1
|
Sixpence A, Vokhiwa M, Kumalakwaanthu W, Pitchford NJ, Seydel KB, Magder LS, Laufer MK, Mathanga DP, Cohee LM. Comparing approaches for chemoprevention for school-based malaria control in Malawi: an open label, randomized, controlled clinical trial. EClinicalMedicine 2024; 76:102832. [PMID: 39318787 PMCID: PMC11421355 DOI: 10.1016/j.eclinm.2024.102832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 08/28/2024] [Accepted: 08/29/2024] [Indexed: 09/26/2024] Open
Abstract
Background School-age children in sub-Saharan Africa suffer an underappreciated burden of malaria which threatens their health and education. To address this problem, we compared the efficacy of two school-based chemoprevention approaches: giving all students intermittent preventive treatment (IPT) or screening and treating only students with detected infections (IST). Methods In a three-arm, open-label, randomized, controlled trial (NCT05244954) in Malawi, 746 primary school students, aged 5-19 years, were individually randomized within each grade-level to IPT (n = 249), IST with a high-sensitivity rapid diagnostic test (hs-RDT, n = 248), or control (n = 249). At six-week intervals three times within the peak malaria transmission season (February-June 2022) treatment with dihydroartemisinin-piperaquine (DP) was administered to girls <10 years and all boys, and chloroquine to older girls. The primary outcome was Plasmodium falciparum (Pf) infection detected by PCR 6-8 weeks after the final intervention. Secondary outcomes included anaemia, clinical malaria, and scores on tests of attention, literacy, and math. Analysis was by modified intention-to-treat. Findings Outcomes analyses included 727 (97%) participants. At the end of the study, prevalence of Pf infection was 17% (41/243) in the IPT arm, 24% (58/244) in the IST arm, and 53% (127/240) in the control arm. Compared to controls, IPT and IST reduced the odds of Pf infection (IPT adjusted odds ratio [aOR]: 0.18 (95% CI: 0.11, 0.27); p < 0.0001; IST aOR: 0.27 (95% CI: 0.18, 0.40); p < 0.0001). However, only participants receiving IPT had a lower incidence of clinical malaria (0.19 cases per person per six months (95% CI: 0.14, 0.27) vs 0.56 (95% CI: 0.46, 0.68); incidence rate ratio: 0.38 (95% CI: 0.26, 0.55); p < 0.0001)) and prevalence of anaemia (8% [20/243] vs 15% [36/240]; aOR: 0.49 (95% CI: 0.27, 0.91); p = 0.023) compared to controls. Literacy scores were higher in both intervention arms. No between group differences in tests of attention or math or number of serious adverse events were found. Interpretation Results support implementation of IST with hs-RDTs or IPT for reduction in the prevalence of infection. Based on reductions in clinical malaria, IPT may provide additional benefits warranting further consideration by school-based malaria chemoprevention programs. Funding Doris Duke Charitable Foundation Clinical Scientist Development Award 2021191, U.S. NIH K24AI114996 & K23AI135076.
Collapse
Affiliation(s)
- Alick Sixpence
- Department of Epidemiology and Department of Global Health, Boston University School of Public Health, 715 Albany St, Talbot Building, Boston, MA, 02118, USA
- Malaria Alert Centre (MAC), Kamuzu University of Health Sciences (KUHeS), Private Bag 360, Chichiri, Blantyre 3, Malawi
| | - Maclean Vokhiwa
- Training & Research Unit of Excellence (TRUE), 1 Kufa Road, Mandala, P.O Box 30538, Chichiri, Blantyre 3, Malawi
| | - Wangisani Kumalakwaanthu
- Malaria Alert Centre (MAC), Kamuzu University of Health Sciences (KUHeS), Private Bag 360, Chichiri, Blantyre 3, Malawi
| | | | - Karl B. Seydel
- Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, 48824, USA
- Blantyre Malaria Project, Kamuzu University of Health Sciences, PO Box 32256, Chichiri, Blantyre, Malawi
| | - Laurence S. Magder
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Miriam K. Laufer
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Don P. Mathanga
- Malaria Alert Centre (MAC), Kamuzu University of Health Sciences (KUHeS), Private Bag 360, Chichiri, Blantyre 3, Malawi
- School of Global and Public Health, Kamuzu University of Health Sciences (KUHeS), Private Bag 360, Chichiri, Blantyre 3, Malawi
| | - Lauren M. Cohee
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| |
Collapse
|
2
|
Mastorci F, Lazzeri MFL, Vassalle C, Pingitore A. The Transition from Childhood to Adolescence: Between Health and Vulnerability. CHILDREN (BASEL, SWITZERLAND) 2024; 11:989. [PMID: 39201923 PMCID: PMC11352511 DOI: 10.3390/children11080989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/31/2024] [Accepted: 08/13/2024] [Indexed: 09/03/2024]
Abstract
Transitioning from childhood into adolescence is an extraordinary time of life, associated with major physical, emotional, cognitive, and social changes and characterized by dynamic development in which interaction with the environment modulates the individual resources responsible for well-being and health. This sensitive period is the time when, in addition to hormonal, metabolic, and neural changes, certain behavioral strategies begin to take shape that will shortly go on to define the emotional, social, and cultural identity of the individual. This narrative review aimed to uncover the crucial processes underlying the transition by identifying processes that are responsible for cognitive, psychosocial, and emotional development, in the absence of disease. For this aim, we highlight (1) the physical, psychological, and social determinants during the transition from childhood to adolescence; (2) the role of health-related variables in resilience or vulnerability mechanisms; and (3) recent school-based strategies to promote health and well-being. Recognizing that health and well-being are the result of the interaction of many biological, psychological, social, cultural, and physical factors will lead to comprehensive health promotion involving all actors joining the growth process, from health professionals and the educational community to parents and community. Furthermore, it is important that psychosocial dimensions are strengthened already during childhood to prevent the onset of frailty and illness in adolescence.
Collapse
Affiliation(s)
- Francesca Mastorci
- Clinical Physiology Institute, CNR, 56124 Pisa, Italy; (M.F.L.L.); (A.P.)
| | | | | | | |
Collapse
|
3
|
Ringbom I, Suvisaari J, Sourander A, Gissler M, Gyllenberg D. Temporal changes in the associations between diagnosed psychiatric disorders and dropping out of school early. Eur Child Adolesc Psychiatry 2024; 33:1443-1450. [PMID: 37380876 PMCID: PMC11098921 DOI: 10.1007/s00787-023-02252-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
Psychiatric problems are risk markers for poor educational attainment. The number of adolescents receiving treatment has increased. We investigated whether the association between psychiatric problems in early adolescence and dropping out of school had changed. We used the register-based 1987 and 1997 Finnish Birth Cohort studies, which include all live births in Finland. Hospital districts with incomplete records were excluded, leaving 25,421 participants born in 1987 and 32,025 born in 1997. The main outcome was not having applied for secondary education by the year the cohort members turned 18. Our main predictors were psychiatric and neurodevelopmental disorders diagnosed by specialized services during 1998-2003 and 2008-2013, when the cohort members were 10-16 years old. We found that 511 (2.0) of subjects born in 1987 and 499 (1.6%) born in 1997 dropped out of school. Having any diagnosis at 10-16 of age was associated with dropping out of school early in both cohorts: 3.9% in 1987 and 4.8% in 1997. The highest proportions were in the subgroup with autism spectrum disorders (ASD), 19.4% in 1987 and 16.2% in 1997. Dropping out early increased among adolescents diagnosed with any psychiatric or neurodevelopmental disorder, from 3.9 to 4.8%, with the clearest increase for learning disabilities, from 3.4 to 9.0%. Dropping out decreased for those with depression, from 4.5 to 2.1%. Adolescents with psychiatric and especially neurodevelopmental disorders, need effective interventions to prevent them dropping out of school early. Increased detection of psychopathology did not result in decreased dropout rates.
Collapse
Affiliation(s)
- Ida Ringbom
- Department of Child Psychiatry and Invest Flagship, University of Turku, Lemminkäisenkatu 3, 3rd. Floor, 20014, Turku, Finland.
- Finnish Institute for Health and Welfare, Helsinki, Finland.
- Department of Adolescent Psychiatry, Helsinki University Hospital, Helsinki, Finland.
| | | | - Andre Sourander
- Department of Child Psychiatry and Invest Flagship, University of Turku, Lemminkäisenkatu 3, 3rd. Floor, 20014, Turku, Finland
- Department of Child Psychiatry, Turku University Central Hospital, Turku, Finland
| | - Mika Gissler
- Department of Child Psychiatry and Invest Flagship, University of Turku, Lemminkäisenkatu 3, 3rd. Floor, 20014, Turku, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Molecular Medicine and Surgery, Sweden and Region Stockholm, Academic Primary Health Care Centre, Karolinska Institute, Stockholm, Sweden
| | - David Gyllenberg
- Department of Child Psychiatry and Invest Flagship, University of Turku, Lemminkäisenkatu 3, 3rd. Floor, 20014, Turku, Finland
- Finnish Institute for Health and Welfare, Helsinki, Finland
| |
Collapse
|
4
|
Rasmussen J, Nørgård BM, Nielsen RG, Bøggild H, Qvist N, Brund RBK, Bruun NH, Fonager K. Implication of Inflammatory Bowel Disease Diagnosed Before the Age of 18 for Achieving an Upper Secondary Education: A Nationwide Population-Based Cohort Study. Inflamm Bowel Dis 2024; 30:247-256. [PMID: 37603772 DOI: 10.1093/ibd/izad157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Educational achievement may be adversely affected by chronic conditions in childhood and adolescence. This study aimed to examine the effect of being diagnosed with IBD on achievement of an upper secondary education and the influence of disease severity and psychiatric comorbidity. METHODS This cohort study was based on nationwide Danish administrative registries. We compared a cohort of patients with IBD with a matched population-based cohort. The IBD cohort included patients born between 1970 and 1994 who were diagnosed with IBD (age <18 years). The outcome was achieving an upper secondary education and was analyzed using Cox regression. The impact of disease severity (expressed by surgery or corticosteroid prescriptions) or psychiatric comorbidity within the IBD cohort was assessed using Poisson regression. RESULTS We identified 3178 patients with IBD (Crohn's disease [CD] n = 1344, ulcerative colitis [UC] n = 1834) and matched them with 28 204 references. The hazard ratio of achieving an upper secondary education was 1.14 (95% confidence interval, 1.07-1.21) for CD and 1.16 (95% confidence interval, 1.10-1.23) for UC. In the IBD cohort, having surgery, a steroid prescription, or a comorbid psychiatric condition was associated with a lower chance of achieving an upper secondary education. CONCLUSION Being diagnosed with IBD before 18 years of age increased the chance of achieving an upper secondary education. However, patients with more severe disease or psychiatric comorbidity were at higher risk of not achieving an upper secondary education than patients with milder disease.
Collapse
Affiliation(s)
- Julie Rasmussen
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Bente Mertz Nørgård
- Center for Clinical Epidemiology, Odense University Hospital, Odense, Denmark
- Research Unit of Epidemiology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Rasmus Gaardskær Nielsen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Henrik Bøggild
- Public Health and Epidemiology, Department of Health Science and Technology, Aalborg University; Aalborg, Denmark
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Qvist
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Research Unit for Surgery, Odense University Hospital, Odense, Denmark
| | | | - Niels Henrik Bruun
- Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Kirsten Fonager
- Department of Social Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
5
|
Askari MS, Olfson M, Belsky DW, Breslau J, Keyes KM. The Influence of the Great Recession on Adolescent Major Depressive Episodes and Treatment in the United States: An Interrupted Time Series Analysis. J Adolesc Health 2024; 74:51-59. [PMID: 37831049 DOI: 10.1016/j.jadohealth.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/22/2023] [Accepted: 08/14/2023] [Indexed: 10/14/2023]
Abstract
PURPOSE In the United States, adolescent depression increased beginning in 2008-2010, coinciding with the Great Recession. We investigated whether this time of changing economic circumstances impacted adolescent depression and treatment. METHODS We analyzed data for adolescents aged 12-17 years from the 2004-2019 National Survey on Drug Use and Health (N = 256,572). Adolescents' past-year major depressive episodes (MDEs) were measured by self-reported symptoms. MDE treatment included seeing a health professional or receiving MDE medication. We tested how MDE and MDE treatment changed from pre-Great Recession (2004 to Fall 2007) to post-Great Recession (Winter 2007-2019) using interrupted time-series segmented regression models, accounting for seasonality and autocorrelation and testing for moderation by household poverty. RESULTS The Great Recession was not associated with an immediate increase in MDE prevalence (β:-0.77 [i.e., quarter-year change in prevalence], 95% confidence interval (CI): -2.23, 0.69). However, the increase in MDE prevalence accelerated following the Great Recession (β: 0.29, 95% CI: 0.13, 0.44). The Great Recession was not associated with immediate or long-term changes in adolescent MDE treatment (immediate β: -2.87, 95% CI: -7.79, 2.04; long-term β: 0.03, 95% CI: -0.46, 0.51). Effects were similar for households by poverty status. DISCUSSION The Great Recession was not associated with increased adolescent depression prevalence, although there was an acceleration in the trend of adolescent MDE following the recession. The prevalence of MDE treatment remained stable. Adolescent depression prevention efforts should be heightened as prevalence increases, including actively engaging caregivers as family supports to alleviate potential negative implications of economic distress for adolescent MDE.
Collapse
Affiliation(s)
- Melanie S Askari
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York.
| | - Mark Olfson
- Columbia University, New York State Psychiatric Institute, New York, New York
| | - Daniel W Belsky
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | | | - Katherine M Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| |
Collapse
|
6
|
Zacher M. Educational Disparities in Hypertension Prevalence and Blood Pressure Percentiles in the Health and Retirement Study. J Gerontol B Psychol Sci Soc Sci 2023; 78:1535-1544. [PMID: 37279558 PMCID: PMC10461534 DOI: 10.1093/geronb/gbad084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVES Hypertension and uncontrolled high blood pressure (BP) are more prevalent among less-educated older adults than those with more schooling. However, these dichotomous indicators may fail to fully characterize educational disparities in BP, a continuous measure that predicts morbidity and mortality across much of its range. This study therefore focuses on the distribution of BP, assessing educational disparities across BP percentiles in addition to disparities in hypertension and uncontrolled BP. METHODS Data are from the 2014-2016 Health and Retirement Study, a nationally representative survey of older U.S. adults (n = 14,498, ages 51-89). To examine associations between education, hypertension, and uncontrolled BP, I estimate linear probability models. To assess relationships between education and BP, I fit linear and unconditional quantile regression models. RESULTS Less-educated older adults are not only more likely to have hypertension and uncontrolled BP than those with more schooling, they also have higher systolic BP across nearly the entire BP distribution. Educational disparities in systolic BP increase in magnitude across BP percentiles and are largest at the highest levels of BP. This pattern is observed for those with and without diagnosed hypertension, is robust to early-life confounders, and is only partially explained by socioeconomic and health-related circumstances in adulthood. DISCUSSION Among older U.S. adults, the distribution of BP is compressed at lower, healthier levels for those with more education, and skewed toward the highest, most harmful levels among those with less education. Educational inequities in hypertension awareness and treatment efficacy may underlie these patterns. Implications for fundamental cause theory are discussed.
Collapse
Affiliation(s)
- Meghan Zacher
- Population Studies and Training Center, Brown University, Providence, Rhode Island, USA
| |
Collapse
|
7
|
Drescher J, Domingue BW. The distribution of child physicians and early academic achievement. Health Serv Res 2023. [PMID: 37286180 DOI: 10.1111/1475-6773.14188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVE To describe the distribution of pediatricians and family physicians (child physicians) across school districts and examine the association between physician supply and third-grade test scores. DATA SOURCES AND STUDY SETTING Data come from the January 2020 American Medical Association Physician Masterfile, the 2009-2013 and 2014-2018 waves of American Community Survey 5-Year Data, and the Stanford Education Data Archive (SEDA), which uses test scores from all U.S. public schools. We use covariate data provided by SEDA to describe student populations. STUDY DESIGN This descriptive analysis constructs a physician-to-child-population ratio for every school district in the country and describes the child population served by the current distribution of physicians. We fit a set of multivariable regression models to estimate the associations between district test score outcomes and district physician supply. Our model includes state fixed effects to control for unobservable state-level factors, as well as a covariate vector of sociodemographic characteristics. DATA COLLECTION Public data from three sources were matched by district ID. PRINCIPAL FINDINGS Physicians are highly unequally distributed across districts: nearly 3640 (29.6%) of 12,297 districts have no child physician, which includes 49% of rural districts. Rural children of color in particular have very little access to pediatric care, and this inequality is more extreme when looking exclusively at pediatricians. Districts that have higher child physician supplies tend to have higher academic test scores in early education, independent of community socioeconomic status and racial/ethnic composition. While the national data show this positive relationship (0.012 SD, 95% CI, 0.0103-0.0127), it is most pronounced for districts in the bottom tertile of physician supply (0.163 SD, 95% CI, 0.108-0.219). CONCLUSIONS Our study demonstrates a highly unequal distribution of child physicians in the U.S., and that children with less access to physicians have lower academic performance in early education.
Collapse
Affiliation(s)
- Jessica Drescher
- Center for Education Policy Analysis, Stanford University Graduate School of Education, Stanford, California, USA
- Center for Population Health Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Benjamin W Domingue
- Center for Education Policy Analysis, Stanford University Graduate School of Education, Stanford, California, USA
- Center for Population Health Sciences, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
8
|
Tong Y, Wang S, Cao L, Zhu D, Wang F, Xie F, Zhang X, Wang G, Su P. School dropouts related to mental disorders: A systematic review and meta-analysis. Asian J Psychiatr 2023; 85:103622. [PMID: 37172421 DOI: 10.1016/j.ajp.2023.103622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/26/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Affiliation(s)
- Yingying Tong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Shaojie Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Leilei Cao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Dongxue Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Fan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Faliang Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China
| | - Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Gengfu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Puyu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, No 81 Meishan Road, Hefei 230032, Anhui, China.
| |
Collapse
|
9
|
Lamu AN, Chen G, Olsen JA. Amplified disparities: The association between spousal education and own health. Soc Sci Med 2023; 323:115832. [PMID: 36947992 DOI: 10.1016/j.socscimed.2023.115832] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Abstract
Positive associations between own educational attainment and own health have been extensively documented. Studies have also shown spousal educational attainment to be associated with own health. This paper investigates the extent to which spousal education contributes to the social gradient in health, net of own education; and whether parts of a seeming spousal education effect are attributable to differences in early-life human capital, as measured by respondents' height and childhood living standard. Furthermore, we investigate the relative contribution of predictors in the regression analysis by use of Shapley value decomposition. We use data from a comprehensive health survey from Northern Norway (conducted in 2015/16, N = 21,083, aged 40 and above). We apply three alternative health outcome measures: the EQ-5D-5L index, a visual analogue scale (EQ-VAS) and self-rated health. In all models considered, spousal education is generally positively significant for both men and women. The results also suggest that spousal education is generally more important for men than women. In the sub-sample of individuals having a spouse, decomposition analyses showed that the relative contribution of spousal education to the goodness-of-fit in men's (women's) health was 13% (14%) with the EQ-5D-5L; 25% (20%) with the EQ-VAS and; 30% (21%) with self-rated health. Heterogeneity analyses showed stronger spousal education effects in younger age groups. In conclusion, we have provided empirical evidence that spousal education may contribute to explaining the amplified health gradient in an egalitarian country like Norway.
Collapse
Affiliation(s)
- Admassu N Lamu
- NORCE - Norwegian Research Center, Bergen, Norway; Department of Community Medicine, UiT - the Arctic University of Norway, Tromsø, Norway
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Australia
| | - Jan Abel Olsen
- Department of Community Medicine, UiT - the Arctic University of Norway, Tromsø, Norway; Centre for Health Economics, Monash University, Melbourne, Australia; Norwegian Institute of Public Health, Oslo, Norway.
| |
Collapse
|
10
|
Rockers PC, Zuilkowski SS, Fink G. Childhood adversity and educational attainment: Evidence from Zambia on the role of personality. Front Psychol 2023; 14:995343. [PMID: 36777195 PMCID: PMC9912843 DOI: 10.3389/fpsyg.2023.995343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/10/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction We examine whether personality traits mediate the association between childhood adversity and educational attainment using longitudinal data from a cohort in Zambia. Methods We fit a structural equation model using data on three forms of childhood adversity-household poverty, stunting as a measure of chronic malnutrition, and death of a parent-and data on the "Big Five" personality traits and educational attainment assessed at 15 years of age. Results We find that childhood poverty and death of a parent are associated with lower openness to experience. Furthermore, openness to experience mediates 93% of the negative association between death of a parent and school enrollment and 19% of the negative association between childhood poverty and enrollment. Discussion Our findings reinforce a diverse and growing body of evidence linking childhood adversity to educational attainment while also placing it in a new light. Future work should continue to examine the biological and psychosocial pathways that determine openness to experience and other personality traits, as well as their role in shaping important life outcomes.
Collapse
Affiliation(s)
- Peter C. Rockers
- Department of Global Health, Boston University School of Public Health, Boston, MA, United States
| | - Stephanie Simmons Zuilkowski
- Department of Educational Leadership and Policy Studies, Florida State University, Tallahassee, FL, United States
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| |
Collapse
|
11
|
Pokhilenko I, Kast T, Janssen LMM, Evers SMAA, Paulus ATG, Simon J, Mayer S, Berger M, Konnopka A, Muntendorf L, Brodszky V, García-Pérez L, Park A, Salvador-Carulla L, Drost RMWA. International comparability of reference unit costs of education services: when harmonizing methodology is not enough (PECUNIA project). Expert Rev Pharmacoecon Outcomes Res 2023; 23:135-141. [PMID: 36472303 DOI: 10.1080/14737167.2023.2152331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Health problems can lead to costs in the education sector. However, these costs are rarely incorporated in health economic evaluations due to the lack of reference unit costs (RUCs), cost per unit of service, of education services and of validated methods to obtain them. In this study, a standardized unit cost calculation tool developed in the PECUNIA project, the PECUNIA RUC Template for services, was applied to calculate the RUCs of selected education services in five European countries. METHODS The RUCs of special education services and of educational therapy were calculated using the information collected via an exploratory gray literature search and contact with service providers. RESULTS The RUCs of special education services ranged from €55 to €189 per school day. The RUCs of educational therapy ranged from €6 to €25 per contact and from €5 to €35 per day. Variation was observed in the type of input data and measurement unit, among other. DISCUSSION The tool helped reduce variability in the RUCs related to costing methodology and gain insights into other aspects that contribute to the variability (e.g. data availability). Further research and efforts to generate high quality input data are required to reduce the variability of the RUCs.
Collapse
Affiliation(s)
- I Pokhilenko
- Centre for Economics of Obesity, Health Economics Unit, Institute of Applied Health Research, College of Dental and Medical Sciences, University of Birmingham, Birmingham, The United Kingdom
| | - T Kast
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - L M M Janssen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - S M A A Evers
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.,Centre of Economic Evaluation & Machine Learning, Trimbos Institute, National Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - A T G Paulus
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.,School of Health Professions Education, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - J Simon
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Vienna, Austria.,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - S Mayer
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - M Berger
- Department of Health Economics, Centre for Public Health, Medical University of Vienna, Vienna, Austria
| | - A Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Muntendorf
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - L García-Pérez
- Servicio de Evaluación, Servicio Canario de la Salud (SESCS), Santa Cruz de Tenerife, Spain
| | - A Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - L Salvador-Carulla
- Mental Health Policy Unit, Health Research Institute, University of Canberra, Canberra, Australia
| | - R M W A Drost
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | | |
Collapse
|
12
|
Colón-López A, García C. 20th Century Puerto Rico and Later-Life Health: The Association Between Multigenerational Education and Chronic Conditions in Island-Dwelling Older Adults. J Aging Health 2023; 35:3-22. [PMID: 35536114 PMCID: PMC10081163 DOI: 10.1177/08982643221097532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Previous research on the association between education and older adult health in the U.S. has not included Puerto Rico. We investigated the effects of multigenerational educational attainment and chronic conditions among older Puerto Ricans residing on the archipelago's main island. METHODS Data were from the longitudinal Puerto Rican Elderly Health Conditions Project. Generalized Poisson regression models were used to examine if multigenerational educational attainment was associated with chronic disease. RESULTS Findings show that parental educational attainment was associated with fewer chronic conditions among females at baseline but not at follow-up, suggesting that the effects of parental education on health over time are less pronounced. For males, educational attainment across the three generations was not significantly associated with chronic disease at baseline or follow-up. DISCUSSION Multigenerational education is an important determinant of older adult health that continues to be relevant in Puerto Rico and the Latin American and Hispanic-Caribbean region.
Collapse
Affiliation(s)
- Alejandra Colón-López
- Department of Sociology, 9968University of Alabama - Birmingham, Birmingham, AL, USA
| | - Catherine García
- Department of Human Development and Family Science, Aging Studies Institute, Center for Aging and Policy Studies, Lerner Center for Public Health Promotion, 2029Syracuse University, Syracuse, NY, USA
| |
Collapse
|
13
|
van Zwieten A, Teixeira-Pinto A, Lah S, Nassar N, Craig JC, Wong G. Special health care needs during childhood and academic achievement in secondary school. Child Care Health Dev 2022; 48:311-323. [PMID: 34806201 DOI: 10.1111/cch.12931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/23/2021] [Accepted: 11/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Secondary education has lifelong implications for wellbeing. We evaluated associations between the duration and timing of special health care needs (SHCN) across childhood and academic achievement in secondary school. METHODS Cohort design. The structured modelling approach was used to evaluate life-course models for associations between the duration and timing of SHCN (measured using a two-item SHCN screener across ages 4-5, 6-7, 8-9 and 10-11 years) and Grade 7 (median age 12.5 years) reading and numeracy achievement. Linear regressions were fitted for each life-course model: four critical period models (each including SHCN exposure in one period), one sensitive period model (including SHCN exposure in all periods) and two strict accumulation models (including the duration of SHCN exposure in linear form then categorical form). Interactions of SHCN with child sex and family socio-economic status (SES) were examined. RESULTS Of 3734 children, 1845 were female. The number of children with SHCN was 434 (11.7%), 458 (12.9%), 534 (14.7%), 551 (15.4%) at 4-5, 6-7, 8-9 and 10-11 years respectively. For both outcomes, the linear strict accumulation model fitted best, and interactions of SHCN with sex and SES were non-significant. The average decrease in school achievement z score (95% confidence interval) per period of having SHCN was 0.04 (-0.07 to -0.02) for reading and 0.08 (-0.11 to -0.05) for numeracy. CONCLUSIONS A longer duration of SHCN from age 4-11 years has small-sized cumulative associations with poorer Grade 7 reading and numeracy achievement. Each period of SHCN between 4 and 5 and 10-11 years was associated with nearly 0.05 and 0.1 of a standard deviation reduction in Grade 7 reading and numeracy scores respectively, and these associations did not appear to differ across sex or SES. These findings suggest that children with persistent SHCN are at risk of academic deficits and should receive focused interventions.
Collapse
Affiliation(s)
- Anita van Zwieten
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, Sydney, New South Wales, Australia.,Australian Research Council Centre of Excellence for Cognition and its Disorders (ARC CCD), Macquarie University, Sydney, New South Wales, Australia
| | - Natasha Nassar
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Germaine Wong
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| |
Collapse
|
14
|
Langford R, Davies A, Howe L, Cabral C. Links between obesity, weight stigma and learning in adolescence: a qualitative study. BMC Public Health 2022; 22:109. [PMID: 35033056 PMCID: PMC8761050 DOI: 10.1186/s12889-022-12538-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 12/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Educational attainment is a key social determinant of health. Health and education are linked by multiple pathways, many of which are not well understood. One such pathway is the association between being above a healthy weight and lower academic achievement. While various explanations have been put forward to explain this relationship, evidence for causal pathways is sparse and unclear. This study addresses that evidence gap. METHODS We interviewed 19 adults (late 20s; 14 female, 5 male) and one young person (14 years, male) from the UK in 2019/2020. Participants were recruited from the ALSPAC 1990s birth cohort, sampled to ensure diversity in socio-economic status and educational attainment, and a community-based weight management group for young people. Interviews focused on experiences of being above a healthy weight during secondary school and how this may have affected their learning and achievement. Interviews were face-to-face, digitally recorded, and transcribed verbatim. We analysed the data thematically. RESULTS We identified key pathways through which higher body weight may negatively impact educational performance and showed how these are linked within a novel theoretical model. Because larger body size is highly stigmatised, participants engaged in different strategies to minimise their exposure to negative attention. Participants sought to increase their social acceptance or become less socially visible (or a combination of both). A minority navigated this successfully; they often had many friends (or the 'right' friends), experienced little or no bullying at school and weight appeared to have little effect on their achievement at school. For most however, the behaviours resulting from these strategies (e.g. disruptive behaviour, truanting, not working hard) or the physical, social or mental impacts of their school experiences (e.g. hungry, tired, self-conscious, depressed) made it difficult to concentrate and/or participate in class, which in turn affected how teachers viewed them. CONCLUSIONS Action to combat weight stigma, both within schools and in wider society, is urgently required to help address these educational disparities that in turn can impact health in later life.
Collapse
Affiliation(s)
- Rebecca Langford
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
| | - Alisha Davies
- Research and Evaluation Division, Public Health Wales, Floor 5, 2 Capital Quarter, Tyndall Street, Cardiff, CF10 4BZ UK
| | - Laura Howe
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN UK
| | - Christie Cabral
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Rd, Bristol, BS8 2PS UK
| |
Collapse
|
15
|
Mikkonen J, Remes H, Moustgaard H, Martikainen P. Evaluating the Role of Parental Education and Adolescent Health Problems in Educational Attainment. Demography 2021; 57:2245-2267. [PMID: 33001417 PMCID: PMC7732787 DOI: 10.1007/s13524-020-00919-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This article reconsiders the role of social origin in health selection by examining whether parental education moderates the association between early health and educational attainment and whether health problems mediate the intergenerational transmission of education. We used longitudinal register data on Finns born in 1986–1991 (n = 352,899). We measured the completion of secondary and tertiary education until age 27 and used data on hospital care and medication reimbursements to assess chronic somatic conditions, frequent infections, and mental disorders at ages 10–16. We employed linear probability models to estimate the associations between different types of health problems and educational outcomes and to examine moderation by parental education, both overall in the population and comparing siblings with and without health problems. Finally, we performed a mediation analysis with g-computation to simulate whether a hypothetical eradication of health problems would weaken the association between parental and offspring education. All types of health problems reduced the likelihood of secondary education, but mental disorders were associated with the largest reductions. Among those with secondary education, there was further evidence of selection to tertiary education. High parental education buffered against the negative impact of mental disorders on completing secondary education but exacerbated it in the case of tertiary education. The simulated eradication of health problems slightly reduced disparities by parental education in secondary education (up to 10%) but increased disparities in tertiary education (up to 2%). Adolescent health problems and parental education are strong but chiefly independent predictors of educational attainment.
Collapse
Affiliation(s)
- Janne Mikkonen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, PO Box 18 (Unioninkatu 35), FIN-00014, Helsinki, Finland.
| | - Hanna Remes
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, PO Box 18 (Unioninkatu 35), FIN-00014, Helsinki, Finland
| | - Heta Moustgaard
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, PO Box 18 (Unioninkatu 35), FIN-00014, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, PO Box 18 (Unioninkatu 35), FIN-00014, Helsinki, Finland.,Center for Health Equity Studies (CHESS), Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,The Max Planck Institute for Demographic Research, Rostock, Germany
| |
Collapse
|
16
|
Vaalavuo M, Kailaheimo-Lönnqvist S, Kauppinen TM, Sirniö O. Neighbourhood effects on psychiatric disorders among Finnish adolescents: The moderating impact of family background. Health Place 2021; 71:102671. [PMID: 34555783 DOI: 10.1016/j.healthplace.2021.102671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 10/20/2022]
Abstract
We study whether childhood neighbourhood context affects mental health in adolescence in Finland. We also examine heterogeneous effects by family background. By exploiting register data for 1999-2018, we use sibling fixed effects models to gain more robust evidence on the existence of neighbourhood effects. We do not find evidence of an association between neighbourhood characteristics and psychiatric disorders within families. Differences in the effects by family background were not consistent, and variation was mainly found in random effects models. In general, observed family characteristics were strongly associated with psychiatric disorders. This means that interventions should be targeted to children at risk rather than certain neighbourhoods.
Collapse
Affiliation(s)
- Maria Vaalavuo
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland.
| | - Sanna Kailaheimo-Lönnqvist
- Institute of Criminology and Legal Policy, University of Helsinki, P.O. Box 24 (Unioninkatu 40), FI-00014, Finland; Faculty of Social Sciences, Sociology, University of Turku, Assistentinkatu 7, Publicum, FI-20014, Finland.
| | - Timo M Kauppinen
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland.
| | - Outi Sirniö
- Finnish Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland.
| |
Collapse
|
17
|
Cha H, Farina MP, Hayward MD. Socioeconomic status across the life course and dementia-status life expectancy among older Americans. SSM Popul Health 2021; 15:100921. [PMID: 34584932 PMCID: PMC8452881 DOI: 10.1016/j.ssmph.2021.100921] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/24/2021] [Accepted: 09/08/2021] [Indexed: 11/27/2022] Open
Abstract
This study examines how socioeconomic status (SES) across the life course is associated with individuals' lifetime dementia experience - the years of life persons can expect to live and without with dementia. Conceptually, dementia-free life expectancy reflects the ability to postpone dementia onset while dementia life expectancy reflects the average lifetime period with the condition. How SES across the life course contributes to dementia-status life expectancy is the focus of this study. We assess whether persons who are advantaged in their lifetime SES live the most years without dementia and the fewest years with dementia compared to less advantaged persons. Using the Health and Retirement Study (2000-2016), we examine these questions for U.S. adults aged 65 and older using multistate life tables and a microsimulation approach. The results show that higher SES persons can expect to live significantly more years of life without dementia and that the period of life with dementia is compressed compared to less advantaged persons. The results also underscore that importance of cumulative exposure, showing that adults from disadvantaged childhoods who achieve high education levels often have dementia experiences that are similar to or better than those of adults from advantaged childhoods who achieved low education levels.
Collapse
Affiliation(s)
- Hyungmin Cha
- Department of Sociology and Population Research Center, The University of Texas at Austin, USA
| | - Mateo P. Farina
- Andrus School of Gerontology, The University of Southern California, USA
| | - Mark D. Hayward
- Department of Sociology and Population Research Center, The University of Texas at Austin, USA
| |
Collapse
|
18
|
Fenelon A, Boudreaux M, Slopen N, Newman SJ. The Benefits of Rental Assistance for Children's Health and School Attendance in the United States. Demography 2021; 58:1171-1195. [PMID: 33970240 PMCID: PMC8561436 DOI: 10.1215/00703370-9305166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Programs that provide affordable and stable housing may contribute to better child health and thus to fewer missed days of school. Drawing on a unique linkage of survey and administrative data, we use a quasi-experimental approach to examine the impact of rental assistance programs on missed days of school due to illness. We compare missed school days due to illness among children receiving rental assistance with those who will enter assistance within two years of their interview, the average length of waitlists for federal rental assistance. Overall, we find that children who receive rental assistance miss fewer days of school due to illness relative to those in the pseudo-waitlist group. We demonstrate that rental assistance leads to a reduction in the number of health problems among children and thus to fewer days of school missed due to illness. We find that the effect of rental assistance on missed school days is stronger for adolescents than for younger children. Additionally, race-stratified analyses reveal that rental assistance leads to fewer missed days due to illness among non-Hispanic White and Hispanic/Latino children; this effect, however, is not evident for non-Hispanic Black children, the largest racial/ethnic group receiving assistance. These findings suggest that underinvestment in affordable housing may impede socioeconomic mobility among disadvantaged non-Hispanic White and Hispanic/Latino children. In contrast, increases in rental assistance may widen racial/ethnic disparities in health among disadvantaged children, and future research should examine why this benefit is not evident for Black children.
Collapse
Affiliation(s)
- Andrew Fenelon
- School of Public Policy and Department of Sociology and Criminology, Penn State University, University Park, PA, USA
| | - Michel Boudreaux
- Department of Health Policy and Management, University of Maryland, College Park, MD, USA
| | - Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Sandra J Newman
- Department of Health Policy & Management, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
19
|
Lanuza YR, Turney K. The long reach of parental incarceration: The case of institutional engagement. SOCIAL SCIENCE RESEARCH 2020; 92:102485. [PMID: 33172567 DOI: 10.1016/j.ssresearch.2020.102485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 10/12/2020] [Accepted: 10/12/2020] [Indexed: 06/11/2023]
Abstract
Vast surveillance, especially of those with criminal justice contact, is a key feature of contemporary societies. As a consequence of this surveillance, formerly incarcerated individuals both avoid and are excluded from institutions, and this dampened institutional engagement may extend to offspring of the incarcerated. Using the National Longitudinal Study of Adolescent to Adult Health, we examine the relationship between parental incarceration and young adult institutional engagement in different settings, including financial institutions, medical institutions, school and work, volunteer organizations, and religious institutions. We find parental incarceration is associated with diminished institutional engagement in young adulthood. This association is partially explained by reduced parental institutional engagement during adolescence in addition to young adult's impaired health, lack of trust in government, and criminal justice contact. Our findings highlight a subtle and pervasive way that parental incarceration influences the transition to adulthood.
Collapse
|
20
|
Lam J, Vidal S, Baxter J. Chronic conditions, couple-level factors and union dissolution. ADVANCES IN LIFE COURSE RESEARCH 2020; 45:100340. [PMID: 36698278 DOI: 10.1016/j.alcr.2020.100340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 06/17/2023]
Abstract
This paper examines the association between chronic illness and union dissolution by examining rich, longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey. Using competing-risks discrete-time event-history models on longitudinal, dyadic data, we find the risk of union dissolution to be approximately 40 percent higher when either partner reports an illness than in the absence of an illness. We then examine whether the observed associations are mediated by variations in paid work, housework, financial stress and time stress. Financial stress is the factor that contributes most to the indirect associations between dissolution and partner's health condition, but overall these factors account for only 18.5 percent of the association between chronic illness and relationship dissolution. Our results provide further insight into the factors undermining relationship stability and highlight the importance of reducing financial stress associated with chronic illness.
Collapse
Affiliation(s)
- Jack Lam
- Institute for Social Science Research, Life Course Centre - University of Queensland, Australia.
| | - Sergi Vidal
- Centre for Demographic Studies, Universitat Autonoma de Barcelona, Spain
| | - Janeen Baxter
- Institute for Social Science Research, Life Course Centre - University of Queensland, Australia
| |
Collapse
|
21
|
Kirkpatrick KM. Adolescents With Chronic Medical Conditions and High School Completion: The Importance of Perceived School Belonging. CONTINUITY IN EDUCATION 2020; 1:50-63. [PMID: 38774529 PMCID: PMC11104302 DOI: 10.5334/cie.5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/06/2020] [Indexed: 05/24/2024]
Abstract
Students with chronic medical conditions often experience barriers to academic progress, including impact of disease and treatment, increased school absence, and altered expectations of teachers and parents. School belonging is an important element of academic success and can be promoted by positive relationships, structure, and support in the school environment. One aim of this study was to explore group differences in perceived school belonging and rate of on-time high school completion for students with chronic medical conditions as compared to their healthy peers. The second goal was to analyze relations between belonging, health status, and on-time completion of high school. Restricted data from Add Health was used to answer the study questions. Results showed that students with chronic medical conditions reported lower levels of perceived school belonging than their healthy peers (t(1056) = 3.69, p < .001, d = 0.23). Students with chronic medical conditions also attained lower levels of on-time high school graduation than their healthy peers (t(1056) = 2.60, p = .005, d = 0.16). Perceived school belonging had a different impact for students with chronic medical conditions than for those who had no health concerns. Each unit increase in belonging for students with health impairment was related to a 63% increased likelihood of on-time high school graduation (OR = 1.629, p = .003). School belonging is especially important for students living with chronic medical conditions. Finding ways to facilitate a stronger sense of school belonging may be a way to support desired academic outcomes.
Collapse
|
22
|
Jackson MI, Kihara T. The Educational Gradient in Health among Children in Immigrant Families. POPULATION RESEARCH AND POLICY REVIEW 2019; 38:869-897. [PMID: 32788819 PMCID: PMC7418906 DOI: 10.1007/s11113-019-09558-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 09/28/2019] [Indexed: 10/25/2022]
Abstract
Educational inequality in the health of U.S. children-what social scientists refer to as the "educational gradient" in health-is present at birth for virtually every marker of health, and increases throughout childhood. However, a puzzling contradiction to this pattern has been observed among the growing population of youth in immigrant families. Some evidence suggests an ambiguous relationship between education and health among immigrant families, with a flat relationship between maternal education and maternal health behaviors and children's birth outcomes, and a stronger relationship as children become adolescents. Does an educational gradient in health emerge among children in immigrant families during childhood and adolescence? To date, we lack a prospective examination of how the gradient changes from birth throughout childhood and adolescence among this population. Moreover, while the dominant explanation for a weaker gradient among children with immigrant parents centers on the family setting, we know little about family-level dynamics among the same immigrant families as children age. Using national, longitudinal data from the Fragile Families and Child Well-Being Study, we examine the association between maternal education and children's health (measured by mothers' ratings) over the early life course (birth through age 15) among children of immigrants and children of native-born parents, and consider whether changes in children's economic status and family composition contribute to the educational gradient, or lack thereof, in child health. Analyses reveal that: (1) maternal education is strongly predictive of health, even among children of immigrants; (2) immigrant status does not appear to be protective for health within educational groups, as evidenced by poorer health among children of immigrants whose mothers have the lowest level of education, as compared to children of natives; (3) children in the least-educated immigrant families are experiencing better health trajectories as they age than children in similar native-born families; and (4) accounting for economic conditions and family composition does not reduce the size of the gradient over time.
Collapse
|
23
|
De Neve JW, Karlsson O, Canavan CR, Chukwu A, Adu-Afarwuah S, Bukenya J, Darling AM, Harling G, Moshabela M, Killewo J, Fink G, Fawzi WW, Berhane Y. Are out-of-school adolescents at higher risk of adverse health outcomes? Evidence from 9 diverse settings in sub-Saharan Africa. Trop Med Int Health 2019; 25:70-80. [PMID: 31692194 DOI: 10.1111/tmi.13328] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES We analysed mutually comparable surveys on adolescent attitudes and behaviours from nine sites in seven sub-Saharan African countries, to determine the relationship between school enrolment and adolescent health outcomes. METHODS Data from the Africa Research, Implementation Science, and Education Network cross-sectional adolescent health surveys were used to examine the associations of current school enrolment, self-reported general health and four major adolescent health domains: (i) sexual and reproductive health; (ii) nutrition and non-communicable diseases; (iii) mental health, violence and injury; and (iv) healthcare utilisation. We used multivariable Poisson regression models to calculate relative risk ratios with 95% confidence intervals (CI), controlling for demographic and socio-economic characteristics. We assessed heterogeneity by gender and study site. RESULTS Across 7829 adolescents aged 10-19, 70.5% were in school at the time of interview. In-school adolescents were 14.3% more likely (95% CI: 6-22) to report that their life is going well; 51.2% less likely (95% CI: 45-67) to report ever having had sexual intercourse; 32.6% more likely (95% CI: 9-61) to report unmet need for health care; and 30.1% less likely (95% CI: 15-43) to report having visited a traditional healer. School enrolment was not significantly associated with malnutrition, low mood, violence or injury. Substantial heterogeneity was identified between genders for sexual and reproductive health, and in-school adolescents were particularly less likely to report adverse health outcomes in settings with high average school enrolment. CONCLUSIONS School enrolment is strongly associated with sexual and reproductive health and healthcare utilisation outcomes across nine sites in sub-Saharan Africa. Keeping adolescents in school may improve key health outcomes, something that can be explored through future longitudinal, mixed-methods, and (quasi-)experimental studies.
Collapse
Affiliation(s)
- Jan-Walter De Neve
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Omar Karlsson
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Centre for Economic Demography, Lund University, Lund, Sweden
| | - Chelsey R Canavan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Angela Chukwu
- University of Ibadan Research Foundation, University of Ibadan, Ibadan, Nigeria
| | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - Justine Bukenya
- Department of Community Health, Makerere University School of Public Health, Kampala, Uganda
| | - Anne Marie Darling
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Guy Harling
- Institute for Global Health, University College London, London, UK.,Africa Health Research Institute, Kwa-Zulu Natal, South Africa
| | - Mosa Moshabela
- Africa Health Research Institute, Kwa-Zulu Natal, South Africa.,School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Japhet Killewo
- Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Wafaie W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| |
Collapse
|
24
|
Heidinger LS, Willson AE. The childhood roots of adult psychological distress: Interdisciplinary perspectives toward a better understanding of exposure to cumulative childhood adversity. CHILD ABUSE & NEGLECT 2019; 97:104136. [PMID: 31450066 DOI: 10.1016/j.chiabu.2019.104136] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/28/2019] [Accepted: 08/07/2019] [Indexed: 05/28/2023]
Abstract
BACKGROUND Although most children experience at least one adversity, it is the experience of multiple adversities that produces a context of disadvantage that increases the risk of various negative outcomes in adulthood. Previous measures of cumulative childhood adversity consider a limited number of adversities, overlook potential differences across experiences of adversity, and fail to measure the effects of multiple co-occurring childhood adversities. These limitations have led to inconsistent and incomplete conclusions regarding the impact of multiple adverse childhood experiences on adult mental health. OBJECTIVE This study assesses how the operationalization and modeling of exposure to cumulative childhood adversity (CCA) influences estimates of the association between CCA and adult psychological distress and develops an improved measure of CCA. METHODS We use data from the Panel Study of Income Dynamics, a nationally representative sample of households in the United States, and its supplement, the Childhood Retrospective Circumstances Study (N = 4219). We compare four measures of CCA that consider various distinct aspects of adverse experiences (additive, severity, type, and patterns of experience using latent class analysis). RESULTS All measures of CCA were associated with increases in adult psychological distress, but effects depend on the measurement of CCA. Results suggest the sum score overestimates the overall impact of CCA. Latent class analysis captures the co-occurrence of adversities across severity and type, providing an improved measure of CCA. CONCLUSIONS The heterogeneity across adversities impacts estimates of adult psychological distress. Measuring CCA as patterns of co-occurring adverse experiences is a promising approach.
Collapse
Affiliation(s)
- Loanna S Heidinger
- Department of Sociology, Social Science Centre, University of Western Ontario, London, ON N6A 5C2 Canada.
| | - Andrea E Willson
- Department of Sociology, Social Science Centre, University of Western Ontario, London, ON N6A 5C2, Canada.
| |
Collapse
|
25
|
Wilkinson LR, Ferraro KF, Mustillo SA. Wealth in Middle and Later Life: Examining the Life Course Timing of Women's Health Limitations. THE GERONTOLOGIST 2019; 59:902-911. [PMID: 29868906 DOI: 10.1093/geront/gny048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Guided by cumulative inequality theory, this study poses two main questions: (a) Does women's poor health compromise household financial assets? (b) If yes, is wealth sensitive to the timing of women's health limitations? In addressing these questions, we consider the effect of health limitations on wealth at older ages, as well as examine how health limitations influence wealth over particular segments of the life course, giving attention to both the onset and duration of health limitations. RESEARCH DESIGN AND METHODS Using 36 years of data from the National Longitudinal Survey of Mature Women, piecewise growth curve and linear regression models were used to estimate the effects of life course timing and duration of health limitations on household wealth. RESULTS The findings reveal that women who experienced health limitations accumulated substantially less wealth over time, especially if the health limitations were manifest during childhood or early adulthood. DISCUSSION AND IMPLICATIONS This study identifies how early-life health problems lead to less wealth in later life.
Collapse
Affiliation(s)
| | - Kenneth F Ferraro
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana.,Department of Sociology, Purdue University, West Lafayette, Indiana
| | | |
Collapse
|
26
|
Independent and combined influence of healthy lifestyle factors on academic performance in adolescents: DADOS Study. Pediatr Res 2019; 85:456-462. [PMID: 30653194 DOI: 10.1038/s41390-019-0285-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/08/2018] [Accepted: 12/30/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Few studies have analyzed the combined effect of lifestyle factors on academic performance (AP) in adolescents. The aim of this study was to analyze the independent and combined effects of weight status, screen time, sleep quality, daily meal frequency, cardiorespiratory fitness, and physical activity (PA) on AP in adolescents. METHODS A total of 262 adolescents (13.9 ± 0.3 years) from the DADOS study were included in the analysis. Weight status was assessed through body mass index (kg/m2). Participants completed questionnaires to evaluate screen time, sleep quality, and daily meal frequency. Cardiorespiratory fitness was assessed by the 20-m shuttle run test. PA was evaluated by a wrist-worn GENEActiv accelerometer. AP was assessed through the final academic grades and a validated questionnaire. RESULTS Non-overweight status, low screen time, good sleep quality, and proper meal frequency showed independent, positive influence on AP. Moreover, adolescents achieving at least three healthy lifestyles were more likely to be in the high-performance group for academic grades than those achieving ≤1 (math OR: 3.02-9.51, language OR: 3.51-6.76, and grade point average OR: 4.22-9.36). CONCLUSIONS Although individual healthy lifestyles are independently and positively associated with AP, the cumulative effect of multiple healthy lifestyles have a stronger impact.
Collapse
|
27
|
Health problems during childhood and school achievement: Exploring associations between hospitalization exposures, gender, timing, and compulsory school grades. PLoS One 2018; 13:e0208116. [PMID: 30517159 PMCID: PMC6281208 DOI: 10.1371/journal.pone.0208116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 11/12/2018] [Indexed: 01/24/2023] Open
Abstract
Aims To investigate while accounting for health at birth 1) associations between health problems during childhood, measured as hospitalizations, and school achievement in the final year of compulsory school, measured as overall grade points and eligibility for upper secondary education, 2) if and how gender moderates the association between health problems and school achievement, 3) if and how the timing of a health problem during childhood is associated with later school achievement. Methods Analyzes were performed on a population-based cohort (n = 115 196) born in 1990 in Sweden (51.3% boys, 48.7% girls) using data from several national registries. Multiple linear regression and logistic regression were used to analyze associations between study variables. Results Overall grade points and eligibility for continuation to upper secondary school were lower for individuals exposed to hospitalizations. Only the association between hospitalizations and overall grade points was moderated by gender and only for ages 13–16 years. Exposure close to actual grading had worst outcomes. Conclusions Health problems, measured through hospitalizations, was significantly associated with lower school achievements among Swedish children. Girls exposed to health problems requiring hospitalizations had relatively poorer school achievements as compared to boys. Health problems requiring hospitalization during junior high school had the greatest negative association with final achievement at compulsory school.
Collapse
|
28
|
Joergensen AC, Kjaer Urhoj S, Nybo Andersen AM. Primary school achievement and socioeconomic attainment in individuals affected by parental cancer in childhood or adolescence: a Danish nationwide register-based study. J Epidemiol Community Health 2018; 72:982-989. [PMID: 30126977 DOI: 10.1136/jech-2018-210472] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 05/14/2018] [Accepted: 06/12/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Children who experience parental cancer are at increased risk of developing emotional, social, cognitive and behavioural problems. Our aim was to investigate how experience of parental cancer in childhood or adolescence is associated with primary school achievement, educational attainment and income in early adult life. METHODS This is a register-linkage, prospective study of children born in Denmark from 1978 through 1999 and their parents. Parental cancer experience before the ages of 15 and 18 was identified in the Danish National Patient Registry. Final grade point average (GPA) in ninth grade, educational attainment and disposable personal income at the age of 30 were identified in Statistics Denmark registers. General linear models and multinomial logistic regression were used to estimate beta estimates of GPA, and relative risk ratios (RRR) for lower educational and income levels compared with children without parental cancer, taking parental educational status into account. RESULTS Children who had experienced parental cancer achieved a slightly lower final GPA in ninth grade and had a higher risk of low educational attainment (RRR: 1.20; 95% CI 1.14 to 1.25) and attenuated income at the age of 30 (RRR: 1.11; 95% CI 1.06 to 1.16). For all outcomes, analyses suggested substantial deterioration in achievements in subgroups of children whose parent had a severe cancer type (RRRLow education: 1.52; 95% CI 1.39 to 1.66) or if the parent died of cancer (RRRLow education: 1.61; 95% CI 1.49 to 1.75). CONCLUSION Educational and socioeconomic attainments in early adulthood were affected negatively in individuals who had experienced parental cancer as children or adolescents. The associations appeared stronger the more severe the cancer was.
Collapse
Affiliation(s)
- Anne Cathrine Joergensen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Stine Kjaer Urhoj
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
29
|
Carroll JM, Humphries M, Muller C. Mental and physical health impairments at the transition to college: Early patterns in the education-health gradient. SOCIAL SCIENCE RESEARCH 2018; 74:120-131. [PMID: 29961479 PMCID: PMC6050015 DOI: 10.1016/j.ssresearch.2018.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 04/24/2018] [Accepted: 05/06/2018] [Indexed: 06/02/2023]
Abstract
Part of the education-health gradient may be related to inequalities in the transition from high school to college by health impairment status. In this paper, we use the National Longitudinal Survey of Youth 1997 to investigate the link between health impairments beginning prior to high school completion and college-going, distinguishing between individuals with mental, physical, or multiple health impairments and between enrollment in 2-year and 4-year postsecondary institutions. We find that individuals with mental impairments or multiple impairments are less likely to initially enroll in 4-year postsecondary institutions than individuals without health impairments, controlling on background and high school preparation. We also find evidence that advanced math course-taking in high school, an important step on the pathway to a 4-year college for all students, does not provide students with mental impairments the same return as students without health impairments. We discuss implications for policy to address educational inequalities in health.
Collapse
|
30
|
Mikkonen J, Moustgaard H, Remes H, Martikainen P. The Population Impact of Childhood Health Conditions on Dropout from Upper-Secondary Education. J Pediatr 2018; 196:283-290.e4. [PMID: 29551321 DOI: 10.1016/j.jpeds.2018.01.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/08/2017] [Accepted: 01/11/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To quantify how large a part of educational dropout is due to adverse childhood health conditions and to estimate the risk of dropout across various physical and mental health conditions. STUDY DESIGN A registry-based cohort study was conducted on a 20% random sample of Finns born in 1988-1995 (n = 101 284) followed for school dropout at ages 17 and 21. Four broad groups of health conditions (any, somatic, mental, and injury) and 25 specific health conditions were assessed from inpatient and outpatient care records at ages 10-16 years. We estimated the immediate and more persistent risks of dropout due to health conditions and calculated population-attributable fractions to quantify the population impact of childhood health on educational dropout, while accounting for a wide array of sociodemographic confounders and comorbidity. RESULTS Children with any health condition requiring inpatient or outpatient care at ages 10-16 years were more likely to be dropouts at ages 17 years (risk ratio 1.71, 95% CI 1.61-1.81) and 21 years (1.46, 1.37-1.54) following adjustment for individual and family sociodemographic factors. A total of 30% of school dropout was attributable to health conditions at age 17 years and 21% at age 21 years. Mental disorders alone had an attributable fraction of 11% at age 21 years, compared with 5% for both somatic conditions and injuries. Adjusting for the presence of mental disorders reduced the effects of somatic conditions. CONCLUSIONS More than one fifth of educational dropout is attributable to childhood health conditions. Early-onset mental disorders emerge as key targets in reducing dropout.
Collapse
Affiliation(s)
- Janne Mikkonen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
| | - Heta Moustgaard
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Hanna Remes
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland; Center for Health Equity Studies (CHESS), Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; The Max Planck Institute for Demographic Research, Rostock, Germany
| |
Collapse
|
31
|
Kane JB, Harris KM, Morgan SP, Guilkey DK. Pathways of Health and Human Capital from Adolescence into Young Adulthood. SOCIAL FORCES; A SCIENTIFIC MEDIUM OF SOCIAL STUDY AND INTERPRETATION 2018; 96:949-976. [PMID: 30555185 PMCID: PMC6292443 DOI: 10.1093/sf/sox079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Social inequalities in health and human capital are core concerns of sociologists, but little research examines the developmental stage when such inequalities are likely to emerge-the transition to adulthood. With new data and innovative statistical methods we conceptually develop, and empirically operationalize, pathways of physical health and human capital accumulation from adolescence into young adulthood, using an autoregressive cross-lagged structural equation model. Results reveal that pathways of health and human capital accumulate at differential rates across the transition to adulthood; evidence of cross-lagged effects lend support for both social causation and health selection hypotheses. We then apply this model to assess the presence of social inequality in metabolic syndrome-the leading risk factor of cardiovascular disease in the U.S. Findings document social stratification of cardiovascular health that is robust to both observed and unobserved social and health selection mechanisms. We speculate that this social stratification will only increase as this cohort ages.
Collapse
Affiliation(s)
| | | | - S Philip Morgan
- Department of Sociology and Carolina Population Center, University of North Carolina
| | - David K Guilkey
- Department of Economics and Carolina Population Center, University of North Carolina
| |
Collapse
|
32
|
Lee D, Jackson M. The Simultaneous Effects of Socioeconomic Disadvantage and Child Health on Children's Cognitive Development. Demography 2017; 54:1845-1871. [PMID: 28836169 PMCID: PMC5856460 DOI: 10.1007/s13524-017-0605-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Family socioeconomic status (SES) and child health are so strongly related that scholars have speculated child health to be an important pathway through which a cycle of poverty is reproduced across generations. Despite increasing recognition that SES and health work reciprocally and dynamically over the life course to produce inequality, research has yet to address how these two pathways simultaneously shape children's development. Using longitudinal data from the Fragile Families and Child Wellbeing Study and marginal structural models, we ask three questions: (1) how does the reciprocal relationship between socioeconomic disadvantage and child health affect estimates of each circumstance on children's cognitive development?; (2) how do their respective effects vary with age?; and (3) do family SES and child health have differential effects on cognitive development across population subgroups? The results show that the negative effects of socioeconomic disadvantage and poor health are insensitive to their reciprocal relationships over time. We find divergent effects of socioeconomic disadvantage and poor health on children's cognitive trajectories, with a widening pattern for family SES effects and a leveling-off pattern for child health effects. Finally, the effects of socioeconomic disadvantage are similar across all racial/ethnic groups, while the effects of child health are largely driven by white children. We discuss theoretical and policy implications of these findings for future research.
Collapse
Affiliation(s)
- Dohoon Lee
- Department of Sociology, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea, 03722.
| | - Margot Jackson
- Department of Sociology, Brown University, Box 1916, Providence, RI, 02912, USA
| |
Collapse
|
33
|
Sznitman SR, Reisel L, Khurana A. Socioeconomic background and high school completion: Mediation by health and moderation by national context. J Adolesc 2017; 56:118-126. [PMID: 28214662 DOI: 10.1016/j.adolescence.2017.02.004] [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: 12/04/2016] [Revised: 02/01/2017] [Accepted: 02/05/2017] [Indexed: 11/25/2022]
Abstract
This study uses longitudinal data from the Norwegian Health Study linked with registry data (n = 13262) and the U.S. National Longitudinal Survey of Youth 1997 (n = 3604) to examine (1) whether adolescent health mediates the well-established relationship between socioeconomic background and successful high school completion, and (2) whether this mediated pathway of influence varies by national context. Adolescents from lower educated and lower income families reported poorer health, which negatively impacted their likelihood of graduating from high school. The partial mediational effect of adolescent health was stronger in the U.S. than in Norway. These results suggest that policies aimed at preventing high school dropout need to address adolescent health, in addition to the unequal opportunities derived from socioeconomic disadvantage.
Collapse
Affiliation(s)
- Sharon R Sznitman
- School of Public Health, University of Haifa, Eshkol Tower, Room 705, Mt. Carmel, 3190501, Haifa, Israel.
| | - Liza Reisel
- Institute for Social Research, Munthes Gate 31, 0260, Oslo, Norway.
| | - Atika Khurana
- College of Education, University of Oregon, 369 HEDCO, 1655 Alder St., Eugene, OR, 97403, USA.
| |
Collapse
|
34
|
Callander EJ. Pathways between health, education and income in adolescence and adulthood. Arch Dis Child 2016; 101:825-31. [PMID: 27207865 DOI: 10.1136/archdischild-2015-309721] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 05/02/2016] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To quantify the impact of household income, and physical and mental health in adolescence on education attainment, household income and health status in adulthood. DESIGN Path analysis and regression models using waves 1-12 of the Household, Income and Labour Dynamics in Australia survey. PARTICIPANTS Individuals aged 17 or 18 in 2001, 52% were males (n=655) and 48% were female (52%). Of those participating in wave 1, five did not respond in wave 12. MAIN OUTCOME MEASURES Education attainment, household income, physical and mental health at age 29/30. RESULTS For females, physical health at age 17/18 was significantly related to level of education attainment at age 29/30 (standardised total effect 0.290, p<0.001), with this influence being greater in magnitude than that of household income at age 17/18 on level of education attainment at age 29/30 (standardised total effect 0.159, p=0.022). Females' physical health at age 17/18 was also significantly related to household income at age 29/30 (standardised total effect 0.09, p=0.018). Both adjusted for initial household income at age 17/18. For males, the total standardised total effect of physical health at age 17/18 had a greater impact than household income at age 17/18 on education attainment at age 29/30 (0.347, p<0.001 for physical health and 0.276, p<0.001 for household income). The OR of achieving a year 12 or higher level of education attainment was 4.72 (95% CI 1.43 to 15.58, p=0.0110) for females with good physical health at age 17/18 and 5.05 (95% CI 1.78 to 14.36, p=0.0024) for males, compared with those with poor physical health at age 17/18. CONCLUSIONS As physical health in adolescence appears to have a stronger influence on education attainment in adulthood than household income, equity strategies for education attainment should also target those with poor health.
Collapse
|
35
|
Nickel JW. Can a right to health care be justified by linkage arguments? THEORETICAL MEDICINE AND BIOETHICS 2016; 37:293-306. [PMID: 27444281 DOI: 10.1007/s11017-016-9369-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Linkage arguments, which defend a controversial right by showing that it is indispensable or highly useful to an uncontroversial right, are sometimes used to defend the right to health care (RHC). This article evaluates such arguments when used to defend RHC. Three common errors in using linkage arguments are (1) neglecting levels of implementation, (2) expanding the scope of the supported right beyond its uncontroversial domain, and (3) giving too much credit to the supporting right for outcomes in its area. A familiar linkage argument for RHC focuses on its contributions to the right to life. Among the problems with this argument are that it requires a positive conception of the right to life that is not uncontroversial and that it only justifies the subset of RHC that seeks to prevent loss of life. A linkage argument for RHC with better prospects claims that a well-realized right to health care enhances the realization of a number of uncontroversial rights.
Collapse
Affiliation(s)
- James W Nickel
- University of Miami School of Law, 1311 Miller Rd, Coral Gables, FL, 33146, USA.
| |
Collapse
|
36
|
Bauldry S, Shanahan MJ, Macmillan R, Miech RA, Boardman JD, O Dean D, Cole V. Parental and adolescent health behaviors and pathways to adulthood. SOCIAL SCIENCE RESEARCH 2016; 58:227-242. [PMID: 27194662 PMCID: PMC4873711 DOI: 10.1016/j.ssresearch.2016.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 02/01/2016] [Accepted: 02/17/2016] [Indexed: 06/02/2023]
Abstract
This paper examines associations among parental and adolescent health behaviors and pathways to adulthood. Using data from the National Longitudinal Study of Adolescent to Adult Health, we identify a set of latent classes describing pathways into adulthood and examine health-related predictors of these pathways. The identified pathways are consistent with prior research using other sources of data. Results also show that both adolescent and parental health behaviors differentiate pathways. Parental and adolescent smoking are associated with lowered probability of the higher education pathway and higher likelihood of the work and the work & family pathways (entry into the workforce soon after high school completion). Adolescent drinking is positively associated with the work pathway and the higher education pathway, but decreases the likelihood of the work & family pathway. Neither parental nor adolescent obesity are associated with any of the pathways to adulthood. When combined, parental/adolescent smoking and adolescent drinking are associated with displacement from the basic institutions of school, work, and family.
Collapse
|
37
|
Bell MF, Bayliss DM, Glauert R, Harrison A, Ohan JL. Chronic Illness and Developmental Vulnerability at School Entry. Pediatrics 2016; 137:peds.2015-2475. [PMID: 27244787 DOI: 10.1542/peds.2015-2475] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2016] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE This study examined the association between chronic illness and school readiness, by using linked administrative population data. METHODS The sample included children born in 2003-2004 who were residing in Western Australia in 2009 and had a complete Australian Early Development Census record (N = 22 890). Health and demographic information was also analyzed for 19 227 mothers and 19 030 fathers. The impact of child chronic illness on 5 developmental domains (social, emotional, language, cognitive, and physical) at school entry was analyzed. Analyses examined the association between child developmental outcomes and chronic illness generally, single or multiple chronic illness diagnosis, and diagnosis type. Logistic regression models estimated odds ratios for each outcome, adjusted for child, parent, and community sociodemographic variables. RESULTS In the adjusted models, children with a chronic illness had an increased risk of being classified as developmentally vulnerable on all domains, compared with children without a chronic illness (20%-35% increase in risk). There was no increased risk for children with multiple chronic illness diagnoses over those with a single diagnosis (all Ps > .05). There was no evidence of a disease-specific effect driving this risk. CONCLUSIONS Regardless of the number or type of conditions, chronic illness in young children is a risk factor for reduced school readiness. These effects were seen for health conditions not traditionally considered detrimental to school readiness, such as chronic otitis media. Thus, the implications of a broader range of chronic health conditions in early childhood on school readiness need to be considered.
Collapse
Affiliation(s)
- Megan F Bell
- School of Psychology, and Telethon Kids Institute, University of Western Australia, Perth, Western Australia; and
| | | | - Rebecca Glauert
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia; and
| | | | | |
Collapse
|
38
|
An education gradient in health, a health gradient in education, or a confounded gradient in both? Soc Sci Med 2016; 154:18-27. [PMID: 26943010 DOI: 10.1016/j.socscimed.2016.02.029] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 02/13/2016] [Accepted: 02/17/2016] [Indexed: 11/21/2022]
Abstract
There is a positive gradient associating educational attainment with health, yet the explanation for this gradient is not clear. Does higher education improve health (causation)? Do the healthy become highly educated (selection)? Or do good health and high educational attainment both result from advantages established early in the life course (confounding)? This study evaluates these competing explanations by tracking changes in educational attainment and Self-rated Health (SRH) from age 15 to age 31 in the National Longitudinal Study of Youth, 1997 cohort. Ordinal logistic regression confirms that high-SRH adolescents are more likely to become highly educated. This is partly because adolescent SRH is associated with early advantages including adolescents' academic performance, college plans, and family background (confounding); however, net of these confounders adolescent SRH still predicts adult educational attainment (selection). Fixed-effects longitudinal regression shows that educational attainment has little causal effect on SRH at age 31. Completion of a high school diploma or associate's degree has no effect on SRH, while completion of a bachelor's or graduate degree have effects that, though significant, are quite small (less than 0.1 points on a 5-point scale). While it is possible that educational attainment would have greater effect on health at older ages, at age 31 what we see is a health gradient in education, shaped primarily by selection and confounding rather than by a causal effect of education on health.
Collapse
|
39
|
Health Behaviors and Academic Performance Among Korean Adolescents. Asian Nurs Res (Korean Soc Nurs Sci) 2016; 10:123-7. [PMID: 27349669 DOI: 10.1016/j.anr.2016.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 05/12/2015] [Accepted: 10/02/2015] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This study aimed to examine the most prominent health-related behaviors impacting the academic performance of Korean adolescents. METHODS The 2012 Korea Youth Risk Behavior Web-Based Survey data were analyzed using an ordinal regression analysis after adjusting for general and other health behaviors. RESULTS Before adjustment, all health behaviors were significantly associated with academic performance. After adjustment for other health behaviors and confounding factors, only smoking [odds ratio (OR) = 2.07, 95% confidence interval (CI) (1.98, 2.16), p < .001], alcohol consumption [OR = 1.22, 95% CI (1.18, 1.27), p < .001], and physical activity [OR = 1.09, 95% CI (1.06, 1.13), p < .001] were associated with lower academic performance, and engaging in a regular diet [OR = 0.65, 95% CI (0.65, 0.62), p < .001] was associated with higher academic performance. CONCLUSIONS Regular diet, reducing smoking and alcohol drinking, and physical activity should be the target when designing health interventions for improving academic performance in Korean adolescents.
Collapse
|
40
|
Svansdottir E, Arngrimsson SA, Sveinsson T, Johannsson E. Importance of physical health and health-behaviors in adolescence for risk of dropout from secondary education in young adulthood: an 8-year prospective study. Int J Equity Health 2015; 14:140. [PMID: 26597711 PMCID: PMC4657320 DOI: 10.1186/s12939-015-0272-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 11/12/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Education and health constitute two interlinked assets that are highly important to individuals. In Iceland, prevalence of dropout from secondary education poses a considerable problem. This 8-year prospective study assesses to what extent poor physical health and negative health-behaviors of Icelandic adolescents predict increased odds of dropout from secondary education. METHODS The sample included n = 201 Icelandic children who participated at age 15 (baseline) and again at age 23 (follow-up). Data included objective measurements of physical health and questionnaires assessing health-behaviors, education status, parental education, neighborhood characteristics, self-esteem, and depression. Independent t-tests and chi-square were used to assess differences in physical health and health-behaviors at follow-up stratified by education status. Ordinal regression models were conducted to assess whether physical health and health-behaviors at age 15 predicted increased odds of dropout from secondary education at age 23, independent of gender, parental education and psychological factors. RESULTS At age 23, 78 % of girls and 71 % of boys had completed a secondary education. Completion of a secondary education was associated with significant health benefits, especially among women. Women without a secondary education had lower fitness, more somatic complaints, higher diastolic blood pressure, less sports participation, and poorer sleep, whilst men without a secondary education watched more television. In logistic regression models somatic complaints during adolescence were associated with 1.09 (95 % CI: 1.02-1.18) higher odds of dropout from secondary education in young adulthood, independent of covariates. Health-behaviors associated with higher dropout odds included smoking (3.67, 95 % CI: 1.50-9.00), alcohol drinking (2.57, 95 % CI: 1.15-5.75), and time spent watching television (1.27, 95 % CI:1.03-1.56), which were independent of most covariates. Finally, mother's higher education was strongly associated with significantly lower dropout odds (OR 0.54, 95 % CI: 0.34-0.88) independent of father's education and psychological factors, whilst high self-esteem was independently associated with lower dropout odds (OR 0.91, 95 % CI: 0.85-0.98). CONCLUSIONS Completion of a secondary education yields substantial physical health benefits for young women, but not for men. Importantly, somatic complaints and negative health-behaviors among adolescent boys and girls adversely impact their educational outcomes later in life, and may have widespread consequences for their future prospects.
Collapse
Affiliation(s)
- Erla Svansdottir
- School of Education, University of Iceland, Stakkahlíð, 105, Reykjavík, Iceland. .,Landspitali-University Hospital, Eiríksgötu 5, 101, Reykjavík, Iceland.
| | - Sigurbjorn A Arngrimsson
- School of Education, University of Iceland, Stakkahlíð, 105, Reykjavík, Iceland. .,Center for Sport and Health Sciences, University of Iceland, Lindarbraut 4, 840, Laugarvatn, Iceland.
| | - Thorarinn Sveinsson
- Research Centre of Movement Science, School of Health Sciences, University of Iceland, Stapi v/Hringbraut, 101, Reykjavík, Iceland.
| | - Erlingur Johannsson
- School of Education, University of Iceland, Stakkahlíð, 105, Reykjavík, Iceland. .,Center for Sport and Health Sciences, University of Iceland, Lindarbraut 4, 840, Laugarvatn, Iceland.
| |
Collapse
|
41
|
Does a college education reduce depressive symptoms in American young adults? Soc Sci Med 2015; 146:75-84. [PMID: 26513116 DOI: 10.1016/j.socscimed.2015.09.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 08/17/2015] [Accepted: 09/23/2015] [Indexed: 01/04/2023]
Abstract
Higher levels of educational attainment are consistently associated with better mental health. Whether this association represents an effect of education on mental health, however, is less clear as omitted variable bias remains a pressing concern with education potentially serving as a proxy for unobserved factors including family background and genetics. To combat this threat and come closer to a causal estimate of the effect of education on depressive symptoms, this study uses data on 231 monozygotic twin pairs from The National Longitudinal Study of Adolescent to Adult Health and employs a twin-pair difference-in-difference design to account for both unobserved shared factors between twin pairs (e.g. home, school, and neighborhood environment throughout childhood) and a number of observed non-shared but theoretically relevant factors (e.g. cognitive ability, personality characteristics, adolescent health). We find an inverse association between possessing a college degree and depressive symptoms in both conventional and difference-in-difference models. Results of this study also highlight the potentially overlooked role of personality characteristics in the education and mental health literature.
Collapse
|
42
|
Jackson MI. Cumulative inequality in child health and academic achievement. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2015; 56:262-80. [PMID: 25926564 PMCID: PMC4631384 DOI: 10.1177/0022146515581857] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Our understanding of health and social stratification can be enriched by testing tenets of cumulative inequality theory that emphasize how the accumulation of inequality is dependent on the developmental stage being considered, the duration and stability of poor health, and the family resources available to children. I analyze longitudinal data from the British National Child Development Study (N = 9,252) to ask: (1) if child health is a source of cumulative inequality in academic achievement, (2) whether this relationship depends on the timing and duration of poor health, and (3) whether trajectories are sensitive to levels of family capital. The results suggest that the relationship between health and academic achievement emerges very early in life and persists and that whether we observe shrinking or widening inequality as children age depends on when we measure their health and whether children have access to compensatory resources.
Collapse
|
43
|
Sweeting H, Hunt K. Adolescent socio-economic and school-based social status, health and well-being. Soc Sci Med 2014; 121:39-47. [PMID: 25306408 PMCID: PMC4222198 DOI: 10.1016/j.socscimed.2014.09.037] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 09/17/2014] [Accepted: 09/19/2014] [Indexed: 11/16/2022]
Abstract
Studies of adults and adolescents suggest subjective socio-economic status (SES) is associated with health/well-being even after adjustment for objective SES. In adolescence, objective SES may have weaker relationships with health/well-being than at other life stages; school-based social status may be of greater relevance. We investigated the associations which objective SES (residential deprivation and family affluence), subjective SES and three school-based subjective social status dimensions (“SSS-peer”, “SSS-scholastic” and “SSS-sports”) had with physical symptoms, psychological distress and anger among 2503 Scottish 13–15 year-olds. Associations between objective SES and health/well-being were weak and inconsistent. Lower subjective SES was associated with increased physical symptoms and psychological distress, lower SSS-peer with increased psychological distress but reduced anger, lower SSS-scholastic with increased physical symptoms, psychological distress and anger, and lower SSS-sports with increased physical symptoms and psychological distress. Associations did not differ by gender. Objective and subjective SES had weaker associations with health/well-being than did school-based SSS dimensions. These findings underline the importance of school-based SSS in adolescence, and the need for future studies to include a range of school-based SSS dimensions and several health/well-being measures. They also highlight the need for a focus on school-based social status among those working to promote adolescent health/well-being. We examined associations between adolescent social status and several health measures. Models included objective and subjective socio-economic status and school peer, scholastic and sports status. School status had stronger associations with health than did socio-economic status. Different school status dimensions and health measures were associated in different ways. Studies should include a range of school status dimensions and health measures.
Collapse
Affiliation(s)
- Helen Sweeting
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200, Renfield Street, Glasgow G2 3QB, UK.
| | - Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200, Renfield Street, Glasgow G2 3QB, UK
| |
Collapse
|
44
|
Shi X, Tubb L, Chen S, Fulda KG, Franks S, Reeves R, Lister G. Associations of health disparities and physical activity with children's health and academic problems. J Exerc Sci Fit 2014. [DOI: 10.1016/j.jesf.2013.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
45
|
Bauldry S. Conditional health-related benefits of higher education: an assessment of compensatory versus accumulative mechanisms. Soc Sci Med 2014; 111:94-100. [PMID: 24768780 PMCID: PMC4057096 DOI: 10.1016/j.socscimed.2014.04.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/01/2014] [Accepted: 04/05/2014] [Indexed: 11/17/2022]
Abstract
A college degree is associated with a range of health-related benefits, but the effects of higher education are known to vary across different population subgroups. Competing theories have been proposed for whether people from more or less advantaged backgrounds or circumstances will gain greater health-related benefits from a college degree. This study draws on data from the National Longitudinal Study of Adolescent Health (Add Health) and recently developed models for analyzing heterogeneous treatment effects to examine how the effect of obtaining a college degree on the self-rated health of young adults varies across the likelihood of obtaining a college degree, a summary measure of advantage/disadvantage. Results indicate that a college degree has a greater effect on self-rated health for people from advantaged backgrounds. This finding differs from two recent studies, and possible reasons for the contrasting findings are discussed.
Collapse
Affiliation(s)
- Shawn Bauldry
- Department of Sociology, University of Alabama at Birmingham, Heritage Hall 460C, Birmingham, AL 35294, USA.
| |
Collapse
|
46
|
Zajacova A, Walsemann KM, Dowd JB. The Long Arm of Adolescent Health Among Men and Women: Does Attained Status Explain Its Association with Mid-Adulthood Health? POPULATION RESEARCH AND POLICY REVIEW 2014. [DOI: 10.1007/s11113-014-9327-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
47
|
Lê-Scherban F, Diez Roux AV, Li Y, Morgenstern H. Does academic achievement during childhood and adolescence benefit later health? Ann Epidemiol 2014; 24:344-55. [PMID: 24792585 DOI: 10.1016/j.annepidem.2014.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 01/28/2014] [Accepted: 02/08/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE Educational disparities in health persist after adjustment for income and occupation, suggesting that other purely cognitive and psychosocial mechanisms may be involved. Unlike occupation- or income-mediated effects, effects of cognitive and psychosocial gains-as reflected in academic achievement-may be apparent even before schooling is completed. METHODS We used data spanning 10 years on a national U.S. cohort of 2546 children aged 3-14 years at baseline to estimate the effects of academic achievement, measured by standardized tests of cognitive achievement, on future health. We used marginal structural models to address potential mutual influence of achievement and health on each other over time. RESULTS One SD higher academic achievement 1997-2002 was associated with a lower prevalence of poorer health status in 2007 in girls (prevalence ratio = 0.87 [(95% confidence interval) 0.78-0.97]) but not in boys (prevalence ratio = 0.96 [0.86-1.08]). Higher achievement was also weakly associated with lower body mass index and less psychological distress among girls only. CONCLUSIONS Academic achievement may benefit future health but a number of questions remain unanswered, including reasons for the gender differences and how academic achievement-related health disparities may progress over the life course and interact with other social determinants of health.
Collapse
Affiliation(s)
| | - Ana V Diez Roux
- Department of Epidemiology, University of Michigan, Ann Arbor
| | - Yun Li
- Department of Biostatistics, University of Michigan, Ann Arbor
| | - Hal Morgenstern
- Department of Epidemiology, University of Michigan, Ann Arbor; Department of Environmental Health Sciences, University of Michigan, Ann Arbor
| |
Collapse
|
48
|
Elman C, Wray LA, Xi J. Fundamental resource dis/advantages, youth health and adult educational outcomes. SOCIAL SCIENCE RESEARCH 2014; 43:108-126. [PMID: 24267756 DOI: 10.1016/j.ssresearch.2013.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 06/26/2013] [Accepted: 09/01/2013] [Indexed: 06/02/2023]
Abstract
Recent studies find lasting effects of poor youth health on educational attainment but use young samples and narrow life course windows of observation to explore outcomes. We apply a life course framework to three sets of Health and Retirement Study birth cohorts to examine early health status effects on education and skills attainment measured late in life. The older cohorts that we study were the earliest recipients of U.S. policies promoting continuing education through the GI Bill, community college expansions and new credentials such as the GED. We examine a wide range of outcomes but focus on GEDs, postsecondary school entry and adult human capital as job-related training. We find that older U.S. cohorts had considerable exposure to these forms of attainment and that the effects of youth health on them vary by outcome: health selection and ascription group effects are weak or fade, respectively, in outcomes associated with delayed or adult attainment. However, poorer health and social disadvantage in youth and barriers associated with ascription carry forward to limit attainment of key credentials such as diplomas and college degrees. We find that the human capital - health gradient is dynamic and that narrow windows of observation in existing studies miss much of it. National context also matters for studying health-education linkages over the life course.
Collapse
Affiliation(s)
- Cheryl Elman
- Department of Sociology, The University of Akron, Akron, OH 44325-1905, United States.
| | | | | |
Collapse
|
49
|
De Ridder KAA, Pape K, Johnsen R, Holmen TL, Westin S, Bjørngaard JH. Adolescent health and high school dropout: a prospective cohort study of 9000 Norwegian adolescents (the Young-HUNT). PLoS One 2013; 8:e74954. [PMID: 24086408 PMCID: PMC3781164 DOI: 10.1371/journal.pone.0074954] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 08/06/2013] [Indexed: 12/16/2022] Open
Abstract
Background High school dropout is of major concern in the western world. Our aims were to estimate the risk of school dropout in adolescents following chronic somatic disease, somatic symptoms, psychological distress, concentration difficulties, insomnia or overweight and to assess to which extent the family contributes to the association between health and school dropout. Methods A population of 8950 school-attending adolescents (13–21 years) rated their health in the Young-HUNT 1 Study (90% response rate) in 1995–1997. High school dropout or completion, was defined with the Norwegian National Education Database in the calendar year the participant turned 24 years old. Parental socioeconomic status was defined by using linkages to the National Education Database, the National Insurance Administration and the HUNT2 Survey. We used logistic regression to estimate odds ratios and risk differences of high school dropout, both in the whole population and among siblings within families differentially exposed to health problems. Results All explored health dimensions were strongly associated with high school dropout. In models adjusted for parental socioeconomic status, the risk differences of school dropout according to health exposures varied between 3.6% (95% CI 1.7 to 5.5) for having ≥1 somatic disease versus none and 11.7% (6.3 to 17.0) for being obese versus normal weight. The results from the analyses comparing differentially exposed siblings, confirmed these results with the exception of weaker associations for somatic diseases and psychological distress. School dropout was strongly clustered within families (family level conditional intraclass correlation 0.42). Conclusions Adolescent health problems are markers for high school dropout, independent of parental socioeconomic status. Although school dropout it strongly related to family-level factors, also siblings with poor health have reduced opportunity to complete high school compared to healthy siblings. Public health policy should focus on ensuring young people with poor health the best attainable education.
Collapse
Affiliation(s)
- Karin A. A. De Ridder
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
- * E-mail:
| | - Kristine Pape
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Roar Johnsen
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Turid Lingaas Holmen
- HUNT Research Center, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
| | - Steinar Westin
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Johan Håkon Bjørngaard
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
- Forensic Department and Research Centre Bröset, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| |
Collapse
|
50
|
Walsemann KM, Lindley LL, Gentile D, Welihindha SV. Educational Attainment by Life Course Sexual Attraction: Prevalence and Correlates in a Nationally Representative Sample of Young Adults. POPULATION RESEARCH AND POLICY REVIEW 2013; 33:579-602. [PMID: 25382888 DOI: 10.1007/s11113-013-9288-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Researchers know relatively little about the educational attainment of sexual minorities, despite the fact that educational attainment is consistently associated with a range of social, economic, and health outcomes. We examined whether sexual attraction in adolescence and early adulthood was associated with educational attainment in early adulthood among a nationally representative sample of US young adults. We analyzed Waves I and IV restricted data from the National Longitudinal Study of Adolescent Health (n=14,111). Sexual orientation was assessed using self-reports of romantic attraction in Waves I (adolescence) and IV (adulthood). Multinomial regression models were estimated and all analyses were stratified by gender. Women attracted to the same-sex in adulthood only had lower educational attainment compared to women attracted only to the opposite-sex in adolescence and adulthood. Men attracted to the same-sex in adolescence only had lower educational attainment compared to men attracted only to the opposite-sex in adolescence and adulthood. Adolescent experiences and academic performance attenuated educational disparities among men and women. Adjustment for adolescent experiences also revealed a suppression effect; women attracted to the same-sex in adolescence and adulthood had lower predicted probabilities of having a high school diploma or less compared to women attracted only to the opposite-sex in adolescence and adulthood. Our findings challenge previous research documenting higher educational attainment among sexual minorities in the US. Additional population-based studies documenting the educational attainment of sexual minority adults are needed.
Collapse
Affiliation(s)
- Katrina M Walsemann
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 800 Sumter Street, Room 216, Columbia, SC 29208
| | - Lisa L Lindley
- Department of Global and Community Health, George Mason University, 4400 University Drive MS 5B7, Fairfax, VA 22030
| | - Danielle Gentile
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 800 Sumter Street, Room 216, Columbia, SC 29208
| | - Shehan V Welihindha
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 800 Sumter Street, Room 216, Columbia, SC 29208
| |
Collapse
|