol 2016; 45:74-83. [DOI: 10.1111/cdoe.12262] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/07/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Dong-Hun Han
- Department of Preventive and Social Dentistry; Seoul National University School of Dentistry; Seoul South Korea
- Dental Research Institute; Seoul National University; Seoul South Korea
| | - Young-Ho Khang
- Department of Health Policy and Management; Seoul National University College of Medicine; Seoul South Korea
- Institute of Health Policy and Management; Seoul National University Medical Research Center; Seoul South Korea
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von Friesendorff M, McGuigan FE, Wizert A, Rogmark C, Holmberg AH, Woolf AD, Akesson K. Hip fracture, mortality risk, and cause of death over two decades. Osteoporos Int 2016; 27:2945-53. [PMID: 27172936 DOI: 10.1007/s00198-016-3616-5] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED Men and women with hip fracture have higher short-term mortality. This study investigated mortality risk over two decades post-fracture; excess mortality remained high in women up to 10 years and in men up to 20 years. Cardiovascular disease (CVD) and pneumonia were leading causes of death with a long-term doubling of risk. INTRODUCTION Hip fractures are associated with increased mortality, particularly short term. In this study with a two-decade follow-up, we examined mortality and cause of death compared to the background population. METHODS We followed 1013 hip fracture patients and 2026 matched community controls for 22 years. Mortality, excess mortality, and cause of death were analyzed and stratified for age and sex. Hazard ratio (HR) was estimated by Cox regression. A competing risk model was fitted to estimate HR for common causes of death (CVD, cancer, pneumonia) in the short and long term (>1 year). RESULTS For both sexes and at all ages, mortality was higher in hip fracture patients across the observation period with men losing most life years (p < 0.001). Mortality risk was higher for up to 15 years (women (risk ratio (RR) 1.9 [95 % confidence interval (CI) 1.7-2.1]); men (RR 2.8 [2.2-3.5])) and until end of follow-up ((RR 1.8 [1.6-2.0]); (RR 2.7 [2.1-3.3])). Excess mortality by time intervals, censored for the first year, was evident in women (<80 years, up to 10 years; >80 years, for 5 years) and in men <80 years throughout. CVD and pneumonia were predominant causes of death in men and women with an associated higher risk in all age groups. Pneumonia caused excess mortality in men over the entire observation period. CONCLUSION In a remaining lifetime perspective, all-cause and excess mortality after hip fracture was higher even over two decades of follow-up. CVD and pneumonia reduce life expectancy for the remaining lifetime and highlights the need to further improve post-fracture management.
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Affiliation(s)
- M von Friesendorff
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden
- Department of Orthopedics Malmö, Skåne University Hospital, 205 02, Malmö, Sweden
| | - F E McGuigan
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden
- Department of Orthopedics Malmö, Skåne University Hospital, 205 02, Malmö, Sweden
| | - A Wizert
- ERC Syd - Epidemiology and Register Centre South, Skåne University Hospital, Lund, Sweden
| | - C Rogmark
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden
- Department of Orthopedics Malmö, Skåne University Hospital, 205 02, Malmö, Sweden
| | - A H Holmberg
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden
- Department of Orthopedics Malmö, Skåne University Hospital, 205 02, Malmö, Sweden
| | - A D Woolf
- Department of Rheumatology Royal Cornwall Hospital, Truro, UK
| | - K Akesson
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden.
- Department of Orthopedics Malmö, Skåne University Hospital, 205 02, Malmö, Sweden.
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Na-Ek N, Demakakos P. Social mobility and inflammatory and metabolic markers at older ages: the English Longitudinal Study of Ageing. J Epidemiol Community Health 2016; 71:253-260. [DOI: 10.1136/jech-2016-207394] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 07/28/2016] [Accepted: 08/26/2016] [Indexed: 11/03/2022]
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Willson AE, Shuey KM. Life Course Pathways of Economic Hardship and Mobility and Midlife Trajectories of Health. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2016; 57:407-422. [PMID: 27601413 DOI: 10.1177/0022146516660345] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We utilize over 40 years of prospective data from the Panel Study of Income Dynamics (N = 1,229) and repeated-measures latent class analysis to examine how long-term patterns of stability and change in economic hardship from childhood to adulthood are related to subsequent trajectories of midlife health. We review conceptual and methodological approaches to examining health inequality across the life course and highlight the contribution of a person-centered, disaggregated approach to modeling health and its association with long-term pathways of economic resources, including changing resources associated with mobility. Findings suggest those who experienced early mobility out of economic hardship were less likely than those in persistent economic hardship to experience a high-risk health trajectory, while experiencing later mobility did not lessen this risk. We conclude with a call for further investigation into the role of social mobility and the timing, degree, and direction of change in investigations of health inequality.
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Affiliation(s)
| | - Kim M Shuey
- University of Western Ontario, London, ON, Canada
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Padilla-Moledo C, Ruiz JR, Castro-Piñero J. Parental educational level and psychological positive health and health complaints in Spanish children and adolescents. Child Care Health Dev 2016; 42:534-43. [PMID: 27097753 DOI: 10.1111/cch.12342] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 01/14/2016] [Accepted: 03/20/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Interest on the impact of socioeconomic differences on youth's health is growing. The aim of the present study was to examine the association of parental educational level with psychological positive health and health complaints in Spanish children and adolescents. METHODS Parental educational level, psychological positive health indicators (perceived health status, life satisfaction, quality of family relationships, quality of peer relationships and academic performance) and health complaint index (headache, stomach ache, backache, feeling low, irritability or bad temper, feeling nervous, difficulties getting to sleep, feeling dizzy) were self-reported using the Health Behavior in School-aged Children questionnaire in 685 (366 boys and 319 girls) children and adolescents. RESULTS Children reporting parents with non-university studies (father, mother or both) had significantly higher odd ratio of having lower academic performance, lower life satisfaction, perceiving their health status as otherwise (vs. excellent) and having health complaints sometime than their counterparts reporting parents with university studies (father, mother or both). CONCLUSION Current results provide evidence that children having parents with a university degree (father, mother or both) are more likely to have higher psychological positive health and lower health complaints than children reporting parents with non-university studies. This is particularly important for the welfare policy that must pay attention for implementing programs for helping population to access to university studies by their impact on youth health.
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Affiliation(s)
- C Padilla-Moledo
- Department of Physical Education, School of Education, University of Cádiz, Puerto Real, Spain
| | - J R Ruiz
- PROmoting FITness and Health through physical activity research group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - J Castro-Piñero
- Department of Physical Education, School of Education, University of Cádiz, Puerto Real, Spain
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Tiikkaja S, Sandin S, Hultman CM, Modin B, Malki N, Sparén P. Psychiatric disorder and work life: A longitudinal study of intra-generational social mobility. Int J Soc Psychiatry 2016; 62:156-66. [PMID: 26619849 DOI: 10.1177/0020764015614594] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Intra-generational social mobility, which describes the mobility within an individual's own working life, is seldom studied among employees with psychiatric disorders (EPD). There is need of knowledge of the intra-generational mobility patterns, in a broader perspective, among EPD. AIMS To investigate intra-generational social mobility in employed individuals diagnosed with affective disorder, personality disorder, schizophrenia and drug dependence in a national Swedish cohort. METHOD We identified a national sample of employed Swedish adults born in 1939-1949 (N = 876, 738), and among them individuals with a first-time hospital admission for affective psychosis, neurosis and personality disorder, alcoholism, drug dependence or schizophrenia in 1964-1980 (N = 18, 998). Employed individuals without hospital admission for such diagnoses were utilised as a comparison group (N = 866, 442). Intra-individual social class changes between 1980 and 1990 among EPD and the comparison group were described through summary statistics and graphs. RESULTS EPD more often held Low manual occupations at baseline in 1980 than the comparison group (44% vs. 28%), although parental social class was similar. In 1990, 19% of EPD and 4% of the comparison group had lost contact with the labour market. Social stability was less common among EPD (49 %) than in the comparison group (67%). Mobility out of the labour force increased and social stability decreased by number of inpatient admissions. Employees diagnosed with affective psychosis or neurosis and personality disorder fared better in the labour market than employees with schizophrenia. CONCLUSION Employees suffering from psychiatric disorder do not maintain their social class or remain in the labour force to the same extent as individuals without those problems, irrespective of their parental class. Our results support the social drift hypothesis that individuals with poor psychiatric health move downward in the social hierarchy.
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Affiliation(s)
- Sanna Tiikkaja
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bitte Modin
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Ninoa Malki
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pär Sparén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Gebreab SY, Diez Roux AV, Brenner AB, Hickson DA, Sims M, Subramanyam M, Griswold ME, Wyatt SB, James SA. The impact of lifecourse socioeconomic position on cardiovascular disease events in African Americans: the Jackson Heart Study. J Am Heart Assoc 2015; 4:e001553. [PMID: 26019130 PMCID: PMC4599524 DOI: 10.1161/jaha.114.001553] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Few studies have examined the impact of lifecourse socioeconomic position (SEP) on cardiovascular disease (CVD) risk among African Americans. Methods and Results We used data from the Jackson Heart Study (JHS) to examine the associations of multiple measures of lifecourse SEP with CVD events in a large cohort of African Americans. During a median of 7.2-year follow-up, 362 new or recurrent CVD events occurred in a sample of 5301 participants aged 21 to 94. Childhood SEP was assessed by using mother’s education, parental home ownership, and childhood amenities. Adult SEP was assessed by using education, income, wealth, and public assistance. Adult SEP was more consistently associated with CVD risk in women than in men: age-adjusted hazard ratios for low versus high income (95% CIs), 2.46 (1.19 to 5.09) in women and 1.50 (0.87 to 2.58) in men, P for interaction=0.1244, and hazard ratio for low versus high wealth, 2.14 (1.39 to 3.29) in women and 1.06 (0.62 to 1.81) in men, P for interaction=0.0224. After simultaneous adjustment for all adult SEP measures, wealth remained a significant predictor of CVD events in women (HR=1.73 [1.04, 2.85] for low versus high). Education and public assistance were less consistently associated with CVD. Adult SEP was a stronger predictor of CVD events in younger than in older participants (HR for high versus low summary adult SEP score 3.28 [1.43, 7.53] for participants ≤50 years, and 1.90 (1.36 to 2.66) for participants >50 years, P for interaction 0.0846). Childhood SEP was not associated with CVD risk in women or men. Conclusions Adult SEP is an important predictor of CVD events in African American women and in younger African Americans. Childhood SEP was not associated with CVD events in this population.
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Affiliation(s)
- Samson Y Gebreab
- Metabolic, Cardiovascular and Inflammatory Disease Genomics Branch, National Human Genome Research Institute (NHGRI), National Institutes of Health, Bethesda, MD (S.Y.G.)
| | - Ana V Diez Roux
- Michigan Center for Integrative Approaches to Health Disparities (CIAHD), Drexel University, Philadelphia, PA (A.V.D.R.) School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.)
| | - Allison B Brenner
- Department of Epidemiology, School of Public Health, University of Michigan, Jackson, MS (A.B.B.)
| | - DeMarc A Hickson
- School of Medicine, University of Mississippi Medical Center, Jackson, MS (D.M.A.H., M.S., M.E.G., S.B.W.)
| | - Mario Sims
- School of Medicine, University of Mississippi Medical Center, Jackson, MS (D.M.A.H., M.S., M.E.G., S.B.W.)
| | | | - Michael E Griswold
- School of Medicine, University of Mississippi Medical Center, Jackson, MS (D.M.A.H., M.S., M.E.G., S.B.W.)
| | - Sharon B Wyatt
- School of Medicine, University of Mississippi Medical Center, Jackson, MS (D.M.A.H., M.S., M.E.G., S.B.W.) School of Nursing, University of Mississippi Medical Center, Jackson, MS (S.B.W.)
| | - Sherman A James
- Department of Epidemiology, Rollins School ofPublic Health, Emory University, Atlanta, GA (S.A.J.)
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Abstract
ABSTRACTThe objectives were to investigate the associations between social and financial living conditions in childhood, education and morbidity in old age. The study population (N = 591; 76+ years old) was assembled from two nationally representative Swedish surveys, in 1968 and 2011, that together made longitudinal analysis possible. Morbidity in old age comprised self-reported measures of musculoskeletal disorders, cardiovascular disease, self-rated health and impaired mobility. There were no independent associations between adverse childhood living conditions and morbidity. However, adverse childhood living conditions were associated with an increased likelihood of low education. Moreover, low education was associated with a higher probability of health problems in old age. The results did not show any associations between adverse childhood conditions and late-life morbidity. However, adverse childhood conditions were associated with lower levels of education which, in turn, was associated with health problems and attrition from the study. These results suggest that adverse childhood conditions may indeed be associated with health and survival in old age, but mainly through mechanisms acting earlier in the lifecourse.
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Merkin SS, Karlamangla A, Roux AVD, Shrager S, Seeman TE. Life course socioeconomic status and longitudinal accumulation of allostatic load in adulthood: multi-ethnic study of atherosclerosis. Am J Public Health 2014; 104:e48-55. [PMID: 24524526 DOI: 10.2105/ajph.2013.301841] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association of childhood and adult socioeconomic status with longitudinal change in allostatic load (AL), a measure of biological dysfunction. METHODS The study sample included 6135 participants from the Multi-Ethnic Study of Atherosclerosis, aged 45 to 84 years, recruited in 2000 from 6 US counties; 3 follow-up examinations took place through September 2011. We calculated standardized scores for several metabolic and cardiovascular components relative to accepted clinical cut points for "higher risk" and then summed them to create an overall index of AL. We used mixed effects growth curve models to assess the relationship between socioeconomic status and AL as a linear function of time passed since the baseline examination; we included random effects for the intercept and slope. RESULTS Among those with lower baseline AL (< median), high adult education was associated with a significantly slower increase in AL over time, whereas there was no significant association among those with higher baseline AL. CONCLUSIONS The relationship between socioeconomic status and patterns of change in health parameters may vary over time and with the accumulation of biological risk.
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Affiliation(s)
- Sharon Stein Merkin
- At the time of this study, Sharon Stein Merkin, Arun Karlamangla, and Teresa E. Seeman were with the Division of Geriatrics, Geffen School of Medicine, University of California, Los Angeles. Ana V. Diez Roux was with the Department of Epidemiology, University of Michigan, Ann Arbor. Sandi Shrager was with the Department of Biostatistics, University of Washington School of Public Health, Seattle
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Pudrovska T, Anikputa B. Early-life socioeconomic status and mortality in later life: an integration of four life-course mechanisms. J Gerontol B Psychol Sci Soc Sci 2014; 69:451-60. [PMID: 24496607 DOI: 10.1093/geronb/gbt122] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Using data from the Wisconsin Longitudinal Study, we examine (a) how socioeconomic status (SES) at age 18 affects all-cause mortality at ages 54-72, and (b) whether the effect of early-life SES is consistent with the critical period, accumulation of risks, social mobility, and pathway models. We also explore gender differences in the effect of early-life SES and life-course mechanisms. METHOD Participants (N = 6,547) were surveyed in 1957, 1975, and 1993, with vital status established until 2011. We combine discrete-time survival analysis with structural equation modeling. SES and health behaviors are modeled as latent factors. RESULTS Early-life SES affects mortality indirectly via status attainment and health behaviors in adulthood and midlife. This finding is contrary to the critical period and consistent with the pathway model. Persistent disadvantage at three life stages is a strong risk factor for mortality, thus, supporting the accumulation of risks. Moreover, the mortality risk of individuals who experienced downward socioeconomic mobility is comparable to their peers with persistent disadvantage. DISCUSSION This study highlights the complexity of interrelated life-course processes underlying the effect of early-life SES on mortality in later life.
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Affiliation(s)
- Tetyana Pudrovska
- Correspondence should be addressed to Tetyana Pudrovska, Department of Sociology and Criminology, Population Research Institute, Pennsylvania State University, 514 Oswald Tower, University Park, PA 16802. E-mail:
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Alcántara C, Chen CN, Alegría M. Do post-migration perceptions of social mobility matter for Latino immigrant health? Soc Sci Med 2014; 101:94-106. [PMID: 24560229 PMCID: PMC4041158 DOI: 10.1016/j.socscimed.2013.11.024] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 09/06/2013] [Accepted: 11/12/2013] [Indexed: 11/27/2022]
Abstract
Latino immigrants exhibit health declines with increasing duration in the United States, which some attribute to a loss in social status after migration or downward social mobility. Yet, research into the distribution of perceived social mobility and patterned associations to Latino health is sparse, despite extensive research to show that economic and social advancement is a key driver of voluntary migration. We investigated Latino immigrant sub-ethnic group variation in the distribution of perceived social mobility, defined as the difference between respondents' perceived social status of origin had they remained in their country of origin and their current social status in the U.S. We also examined the association between perceived social mobility and past-year major depressive episode (MDE) and self-rated fair/poor physical health, and whether Latino sub-ethnicity moderated these associations. We computed weighted logistic regression analyses using the Latino immigrant subsample (N=1561) of the National Latino and Asian American Study. Puerto Rican migrants were more likely to perceive downward social mobility relative to Mexican and Cuban immigrants who were more likely to perceive upward social mobility. Perceived downward social mobility was associated with increased odds of fair/poor physical health and MDE. Latino sub-ethnicity was a statistically significant moderator, such that perceived downward social mobility was associated with higher odds of MDE only among Puerto Rican and Other Latino immigrants. In contrast, perceived upward social mobility was not associated with self-rated fair/poor physical health. Our findings suggest that perceived downward social mobility might be an independent correlate of health among Latino immigrants, and might help explain Latino sub-ethnic group differences in mental health status. Future studies on Latino immigrant health should use prospective designs to examine the physiological and psychological costs associated with perceived changes in social status with integration into the U.S. mainland.
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Kamphuis CB, Turrell G, Giskes K, Mackenbach JP, van Lenthe FJ. Life course socioeconomic conditions, adulthood risk factors and cardiovascular mortality among men and women: A 17-year follow up of the GLOBE study. Int J Cardiol 2013; 168:2207-13. [DOI: 10.1016/j.ijcard.2013.01.219] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 12/13/2012] [Accepted: 01/18/2013] [Indexed: 12/12/2022]
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Kakinami L, Séguin L, Lambert M, Gauvin L, Nikiema B, Paradis G. Comparison of three lifecourse models of poverty in predicting cardiovascular disease risk in youth. Ann Epidemiol 2013; 23:485-91. [PMID: 23830840 DOI: 10.1016/j.annepidem.2013.05.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 05/21/2013] [Accepted: 05/22/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Childhood poverty heightens the risk of adulthood cardiovascular disease (CVD), but the underlying pathways are poorly understood. Three lifecourse models have been proposed but have never been tested among youth. We assessed the longitudinal association of childhood poverty with CVD risk factors in 10-year-old youth according to the timing, accumulation, and mobility models. METHODS The Québec Longitudinal Study of Child Development birth cohort was established in 1998 (n = 2120). Poverty was defined as annual income below the low-income thresholds defined by Statistics Canada. Multiple imputation was used for missing data. Multivariable linear regression models adjusted for gender, pubertal stage, parental education, maternal age, whether the household was a single parent household, whether the child was overweight or obese, the child's physical activity in the past week, and family history. RESULTS Approximately 40% experienced poverty at least once, 16% throughout childhood, and 25% intermittently. Poverty was associated with significantly elevated triglycerides and insulin according to the timing and accumulation models, although the timing model was superior for predicting insulin and the accumulation model was superior for predicting triglycerides. CONCLUSIONS Early and prolonged exposure to poverty significantly increases CVD risk among 10-year-old youth.
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Affiliation(s)
- Lisa Kakinami
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
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Mishra GD, Chiesa F, Goodman A, De Stavola B, Koupil I. Socio-economic position over the life course and all-cause, and circulatory diseases mortality at age 50-87 years: results from a Swedish birth cohort. Eur J Epidemiol 2013; 28:139-47. [PMID: 23435736 DOI: 10.1007/s10654-013-9777-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Accepted: 01/31/2013] [Indexed: 10/27/2022]
Abstract
Both child and adult socio-economic position (SEP) predict adult mortality, but little is known about the variation in the impact of SEP across the life course. The Uppsala Birth Cohort Study is a representative birth cohort born 1915-1929 in Uppsala, Sweden. For the 5,138 males and 5,069 females alive in 1980, SEP was available at birth; in adulthood (age 31-45); and in later life (age 51-65). Follow-up for mortality (all-cause, and circulatory disease) was from 1980 to 2002. To test which life course model best described the association between SEP and mortality, we compared the fit of a series of nested Cox proportional hazards regression models (representing either the critical, accumulation or sensitive period models) with a fully saturated model. For all-cause mortality in both genders, the sensitive period model best described the influence of SEP across the life course with a heightened effect in later adult life (males: Hazard Ratio (95 % CI) for advantaged SEP: 0.89 (0.81-0.97) at birth, 0.90 (0.81-0.98) in adulthood, 0.74 (0.67-0.82) in later life; females: 0.87 (0.78-0.98), 0.95 (0.86-1.06), 0.73 (0.64-0.83)). The effect of SEP on circulatory diseases mortality in males was cumulative (HR: 0.84 (0.80-0.87) per unit time in advantaged SEP). For circulatory disease mortality among females, a sensitive period model was selected due to SEP in later adult life (HR: 0.64 (0.52-0.80)). These findings suggest that reducing inequality throughout the life course might reduce all-cause and circulatory disease mortality.
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Affiliation(s)
- Gita Devi Mishra
- School of Population Health, University of Queensland, Brisbane, Herston, QLD, 4006, Australia.
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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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Intragenerational mobility and mortality in Russia: short and longer-term effects. Soc Sci Med 2012; 75:2326-36. [PMID: 23047072 DOI: 10.1016/j.socscimed.2012.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Revised: 07/31/2012] [Accepted: 09/05/2012] [Indexed: 11/20/2022]
Abstract
This study uses the Russian Longitudinal Monitoring Survey to explore the relationship between mortality of men age 65 or younger and intragenerational mobility, measured objectively through household income and subjectively through social ranking. This relationship is considered in light of the social selection and social causation mechanisms developed in the literature as well as a proposed mechanism in which mobility itself is a consequential life event. The analysis spans the years 1994-2010, which covers the transitional period in Russia characterized by labor market restructuring and economic crisis as well as a later period of economic growth and recovery. Using Cox proportional hazard models, immediate and longer-term associations between mobility and mortality are estimated. Both subjective and objective downward mobility had an immediate positive association with mortality risk (increased by 44% and 24%, respectively). In contrast, upward mobility had a more pronounced effect over a longer-term horizon and lowered mortality risk by 17%. Controlling for destination status attenuated some associations, but findings were robust to the adjustment of selection-related factors such as alcohol consumption and health status in the year preceding mobility. Findings suggest that the negative relationship between upward mobility and mortality may be driven by social causation, whereas downward mobility may have an independent effect beyond selection or causation.
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Lindström M, Hansen K, Rosvall M. Economic stress in childhood and adulthood, and self-rated health: a population based study concerning risk accumulation, critical period and social mobility. BMC Public Health 2012; 12:761. [PMID: 22962948 PMCID: PMC3491002 DOI: 10.1186/1471-2458-12-761] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 09/04/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Research in recent decades increasingly indicates the importance of conditions in early life for health in adulthood. Only few studies have investigated socioeconomic conditions in both childhood and adulthood in relation to health testing the risk accumulation, critical period, and social mobility hypotheses within the same setting. This study investigates the associations between economic stress in childhood and adulthood, and self-rated health with reference to the accumulation, critical period and social mobility hypotheses in life course epidemiology, taking demographic, social support, trust and lifestyle factors into account. METHODS The public health survey in Skåne (southern Sweden) in 2008 is a cross-sectional postal questionnaire study based on a random sample, in which 28,198 persons aged 18-80 years participated (55% participation). Logistic regression models were used to investigate associations between economic stress in childhood and adulthood, and self-rated health. RESULTS Three life-course socioeconomic models concerning the association between economic stress and self-rated health (SRH) were investigated. The results showed a graded association between the combined effect of childhood and adulthood economic stress and poor SRH in accordance with the accumulation hypothesis. Furthermore, upward social mobility showed a protecting effect and downward mobility increased odds ratios of poor SRH in accordance with the social mobility hypothesis. High/severe economic stress exposures in both stages of life were independently associated with poor SRH in adulthood. Furthermore, stratifying the study population into six age groups showed similar odds ratios of poor SRH regarding economic stress exposure in childhood and adulthood in all age groups among both men and women. CONCLUSIONS The accumulation and social mobility hypotheses were confirmed. The critical period model was confirmed in the sense that both economic stress in childhood and adulthood had independent effects on poor SRH. However, it was not confirmed in the sense that a particular window in time (in childhood or adulthood) had a specifically high impact on self-rated health.
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Affiliation(s)
- Martin Lindström
- Department of Clinical Sciences, Malmö University Hospital, Lund University, S-205 02, Malmö, Sweden
- Centre for Economic Demography, Lund University, Lund, Sweden
| | - Kristina Hansen
- Department of Clinical Sciences, Malmö University Hospital, Lund University, S-205 02, Malmö, Sweden
| | - Maria Rosvall
- Department of Clinical Sciences, Malmö University Hospital, Lund University, S-205 02, Malmö, Sweden
- Centre for Economic Demography, Lund University, Lund, Sweden
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Niedzwiedz CL, Katikireddi SV, Pell JP, Mitchell R. Life course socio-economic position and quality of life in adulthood: a systematic review of life course models. BMC Public Health 2012; 12:628. [PMID: 22873945 PMCID: PMC3490823 DOI: 10.1186/1471-2458-12-628] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 08/03/2012] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND A relationship between current socio-economic position and subjective quality of life has been demonstrated, using wellbeing, life and needs satisfaction approaches. Less is known regarding the influence of different life course socio-economic trajectories on later quality of life. Several conceptual models have been proposed to help explain potential life course effects on health, including accumulation, latent, pathway and social mobility models. This systematic review aimed to assess whether evidence supported an overall relationship between life course socio-economic position and quality of life during adulthood and if so, whether there was support for one or more life course models. METHODS A review protocol was developed detailing explicit inclusion and exclusion criteria, search terms, data extraction items and quality appraisal procedures. Literature searches were performed in 12 electronic databases during January 2012 and the references and citations of included articles were checked for additional relevant articles. Narrative synthesis was used to analyze extracted data and studies were categorized based on the life course model analyzed. RESULTS Twelve studies met the eligibility criteria and used data from 10 datasets and five countries. Study quality varied and heterogeneity between studies was high. Seven studies assessed social mobility models, five assessed the latent model, two assessed the pathway model and three tested the accumulation model. Evidence indicated an overall relationship, but mixed results were found for each life course model. Some evidence was found to support the latent model among women, but not men. Social mobility models were supported in some studies, but overall evidence suggested little to no effect. Few studies addressed accumulation and pathway effects and study heterogeneity limited synthesis. CONCLUSIONS To improve potential for synthesis in this area, future research should aim to increase study comparability. Recommendations include testing all life course models within individual studies and the use of multiple measures of socio-economic position and quality of life. Comparable cross-national data would be beneficial to enable investigation of between-country differences.
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Affiliation(s)
- Claire L Niedzwiedz
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Srinivasa V Katikireddi
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, Glasgow, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Richard Mitchell
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Scharoun-Lee M, Gordon-Larsen P, Adair LS, Popkin BM, Kaufman JS, Suchindran CM. Intergenerational profiles of socioeconomic (dis)advantage and obesity during the transition to adulthood. Demography 2012; 48:625-51. [PMID: 21491185 DOI: 10.1007/s13524-011-0024-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Investigations of socioeconomic status (SES) and health during the transition to adulthood in the United States are complicated by the later and more varied transitions in residence, employment, schooling, and social roles compared with previous generations. Parental SES is an important influence during adolescence but cannot sufficiently capture the SES of the independent young adult. Typical, single SES indicators based on income or education likely misclassify the SES of young adults who have not yet completed their education or other training, or who have entered the labor force early with ultimately lower status attainment. We use a latent class analysis (LCA) framework to characterize five intergenerational SES groups, combining multidimensional SES information from two time points-that is, adolescent (parental) and young adult (self) SES data. Associations of these groups with obesity, a high-risk health outcome in young adults, revealed nuanced relationships not seen using traditional intergenerational SES measures. In males, for example, a middle-class upbringing in adolescence and continued material advantage into adulthood was associated with nearly as high obesity as a working poor upbringing and early, detrimental transitions. This intergenerational typology of early SES exposure facilitates understanding of SES and health during young adulthood.
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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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Merkin SS, Azziz R, Seeman T, Calderon-Margalit R, Daviglus M, Kiefe C, Matthews K, Sternfeld B, Siscovick D. Socioeconomic status and polycystic ovary syndrome. J Womens Health (Larchmt) 2011; 20:413-9. [PMID: 21323584 DOI: 10.1089/jwh.2010.2303] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common metabolic-endocrine disorder in women and is associated with a number of metabolic morbidities. We examined the association of PCOS and its components with socioeconomic status (SES) over the life course to explore the role of the environment on the development of PCOS. METHODS Participants included 1163 women, aged 34-39, from the Coronary Artery Risk Development in Young Adults (CARDIA) Women's Study, examined at year 16 of the CARDIA study (2001). PCOS was defined according to the 1990 National Institutes of Health (NIH) criteria. RESULTS Logistic regression models, adjusted for age, body mass index (BMI), waist circumference, and oral contraceptive (OC) use, demonstrated a statistically significant association between those women with low parental education/high personal education and PCOS (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.4-4.4). CONCLUSIONS Our results indicate that women who experienced low childhood SES are at increased risk of PCOS, but this risk is limited to those who have personally attained a high level of education. More research is needed to determine the childhood socioeconomic factors that might influence this risk and whether conditions associated with upward life mobility play a role or if this group of at-risk women is simply more likely to recall the symptoms that define PCOS.
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Affiliation(s)
- Sharon Stein Merkin
- The David Geffen School of Medicine at UCLA, University of California-Los Angeles, 10945 Le Conte Avenue, CA 90095, USA.
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Liu S, Jones RN, Glymour MM. Implications of Lifecourse Epidemiology for Research on Determinants of Adult Disease. Public Health Rev 2010; 32:489-511. [PMID: 24639598 DOI: 10.1007/bf03391613] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Many diseases commonly associated with aging are now thought to have social and physiologic antecedents in early life. Understanding how the timing of exposure to early life risk factors influences later-life health may illuminate mechanisms driving adult health inequalities and identify possible points for effective interventions. Recognizing chronic diseases as developing across the lifecourse also has implications for the conduct of research on adult risk factors for disease. We review alternative conceptual models that describe how the timing of risk factor exposure relates to the development of disease. We propose some expansions of lifecourse models to improve their relevance for research on adult chronic disease, using the relationship between education and adult cognitive decline and dementia as an example. We discuss the important implications each of the lifecourse conceptual models has on study design, analysis, and interpretation of research on aging and chronic diseases. We summarize several research considerations implied by the lifecourse framework, including: advantages of analyzing change in function rather than onset of impairment; the pervasive challenge of survivor bias; the importance of controlling for possible confounding by early life conditions; and the likely heterogeneity in responses of adults to treatment.
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Affiliation(s)
- Sze Liu
- Department of Society, Human Development, and Health, Harvard School of Public Health
| | - Richard N Jones
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School
| | - M Maria Glymour
- Department of Society, Human Development, and Health, Harvard School of Public Health
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Bernabé E, Suominen AL, Nordblad A, Vehkalahti MM, Hausen H, Knuuttila M, Kivimäki M, Watt RG, Sheiham A, Tsakos G. Education level and oral health in Finnish adults: evidence from different lifecourse models. J Clin Periodontol 2010; 38:25-32. [PMID: 21058971 DOI: 10.1111/j.1600-051x.2010.01647.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To assess the relationship between education level and several oral health outcomes in Finnish adults, using three conceptual lifecourse models. MATERIALS AND METHODS This study analysed data from 7112 subjects, aged 30 years or over, who participated in the nationally representative Finnish Health 2000 Survey. Parental and own education levels were the childhood and adulthood socioeconomic measures, respectively. Oral health was indicated by edentulousness, perceived oral health and levels of dental caries and periodontal disease. Three conceptual lifecourse models, namely critical period, accumulation and social trajectories, were separately tested in regression models. RESULTS In line with the critical period model, parental and own education levels were independently associated with oral health after mutual adjustment. There was also a graded linear relationship between the number of periods of socioeconomic disadvantage and oral health, corresponding to the accumulation model. Gradual declines in oral health were evident between social trajectories from persistently high to upwardly mobile, downwardly mobile and persistently low groups. CONCLUSION There was similar support for the lifecourse models of critical period, accumulation and social trajectories. They collectively contribute to a better understanding of oral health inequalities.
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Affiliation(s)
- Eduardo Bernabé
- Department of Epidemiology and Public Health, University College London, London, UK.
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41
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Schreier HMC, Chen E. Socioeconomic status in one's childhood predicts offspring cardiovascular risk. Brain Behav Immun 2010; 24:1324-31. [PMID: 20600814 DOI: 10.1016/j.bbi.2010.06.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 06/04/2010] [Accepted: 06/15/2010] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To test whether effects of socioeconomic environments can persist across generations, we examined whether parents' childhood socioeconomic status (SES) could predict blood pressure (BP) trajectories in their youth across a 12-month study period and C-reactive protein (CRP) levels at one year follow-up. METHODS BP was assessed in 88 healthy youth (M age = 13 ± 2.4) at three study visits, each 6 months apart. CRP was also assessed in youth at baseline and one year follow-up. Parents reported on current and their own childhood SES (education and crowding). RESULTS If parents' childhood SES was lower, their children displayed increasing SBP and CRP over the 12-month period, or conversely, the higher parents' childhood SES, the greater the decrease in SBP and CRP in their youth over time. These effects persisted even after controlling for current SES. A number of other factors, including child health behaviors, parent psychosocial characteristics, general family functioning, and parent physiology could not explain these effects. CONCLUSION Our study suggests that the SES environment parents grow up in may influence physical health across generations, here, SBP and CRP in their children, and hence that intergenerational histories are important to consider in predicting cardiovascular health in youth.
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Affiliation(s)
- Hannah M C Schreier
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada.
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Gustafsson PE, Janlert U, Theorell T, Westerlund H, Hammarström A. Fetal and life course origins of serum lipids in mid-adulthood: results from a prospective cohort study. BMC Public Health 2010; 10:484. [PMID: 20712860 PMCID: PMC2936420 DOI: 10.1186/1471-2458-10-484] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Accepted: 08/16/2010] [Indexed: 11/10/2022] Open
Abstract
Background During the past two decades, the hypothesis of fetal origins of adult disease has received considerable attention. However, critique has also been raised regarding the failure to take the explanatory role of accumulation of other exposures into consideration, despite the wealth of evidence that social circumstances during the life course impact on health in adulthood. The aim of the present prospective cohort study was to examine the contributions of birth weight and life course exposures (cumulative socioeconomic disadvantage and adversity) to dyslipidemia and serum lipids in mid-adulthood. Methods A cohort (effective n = 824, 77%) was prospectively examined with respect to self-reported socioeconomic status as well as stressors (e.g., financial strain, low decision latitude, separation, death or illness of a close one, unemployment) at the ages of 16, 21, 30 and 43 years; summarized in cumulative socioeconomic disadvantage and cumulative adversity. Information on birth weight was collected from birth records. Participants were assessed for serum lipids (total cholesterol, low- and high-density lipoprotein cholesterol and triglycerides), apolipoproteins (A1 and B) and height and weight (for the calculation of body mass index, BMI) at age 43. Current health behavior (alcohol consumption, smoking and snuff use) was reported at age 43. Results Cumulative life course exposures were related to several outcomes; mainly explained by cumulative socioeconomic disadvantage in the total sample (independently of current health behaviors but attenuated by current BMI) and also by cumulative adversity in women (partly explained by current health behavior but not by BMI). Birth weight was related only to triglycerides in women, independently of life course exposures, health behaviors and BMI. No significant association of either exposure was observed in men. Conclusions Social circumstances during the life course seem to be of greater importance than birth weight for dyslipidemia and serum lipid levels in adulthood.
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Affiliation(s)
- Per E Gustafsson
- Dept of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
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Cohen S, Janicki-Deverts D, Chen E, Matthews KA. Childhood socioeconomic status and adult health. Ann N Y Acad Sci 2010; 1186:37-55. [PMID: 20201867 DOI: 10.1111/j.1749-6632.2009.05334.x] [Citation(s) in RCA: 406] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Socioeconomic status (SES) exposures during childhood are powerful predictors of adult cardiovascular morbidity, cardiovascular mortality, all-cause mortality, and mortality due to a range of specific causes. However, we still know little about when childhood SES exposures matter most, how long they need to last, what behavioral, psychological, or physiological pathways link the childhood SES experience to adult health, and which specific adult health outcomes are vulnerable to childhood SES exposures. Here, we discuss the evidence supporting the link between childhood and adolescent SES and adult health, and explore different environmental, behavioral, and physiological pathways that might explain how early SES would influence adult health. We also address the ages when SES exposures matter most for setting adult health trajectories as well as the role of exposure duration in SES influences on later health. While early childhood exposures seem to be potent predictors of a range of health outcomes, we emphasize that later childhood and adolescent exposures are risks for other health outcomes.
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Affiliation(s)
- Sheldon Cohen
- Carnegie Mellon University, Pittsburgh, PA 15213, USA.
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Gustafsson PE, Janlert U, Theorell T, Hammarström A. Life-course socioeconomic trajectories and diurnal cortisol regulation in adulthood. Psychoneuroendocrinology 2010; 35:613-23. [PMID: 19879057 DOI: 10.1016/j.psyneuen.2009.09.019] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Revised: 09/24/2009] [Accepted: 09/29/2009] [Indexed: 11/29/2022]
Abstract
Although the health risk of socioeconomic disadvantage over the life-course is fairly established, the mechanisms are less studied. One candidate pathway is long-term dysregulation of cortisol. This study assesses whether socioeconomic trajectories from adolescence to adulthood influences the regulation of cortisol in mid-adulthood, and further investigates the importance of adolescence as a critical period and of accumulation of socioeconomic disadvantage. Participants were drawn from a 27-year prospective cohort study (n=732, 68% of the original cohort). Information on socioeconomic status (SES) was collected at the ages of 16 (based on parental occupation), 21, 30 and 43 (based on own occupation) years, and at 43 years participants collected one-day salivary cortisol samples at awakening, after 15min, before lunch and at bedtime. We found that the cortisol awakening response (CAR) differed with respect to SES trajectory; those with stable low or early low/upwardly mobile SES tended to display higher CAR than those with early high/downwardly mobile, highly mobile or stable high trajectories. Further analyses revealed that early low SES was related to higher CAR, and in women low SES was related to lower bedtime cortisol, independently of later SES and potential confounders. We found no support for a linear effect of accumulation of socioeconomic disadvantage. In conclusion, our study gives support for an independent effect of low socioeconomic status early in life, on the regulation of cortisol in adulthood.
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Affiliation(s)
- Per E Gustafsson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, SE-901 85 Umeå, Sweden.
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Seo JH, Kim H, Shin YJ. [Analysis for the impact of adulthood and childhood socioeconomic positions and intergenerational social mobility on adulthood health]. J Prev Med Public Health 2010; 43:138-50. [PMID: 20383047 DOI: 10.3961/jpmph.2010.43.2.138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES There are at least three conceptual models for the effects of the childhood social environment on adult health: the critical period model, the social mobility model, and the cumulative risk model. However, few studies have investigated all three different models within the same setting. This study aims to examine the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility over the life course on the health in adulthood based both on the critical period model and the social mobility model. METHODS This study was conducted on 9583 adults aged between 25 and 64 years old and they were the respondents to the Korea Welfare Panel Study (2006). A multivariate logistic regression analysis was carried out, using the critical period model and the social mobility model out of the life course approaches, to look into the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility on the health status in adulthood. RESULTS Household income and occupation out of the adulthood socioeconomic position indicators had an independent influence on the adulthood health status. The childhood socioeconomic position indicators, except for the place of childhood residence, affected the adulthood health status even after adjustment for the adulthood socioeconomic position. The effect of intergenerational social mobility was also statistically significant even after adjusting for the adulthood socioeconomic position, but it became insignificant when the childhood socioeconomic position was additionally adjusted for. CONCLUSIONS Adulthood health is indeed affected by both the childhood and adulthood socioeconomic positions as well as intergenerational social mobility. This result shows that a life course approach needs to be adopted when dealing with health issues.
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Affiliation(s)
- Jae-Hee Seo
- Department of Preventive Medicine, Hanyang University College of Medicine, Korea
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Karakis I, Bolotin A, Kordysh E, Belmaker I, Sarov B. Mortality in the bedouin population and proximity to a regional industrial complex. ENVIRONMENTAL HEALTH INSIGHTS 2008; 1:21-29. [PMID: 21572844 PMCID: PMC3091347 DOI: 10.4137/ehi.s891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The study was initiated by public concern about exposure to an industrial park (IP) emission. The study examined whether mortality in the Bedouin population in the southern part of Israel is associated with the residential distance to the IP. MATERIAL AND METHODS Ecological study during 1995-2001 included the entire Bedouin population. Mortality data was obtained from the Central Bureau of Statistics. As an indirect measurement of exposure we used residential distance to the IP (with 20 km radius as a cut-of-point) based on residents' complaints about odor related to the IP. Differences in mortality rates by distance were assessed by the Mantel-Haenszel relative risk (M-H RR) within the 95% CI. The country Arab population served as a reference for calculation of the age-adjusted standardized mortality ratio (SMR). RESULTS Increased mortality rates due to symptoms/ill-defined conditions and non-external causes were observed in the Bedouin population of both sexes, residing up to 20 km from the IP, compared to those living in more remote areas. Corresponding M-H RR (plus 95% CI) were 1.66 (1.17-2.36), 1.24 (1.06-1.44) in females, and 1.55 (1.15-2.10), 1.32 (1.15-1.52) in males. CONCLUSIONS The study results suggest an association between residential proximity to the regional IP and increased mortality rates in the Negev Bedouin population. These findings have been accepted by the authorities as an issue for community health protection.
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Affiliation(s)
- Isabella Karakis
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beersheba, Israel
- School of Public Health, Haifa University, Haifa, Israel
| | - Arkady Bolotin
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Ella Kordysh
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Ilana Belmaker
- Southern Regional Health Department of the Israeli Ministry of Health, Beersheba, Israel
| | - Batia Sarov
- Department of Epidemiology and Health Services Evaluation, Ben-Gurion University of the Negev, Beersheba, Israel
- Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, U.S.A
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