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Piiroinen I, Tuomainen TP, Tolmunen T, Kraav SL, Jarroch R, Voutilainen A. Change in sense of coherence mediates the association between economic recession and mortality among middle-aged men: A population-based cohort study from Eastern Finland. Soc Sci Med 2023; 332:116127. [PMID: 37531907 DOI: 10.1016/j.socscimed.2023.116127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 07/22/2023] [Accepted: 07/27/2023] [Indexed: 08/04/2023]
Abstract
A financial recession has been associated with a decrease in all-cause mortality, but little is known about how psychosocial fluctuations in stress tolerance or orientation to life affect this association. Sense of Coherence (SOC) is a core construct in the Salutogenic Model of Health and is determined by generalized resistance resources and measures one's orientation to life by comprehensibility, manageability, and meaningfulness. We followed the mortality of a cohort of middle-aged Finnish men (n = 854) from the 1980s to the end of 2019. The cohort baseline was stratified into four age groups at baseline: 42, 48, 54, and 60. SOC was measured twice, at the baseline and at the 11-year follow-up visit. Between these SOC measurements, Finland confronted a deep financial recession, the effects of which were examined at the follow-up visit by questionnaires related to economic hardship (sum of nine items) and experience of the recession (one item). Using age group, marital status, employment status, and education as covariates, the change in SOC mediated both the economic hardship and the experience of recession relations to mortality: the indirect effects -19.57 (95% CI -43.23 to -0.92), and -26.82 (95% CI -59.52 to -0.61), respectively. Every one-point increase in economic hardship predicted about 2 and a half weeks shorter life expectancy, and those who experienced very strong disadvantages of economic recession had about 3 and a half months lower life expectancy by the end of 2019 than those who fully avoided the disadvantages. Furthermore, the younger age groups, 42 and 48, experienced the recession more severely than the older groups, 54 and 60. We conclude that following how orientation to life changes among middle-aged might be an informative approach after a recession.
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Affiliation(s)
- Ilkka Piiroinen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland; School of Social Services and Health Care, Tampere University of Applied Sciences, Finland.
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Tommi Tolmunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland; Department of Adolescent Psychiatry, Kuopio University Hospital, Institute of Clinical Medicine / Psychiatry, University of Eastern Finland, Finland
| | - Siiri-Liisi Kraav
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Finland; Department of Social Sciences, University of Eastern Finland, Finland
| | - Rand Jarroch
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
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Stanley SL, Denney JT. All-cause mortality risk for men and women in the United States: the role of partner's education relative to own education. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2023; 32:161-178. [PMID: 36106426 DOI: 10.1080/14461242.2022.2113907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/11/2022] [Indexed: 05/18/2023]
Abstract
This study examines the association between educational attainment, relative to that of an intimate partner, and all-cause mortality for men and women in different-sex relationships. Research suggests some health benefits for partnered adults that arise from economic benefits and improved access to health-promoting tools. One way these benefits could be gained is through the pairing of the highly educated. While high individual educational attainment lowers mortality risk, less is known about the risks of mortality associated with one's education, relative to their partner's education. Using National Health Interview Survey Linked Mortality Files (NHIS-LMF) for the years 1999-2014 with prospective mortality follow-up through December 2015 (N = 347,994), we document the association between relative educational attainment and mortality for men and women with different-sex partners in the United States. Fully adjusted Cox proportional hazard models revealed a higher risk of all-cause mortality for men and women who have more education than their partner, relative to those having the same education as their partner. For women only, having less education than their male partner was associated with a lower risk of all-cause mortality. A better understanding of relative status within different-sex partnerships provides insights into partnered adult's mortality risks.
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Affiliation(s)
- Sandte L Stanley
- Department of Sociology, Washington State University, Pullman, WA, USA
| | - Justin T Denney
- Department of Sociology, Washington State University, Pullman, WA, USA
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Boen CE, Keister LA, Gibson-Davis CM, Luck A. The Buffering Effect of State Eviction and Foreclosure Policies for Mental Health during the COVID-19 Pandemic in the United States. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023:221465231175939. [PMID: 37334797 PMCID: PMC10288207 DOI: 10.1177/00221465231175939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
The COVID-19 pandemic spurred an economic downturn that may have eroded population mental health, especially for renters and homeowners who experienced financial hardship and were at risk of housing loss. Using household-level data from the Census Bureau's Household Pulse Survey (n = 805,223; August 2020-August 2021) and state-level data on eviction/foreclosure bans, we estimated linear probability models with two-way fixed effects to (1) examine links between COVID-related financial hardship and anxiety/depression and (2) assess whether state eviction/foreclosure bans buffered the detrimental mental health impacts of financial hardship. Findings show that individuals who reported difficulty paying for household expenses and keeping up with rent or mortgage had increased anxiety and depression risks but that state eviction/foreclosure bans weakened these associations. Our findings underscore the importance of state policies in protecting mental health and suggest that heterogeneity in state responses may have contributed to mental health inequities during the pandemic.
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Dhungel B, Murakami T, Wada K, Ikeda S, Gilmour S. Difference in Mortality Rates by Occupation in Japanese Male Workers Aged 25 to 64 Years from 1980 to 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11328. [PMID: 36141600 PMCID: PMC9517138 DOI: 10.3390/ijerph191811328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
This study examines the trends in mortality among Japanese working men, across various occupational categories, from 1980 to 2015. A Poisson model of trend, occupational category, and step variable was analysed for eight occupational categories separately, by cause, to explore the trends in mortality. This study found a sharp increase in mortality in the late 1990s, especially among professionals and managers. The overall trends in cancer, ischemic heart disease (IHD), cerebrovascular disease (CVD), and suicide mortality decreased across almost all occupational categories from 1980 to 2015, although there was an increasing trend in cancer of 0.5% among managers. Clerical workers had the greatest relative decrease in mortality rates from cancer (-82.9%), IHD (-81.7%), and CVD (-89.1%). Japan continues to make gains in lowering mortality and extending life expectancy, but its workplace culture must improve to ensure that those working at the heart of the Japanese corporate world can also benefit from Japan's progress in health. Mortality rates in working-aged Japanese men have been declining. However, similar declines are not evident among managers, for whom the mortality rate is remaining stable or slightly increasing. There is a need to address the needs of managers and improve workplace environments for these workers.
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Affiliation(s)
- Bibha Dhungel
- Graduate School of Public Health, St. Luke’s International University, Tsukiji, Tokyo 104-0044, Japan
- Department of Health Policy, National Centre for Child Health and Development, Setagaya, Tokyo 157-8535, Japan
| | - Tomoe Murakami
- Graduate School of Medicine, International University of Health and Welfare, Akasaka, Tokyo 107-8402, Japan
| | - Koji Wada
- Graduate School of Medicine, International University of Health and Welfare, Akasaka, Tokyo 107-8402, Japan
| | - Shunya Ikeda
- Graduate School of Medicine, International University of Health and Welfare, Akasaka, Tokyo 107-8402, Japan
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke’s International University, Tsukiji, Tokyo 104-0044, Japan
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Yu X, Langa KM, Cho TC, Kobayashi LC. Association of Perceived Job Insecurity With Subsequent Memory Function and Decline Among Adults 55 Years or Older in England and the US, 2006 to 2016. JAMA Netw Open 2022; 5:e227060. [PMID: 35416992 PMCID: PMC9008497 DOI: 10.1001/jamanetworkopen.2022.7060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/23/2022] [Indexed: 12/02/2022] Open
Abstract
Importance Intensified global economic competition and recent financial crises, including those associated with the COVID-19 pandemic, have contributed to uncertainty about job security. However, little is known about the association of perceived job insecurity with memory function and decline among older adults. Objectives To investigate the association between perceived job insecurity and subsequent memory function and rate of memory decline among older adults in the US and England. Design, Setting, and Participants This 10-year prospective population-based cohort study used data from the US Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA) collected from 2006 to 2016. Participants included 9538 adults 55 years or older. Data were analyzed from August 1 to 31, 2021. Exposures Perceived job insecurity (yes vs no) at baseline. Main Outcomes and Measures Episodic memory z scores at baseline and rate of decline during the follow-up. Results Among the 9538 study participants, the mean (SD) age at baseline was 60.97 (6.06) years, and 4981 (52.22%) were women. A total of 2320 participants (24.32%) reported job insecurity at baseline (1088 of 3949 [27.55%] in England and 1232 of 5589 [22.04%] in the US). Perceived job insecurity after 55 years of age was associated with lower baseline memory z scores in the fully adjusted model (β = -0.04 [95% CI, -0.08 to -0.01]) but not with rate of memory decline (β = 0.01 [95% CI, -0.01 to 0.01]). The association appeared to be stronger in the US than in England (job insecurity × US, β = -0.05 [95% CI, -0.11 to 0.02]), but the estimate was imprecise, potentially owing to low statistical power. Conclusions and Relevance The findings of this cohort study suggest that exposure to job insecurity in middle to late life was associated with worse memory function among older adults in the US and England. This association may vary across socioeconomic and social welfare contexts, although future studies with large samples from diverse socioeconomic settings are warranted.
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Affiliation(s)
- Xuexin Yu
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Kenneth M. Langa
- Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Veterans Affairs Ann Arbor Center for Clinical Management Research, Ann Arbor, Michigan
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor
| | - Tsai-Chin Cho
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Lindsay C. Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- MRC (Medical Research Council)/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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6
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Yakusheva O, van den Broek-Altenburg E, Brekke G, Atherly A. Lives saved and lost in the first six month of the US COVID-19 pandemic: A retrospective cost-benefit analysis. PLoS One 2022; 17:e0261759. [PMID: 35061722 PMCID: PMC8782469 DOI: 10.1371/journal.pone.0261759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 11/25/2021] [Indexed: 12/30/2022] Open
Abstract
In the beginning of the COVID-19 US epidemic in March 2020, sweeping lockdowns and other aggressive measures were put in place and retained in many states until end of August of 2020; the ensuing economic downturn has led many to question the wisdom of the early COVID-19 policy measures in the US. This study's objective was to evaluate the cost and benefit of the US COVID-19-mitigating policy intervention during the first six month of the pandemic in terms of COVID-19 mortality potentially averted, versus mortality potentially attributable to the economic downturn. We conducted a synthesis-based retrospective cost-benefit analysis of the full complex of US federal, state, and local COVID-19-mitigating measures, including lockdowns and all other COVID-19-mitigating measures, against the counterfactual scenario involving no public health intervention. We derived parameter estimates from a rapid review and synthesis of recent epidemiologic studies and economic literature on regulation-attributable mortality. According to our estimates, the policy intervention saved 866,350-1,711,150 lives (4,886,214-9,650,886 quality-adjusted life-years), while mortality attributable to the economic downturn was 57,922-245,055 lives (2,093,811-8,858,444 life-years). We conclude that the number of lives saved by the spring-summer lockdowns and other COVID-19-mitigation was greater than the number of lives potentially lost due to the economic downturn. However, the net impact on quality-adjusted life expectancy is ambiguous.
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Affiliation(s)
- Olga Yakusheva
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, Ann Arbor, MI, United States of America
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | | | - Gayle Brekke
- University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Adam Atherly
- Larner College of Medicine, University of Vermont, Burlington, VT, United States of America
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7
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The Health Effects of Workforce Involvement and Transitions for Europeans 50–75 Years of Age: Heterogeneity by Financial Difficulties and Gender. Can J Aging 2021; 41:304-319. [DOI: 10.1017/s0714980821000556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
A prominent demographic trend throughout the industrialized world is population aging. Concerns about economic growth and labour force shortages have led many European nations to enact policies aimed at prolonging working life. Understanding how paid work among late-middle-aged and senior adults is associated with health is therefore important. Using a sample of persons who were 50–75 years of age in 2015 from waves six (2015) and seven (2017) of the Survey of Health, Ageing and Retirement in Europe (n = 38,884), this study shows how a comprehensive set of six workforce involvement/transitions patterns are associated with health. The results show benefits of paid work, especially among respondents having financial difficulties. There is further heterogeneity by gender. The more fragmented employment histories of 50–75-year-old women are associated with stable paid work being of less benefit for addressing financial difficulties and with their health being especially vulnerable to unemployment while they are undergoing financial troubles.
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8
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Ping Y, Oddén MC, Stawski RS, Abdel Magid HS, Wu C. Creation and validation of a polysocial score for mortality among community-dwelling older adults in the USA: the health and retirement study. Age Ageing 2021; 50:2214-2221. [PMID: 34473824 DOI: 10.1093/ageing/afab174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND the interrelatedness between social determinants of health impedes researchers to identify important social factors for health investment. A new approach is needed to quantify the aggregate effect of social factors and develop person- centred social interventions. METHODS participants ([n = 7,383], 54.5% female) were aged 65 years or above who complete an additional psychosocial questionnaire in the health and retirement study in 2006 or 2008. Social determinants of health encompassed five social domains: economic stability, neighbourhood and physical environment, education, community and social context, and healthcare system. We used the forward stepwise logistic regression to derive a polysocial score model for 5-year mortality. Indices of goodness-of-fit, discrimination and reclassification were used to assess model performance. We used logistic regression to identify the association between polysocial score and mortality. Subgroup analyses were conducted to examine sex- and race-specific association. RESULTS polysocial score was created using 14 social determinants of health. In the training cohort, the C-statistic was 0.71 for the reference model (only age, sex and race/ethnicity) and increased to 0.75 for the continuous and categorical polysocial score. Compared with the reference model, the integrated discrimination index for adding the continuous or categorical polysocial score was both 0.03 (P values < 0.001). Participants with an intermediate (odds ratio [OR] = 0.69; 95% confidence interval [CI], 0.51-0.82) or high (OR = 0.48; 95% CI, 0.38-0.60) polysocial score had lower odds of death than those in the low category in the fully adjusted model, respectively. CONCLUSIONS the polysocial approach may offer possible solutions to monitor social environments and suggestions for older people to improve their social status for specific health outcomes.
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Affiliation(s)
- Yongjing Ping
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Michelle C Oddén
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford University Stanford, CA, USA
| | - Robert S Stawski
- School of Social and Behavioral Health Sciences Oregon State University, Corvallis, OR, USA
| | - Hoda S Abdel Magid
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford University Stanford, CA, USA
| | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
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9
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Koltai J, Varchetta FM, McKee M, Stuckler D. The softer they fall: a natural experiment examining the health effects of job loss before and after Fornero's unemployment benefit reforms in Italy. Eur J Public Health 2021; 31:724-730. [PMID: 34491345 DOI: 10.1093/eurpub/ckab092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Job loss is a well-established social determinant of health. Recent research has taken an 'institutional turn', asking whether unemployment support could buffer the health consequences of job loss. Here, we exploit a quasi-natural experiment based on the Fornero reforms in Italy, which increased wage replacement rates from 60% to 75% on 1 January 2013. METHODS We employed difference-in-difference models using longitudinal data covering 202 incidents of job loss from the EU-Survey on Income and Living Conditions to quantify the impact of job loss on changes in self-reported health prior to and after the Fornero reforms (2011-14). RESULTS Job loss pre-Fornero was associated with health declines -0.342 [95% confidence interval (CI): -0.588 to -0.096] but did not significantly influence health post-Fornero 0.031 (95% CI: -0.101 to 0.164). The difference-in-difference estimate was 0.373 (95% CI: 0.107-0.639), or a -0.51 standard deviation in self-reported health, consistent with the buffering hypothesis. To put the magnitude of this estimate in perspective, the incidence of a chronic illness, such as diabetes, results in a similar magnitude decline in self-reported health. CONCLUSIONS Our analysis contributes to a growing body of evidence that the impact of job loss on health depends critically on the strength of social protection systems and, in some cases, could be eliminated completely.
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Affiliation(s)
- Jonathan Koltai
- Sociology Department, University of New Hampshire, Durham, NH, USA
| | - Francesco Maria Varchetta
- Carlo F. Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - David Stuckler
- Carlo F. Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
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10
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Doza A, Jensen GA, Tarraf W. Racial/Ethnic Differences in Mortality in Late Midlife: Have They Narrowed in Recent Years? J Gerontol B Psychol Sci Soc Sci 2021; 76:1475-1487. [PMID: 33053179 DOI: 10.1093/geronb/gbaa175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To examine whether racial/ethnic differences in mortality rates have changed in recent years among adults in late midlife, and if so, how. METHODS We analyze Health and Retirement Study data on non-Hispanic Whites (Whites), non-Hispanic Blacks (Blacks), and English- and Spanish-speaking Hispanics (Hispanic-English and Hispanic-Spanish), aged 50-64 from 2 periods: 1998-2004 (Period 1, n = 8,920) and 2004-2010 (Period 2, n = 7,224). Using survey-generalized linear regression techniques, we model death-by-end-of-period as a function of race/ethnicity and sequentially adjust for a series of period-specific baseline risk factors including demographics, health status, health insurance, health behaviors, and social networks. Regression decomposition techniques are used to assess the contribution of these factors to observed racial/ethnic differences in mortality rates. RESULTS The odds ratio for death (ORD) was not statistically different for Blacks (vs. Whites) in Period 1 but was 33% higher in Period 2 (OR = 1.33; 95% confidence interval [CI] = 1.05-1.69). The adjusted ORD among Hispanic-English (vs. Whites) was not statistically different in both periods. The adjusted ORD among Hispanic-Spanish (vs. Whites) was lower (ORD = 0.36; 95% CI = 0.22-0.59) in Period 1 but indistinguishable in Period 2. In Period 1, 50.1% of the disparity in mortality rates among Blacks was explained by baseline health status, 53.1% was explained by financial factors. In Period 2, 55.8% of the disparity in mortality rates was explained by health status, 40.0% by financial factors, and 16.2% by health insurance status. DISCUSSION Mortality rates among Blacks and Hispanic-Spanish have risen since the mid-1990s. Hispanic-Spanish may be losing their advantageous lower risk of mortality, long known as the "Hispanic Paradox."
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Affiliation(s)
- Adit Doza
- Department of Economics and Institute of Gerontology, Wayne State University, Detroit, Michigan
| | - Gail A Jensen
- Institute of Gerontology and Department of Economics, Wayne State University, Detroit, Michigan
| | - Wassim Tarraf
- Institute of Gerontology and Division of Health Sciences, Wayne State University, Detroit, Michigan
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Abstract
OBJECTIVE The Great Recession in 2008 was a period of severe economic upheaval and myriad financial stressors. Financial stress is associated with poorer health, but for whom is this stress the most health-relevant? The current study examined the association between financial stressors and mortality, as well as whether this association varied based on people's financial status. METHODS Participants from the Midlife in the United States study (n = 2760) were assessed before (2004-2005) and after (2013-2014) the Great Recession (2008). Mortality status was then tracked from 2013 to 2017. RESULTS People who experienced more financial stressors during the Great Recession were at greater risk of early mortality over the 4-year follow-up (hazard ratio [HR] = 1.14 [1.00-1.29], p = .046). This association was moderated by the importance of financial security (B = 0.34 [0.08-0.59], p = .009). Financial stressors were more strongly associated with mortality among people who reported that financial security was important to their well-being (HR = 1.29 [1.08-1.54], p = .006) compared with people who reported it was not (HR = 1.02 [0.82-1.26], p = .89). Household income and subjective financial status did not moderate the association between financial stressors and mortality. CONCLUSIONS Experiencing financial stressors during the Great Recession was associated with increased mortality over the 4-year follow-up period, particularly for people who reported financial security was important to their well-being. Interventions designed to reduce financial stress to improve health may benefit from targeting people for whom such stressors are particularly important.
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Affiliation(s)
- Kyle J Bourassa
- From the Center for the Study of Aging and Human Development, Duke University Medical Center, and Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
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12
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Suicide Distribution and Trends Among Male Older Adults in the U.S., 1999-2018. Am J Prev Med 2021; 60:802-811. [PMID: 33653647 DOI: 10.1016/j.amepre.2020.12.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/06/2020] [Accepted: 12/09/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION This study examines the distribution and trends in suicide death rates among male adults aged ≥65 years in the U.S. from 1999 to 2018. METHODS Suicide mortality data were derived from Multiple Cause of Death from the Center for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research database. Suicides were identified from the underlying causes of death. Joinpoint regression examined the distribution and shift in suicide age-adjusted death rates overall and by age groups, race/ethnicity, method of suicide, and urbanicity. Analyses were conducted in 2020. RESULTS Between 1999 and 2018, a total of 106,861 male adults aged ≥65 years died of suicide (age-adjusted rate=31.4 per 100,000 population, 95% CI=31.2, 31.6). Suicide rates showed a V-shaped trend. They were declining annually by 1.8% (95% CI= -2.4, -1.2); however, starting in 2007, there was a shift upward, increasing significantly by 1.7% per year for the next decade (95% CI=1.0, 1.6). Suicide rates were highest among those aged ≥85 years (48.8 per 100,000 population with an upward shift in 2008), Whites (35.3 per 100,000 population with an upward shift in trend in 2007), and the most rural communities (39.0 per 100,000 population). Most suicides were due to firearms (78.3% at a rate of 24.7 per 100,000 population), especially in rural areas, and shifted upward after 2007. CONCLUSIONS Increases in suicide rates among male older adults in the U.S., particularly after the 2007-2008 economic recession, are concerning. Tailored suicide prevention intervention strategies are needed to address suicide-related risk factors.
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Abrams LR, Finlay JM, Kobayashi LC. Job transitions and mental health outcomes among US adults aged 55 and older during the COVID-19 pandemic. J Gerontol B Psychol Sci Soc Sci 2021; 77:e106-e116. [PMID: 33837416 PMCID: PMC8083363 DOI: 10.1093/geronb/gbab060] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives Adults around retirement age are especially vulnerable to the effects of the recent economic downturn associated with COVID-19. This study investigated disturbances to working life and mental health among Americans aged ≥55 during early months of the pandemic. Methods Using data from the nation-wide COVID-19 Coping Study (N=6,264), we examined rates of job loss, furloughs, hour/income reductions, and work-from-home, along with unchanged work status, by age, gender, race/ethnicity, educational attainment, and occupation. We next described sources of worry by job transition group and tested the adjusted associations of COVID-19-related job transitions with life satisfaction, loneliness, depressive symptoms, and anxiety symptoms. Results Most job loss occurred among respondents under age 65 and those without college degrees. Job loss and reduced hours/income were more common among Hispanics compared to other racial/ethnic groups, and work-from-home transitions were most common among respondents with high educational attainment and jobs in government- and education-related occupations. Workers who lost their jobs had the lowest life satisfaction and the highest loneliness and depressive symptoms, followed by workers who were furloughed and workers with reduced hours/income. Work-from-home was associated with more anxiety than unchanged work. Discussion COVID-19-related job transitions are detrimental to mental health, even when they might keep workers safe. These results enhance our understanding of the potentially long-term mental health effects of social and economic aspects of the COVID-19 pandemic and highlight the need for economic and mental health support for aging Americans.
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Affiliation(s)
- Leah R Abrams
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA
| | - Jessica M Finlay
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI
| | - Lindsay C Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
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14
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Affiliation(s)
- Martin Hensher
- Menzies Institute for Medical Research, University of Tasmania
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15
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Abstract
The coronavirus disease (COVID-19), while mild in most cases, has nevertheless caused significant mortality. The measures adopted in most countries to contain it have led to colossal social and economic disruptions, which will impact the medium- and long-term health outcomes for many communities. In this paper, we deliberate on the reality and facts surrounding the disease. For comparison, we present data from past pandemics, some of which claimed more lives than COVID-19. Mortality data on road traffic crashes and other non-communicable diseases, which cause more deaths each year than COVID-19 has so far, is also provided. The indirect, serious health and social effects are briefly discussed. We also deliberate on how misinformation, confusion stemming from contrasting expert statements, and lack of international coordination may have influenced the public perception of the illness and increased fear and uncertainty. With pandemics and similar problems likely to re-occur, we call for evidence-based decisions, the restoration of responsible journalism and communication built on a solid scientific foundation.
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Bruckner TA, Ima AM, Nguyen TT, Noymer A. Race and life expectancy in the USA in the Great Depression. GENUS 2019. [DOI: 10.1186/s41118-019-0063-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Assari S, Schatten HT, Arias SA, Miller IW, Camargo CA, Boudreaux ED. Higher Educational Attainment is Associated with Lower Risk of a Future Suicide Attempt Among Non-Hispanic Whites but not Non-Hispanic Blacks. J Racial Ethn Health Disparities 2019; 6:1001-1010. [PMID: 31278625 PMCID: PMC6739140 DOI: 10.1007/s40615-019-00601-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/16/2019] [Accepted: 05/19/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE In a sample of patients presenting to the emergency department (ED), the current study was conducted with two aims: (1) to investigate the protective effects of educational attainment (i.e., completing college) on subsequent risk of suicide attempt/death among patients presenting to the ED and (2) to compare this effect between non-Hispanic Black and non-Hispanic White ED patients. METHODS The current study analyzed data from the Emergency Department Safety Assessment and Follow-Up Evaluation (ED-SAFE) study, a quasi-experimental, eight-center study of universal suicide screening and follow-up of ED patients presenting for suicidal ideation and behavior. Our sample included 937 non-Hispanic White and 211 non-Hispanic Blacks. The dependent variable was suicide attempt/death during the 52-week follow-up. The independent variable was completing college. Age, gender, lesbian/gay/bisexual status, psychiatric history, and previous suicide attempts at baseline were covariates. Race/ethnicity was the focal effect modifier. Logistic regression models were used to test the protective effects of educational attainment on suicide risk in the overall sample and by race/ethnicity. RESULTS In the overall sample, educational attainment was not associated with suicide risk over the follow-up period. A significant interaction was found between race/ethnicity and educational attainment on suicide risk, suggesting a larger protective effect for non-Hispanic Whites compared with non-Hispanic Blacks. In race/ethnicity-specific models, completing college was associated with decreased future suicide risk for non-Hispanic Whites but not Blacks. CONCLUSIONS Consistent with the Minorities' Diminished Return theory, educational attainment better protected non-Hispanic White than non-Hispanic Blacks against future suicide attempt/death. While Whites who have not completed college may be at an increased risk of suicide, risk of suicide seems to be independent of educational attainment for non-Hispanic Blacks.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, 1731 E. 120th St, Los Angeles, CA, 90059, USA.
| | - Heather T Schatten
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | - Sarah A Arias
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | - Ivan W Miller
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Box G-BH, Providence, RI, USA
- Butler Hospital, Providence, RI, USA
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Edwin D Boudreaux
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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Single transitions and persistence of unemployment are associated with poor health outcomes. BMC Public Health 2019; 19:740. [PMID: 31196081 PMCID: PMC6567908 DOI: 10.1186/s12889-019-7059-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 05/29/2019] [Indexed: 12/23/2022] Open
Abstract
Background Although job loss has been associated with decline in health, the effect of long term unemployment is less clear and under-researched. Furthermore, the impact of an economic recession on this relationship is unclear. We investigated the associations of single transitions and persistence of unemployment with health. We subsequently examined whether these associations are affected by the latest recession, which began in 2008. Methods In total, 57,911 participants from the Dutch Health Interview Survey who belonged to the labour force between 2004 and 2014 were included. Based on longitudinal tax registration data, single employment transitions between time point 1 (t1) and time point 2 (t2) and persistent unemployment (i.e. number of years individuals were unemployed) between t1 and time point 5 (t5) were defined. General and mental health, smoking and obesity were assessed at respectively time point 3 (t3) and time point 6 (t6). Logistic regression models were performed and interactions with recession indicators (year, annual gross domestic product estimates and regional unemployment rates) were tested. Results Compared with individuals who stayed employed at t1 and t2, the likelihood of poor mental health at the subsequent year was significantly higher in those who became unemployed at t2. Persistent unemployment was associated with poor mental health, especially for those who were persistently unemployed for 5 years. Similar patterns, although less pronounced for smoking, were found for general health and obesity. Indicators of the economic recession did not modify these associations. Conclusions Single transitions into unemployment and persistent unemployment are associated with poor mental and general health, obesity, and to a lesser extend smoking. Our study suggests that re-employment might be an important strategy to improve health of unemployed individuals. The relatively extensive Dutch social security system may explain that the economic recession did not modify these associations.
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Assari S, Mistry R. Diminished Return of Employment on Ever Smoking Among Hispanic Whites in Los Angeles. Health Equity 2019; 3:138-144. [PMID: 31289772 PMCID: PMC6608689 DOI: 10.1089/heq.2018.0070] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: According to the Minorities' Diminished Return (MDR) theory, socioeconomic status (SES) indicators such as employment status produce smaller tangible outcomes for racial and ethnic minority groups, however, very limited information exists on such diminished returns for Hispanics. To test whether MDR also holds for the social patterning of smoking behaviors among white adults, this study explored ethnic differences in the association between employment status and ever smoking in a representative sample of adults in Los Angeles. Methods: Los Angeles Family and Neighborhood Survey 2001 included 907 non-Hispanic white and 2117 Hispanic white adults (ages 18 or older). Ethnicity, gender, age, employment status, marital status, immigration status, and ever smoking were measured. Logistic regression models were used for data analysis. Results: In the pooled sample that included both non-Hispanic whites and Hispanic whites, being employed was associated with lower odds of ever smoking, net of covariates. A significant interaction was found between ethnicity and employment status on odds of ever smoking, suggesting a stronger inverse association between employment status and ever smoking for non-Hispanic whites than Hispanic whites. Ethnic specific models showed an inverse association between being employed and ever smoking status for non-Hispanic whites, but not for Hispanic whites. Conclusion: Even among whites, whether or not employment reduces the risk of ever smoking may depend on ethnicity, with Hispanics being at a disadvantage relative to non-Hispanic whites in terms of lower odds of ever smoking from their employment status.
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Affiliation(s)
- Shervin Assari
- Department of Psychology, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, California
- BRITE Center for Science, Research and Policy, University of California, Los Angeles (UCLA), Los Angeles, California
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, Michigan
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
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20
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Assari S. Subjective financial status and suicidal ideation among American college students: Racial differences. ARCHIVES OF GENERAL INTERNAL MEDICINE 2019; 3:16-21. [PMID: 34308338 PMCID: PMC8297587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The current study aimed to compare American Black and White college students for the protective effect of subjective socioeconomic status (SES) on suicidal ideation. METHODS This study used data from the Healthy Mind Study (HMS 2015-2017). This study included 2,983 undergraduate college students who were at least 18 years of old. These participants were either White (n=2,704) or Black (n=279). The dependent variable was suicidal ideation. The independent variable was subjective SES. Age, gender, transition status, first generation status, and social isolation were covariates. Race/ethnicity was the moderator. Logistic regressions were applied to test the effect of subjective SES on suicidal ideation in the overall sample and by race/ ethnicity. RESULTS In the overall sample, high subjective SES was associated with less suicidal ideation in the pooled sample of college students. A significant interaction was found between race and subjective SES on suicide risk, suggesting a larger protective effect of high subjective SES for Whites than Blacks. In race-stratified models, high subjective SES was associated with less suicidal ideation for White college students but not for Black college students. CONCLUSIONS Consistent with the Minorities' Diminished Returns theory and in line with previous research that has documented worse mental health of high SES Blacks particularly Black men, this study showed that high SES protects White college students but not Black college students against suicidal ideation. While Whites with low SES are protected against risk of suicide, risk of suicidal ideation seems to be constant regardless of SES among Black college students.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Fernández-Niño JA, Bonilla-Tinoco LJ, Manrique-Espinoza BS, Romero-Martínez M, Sosa-Ortiz AL. Work status, retirement, and depression in older adults: An analysis of six countries based on the Study on Global Ageing and Adult Health (SAGE). SSM Popul Health 2018; 6:1-8. [PMID: 30101185 PMCID: PMC6083014 DOI: 10.1016/j.ssmph.2018.07.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/25/2018] [Accepted: 07/30/2018] [Indexed: 01/01/2023] Open
Abstract
The aim of the present study was to analyse the association between the occurrence of a major depressive episode among older adults and work status in low- and medium-income countries. A cross-sectional study was conducted with people 60 years of age and older from the six countries (Mexico, India, China, Russian Federation, Ghana and South Africa) included in the Study on Global Ageing and Adult Health (SAGE) and who participated in its first wave (2009-2010). The occurrence of a major depressive episode (MDE) over the previous 12 months was determined based on an adaptation of the ICD-10 diagnostic criteria. The association between current work status and the presence of an MDE was estimated using binary logistic regression models with country-level fixed effects, and interaction terms between the country and work status. Results showed the odds of presenting an MDE were lower for older adults who were retired with a pension than for those who were currently working, although this protective association was observed only for men in China (OR=0.23; CI 95%:0.08-0.70) and Ghana (OR=0.25; CI 95%:0.07-0.95) and for women in India (OR=0.05; CI 95%:0.01-0.51) and South Africa (OR=0.19; CI 95%:0.04-0.97). For women, being a homemaker also showed a protective association in South Africa (OR=0.09; CI95%:0.01-0.66) and Mexico (OR=0.32; CI95%:0.14-0.76). In the case of being retired without a pension, no significant association was found in any country. The previous indicates that retirement with pension has a protective association with MDE only for men in China and Ghana and women in India and South Africa. The heterogeneity of this association reflects cultural and socioeconomic differences between the analysed countries.
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Affiliation(s)
| | | | | | - Martin Romero-Martínez
- Instituto Nacional de Salud Pública, Avenida Universidad 655, Santa María Ahuacatitlán, 62100 Cuernavaca, México
| | - Ana Luisa Sosa-Ortiz
- Laboratorio de Demencias – Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”, Av. Insurgentes Sur 3877 Del, Tlalpan, Col. La Fama, Ciudad de México, México
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Song Y. Job displacement and subjective well-being: findings from the American Time Use Survey Well-Being Modules. JOURNAL FOR LABOUR MARKET RESEARCH 2018; 52:13. [PMID: 30596196 PMCID: PMC6276284 DOI: 10.1186/s12651-018-0249-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 11/22/2018] [Indexed: 06/09/2023]
Abstract
Using matched cross-sectional data drawn from the 2010 and 2012 Displaced Workers Supplements of the Current Population Surveys and the 2010, 2012, and 2013 American Time Use Survey Well-Being Modules, this paper examines the relationship between job displacement and various measures of subjective well-being by sex. Displaced men report lower levels of life evaluation than nondisplaced men due to the differences in employment, marital status and income, whereas displaced women report lower levels of net affect and happiness and increased pain, sadness, and stress than nondisplaced women, but no difference in their life evaluation. Among men, those displaced by layoffs, not by plant closings, express lower levels of life evaluation than those not displaced, but there is no such difference by cause of displacement among women. The negative relationship between job displacement and subjective well-being decreases over time for both men and women.
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Affiliation(s)
- Younghwan Song
- Department of Economics, Union College, Schenectady, NY 12308 USA
- IZA, Bonn, Germany
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Reinhard E, Layte R, McCrory C, Panico L, Avendano M. The Great Recession and the Health of Young Children: A Fixed-Effects Analysis in Ireland. Am J Epidemiol 2018; 187:1438-1448. [PMID: 29370331 DOI: 10.1093/aje/kwy001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 01/03/2018] [Indexed: 12/19/2022] Open
Abstract
Economic recessions have been linked to adult health, but few studies have examined how recessions influence the health of young children. This study examined the impact of life transitions linked to the recent financial crisis on the health of young children in Ireland. Data came from the Growing Up in Ireland Infant Cohort Study (n = 11,134), which assessed children before (2008), during (2011), and after (2013) the Great Recession that followed the financial crisis of 2008 and incorporated questions on the impacts of the financial crisis on families. Using fixed-effects models to control for confounding, we found that a reduction in welfare benefits during the recession was associated with a significant increase in the risks of asthma (β = 0.014, 95% confidence interval (95% CI): 0.004, 0.023) and atopy (β = 0.014, 95% CI: 0.001, 0.027). While parental job loss was not associated with child health, a reduction in working hours was associated with increased reports of child health problems (β = 0.024, 95% CI: 0.004, 0.043), as were difficulties affording basic necessities (β = 0.019, 95% CI: 0.001, 0.038). Results suggest that failing to protect vulnerable families and children during economic recessions may have long-lasting implications for child health.
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Affiliation(s)
- Erica Reinhard
- Department of Global Health and Social Medicine, King’s College London, London, United Kingdom
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Richard Layte
- Department of Sociology, Trinity College Dublin, Dublin, Ireland
- Economic and Social Research Institute, Dublin, Ireland
| | - Cathal McCrory
- Economic and Social Research Institute, Dublin, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Lidia Panico
- National Institute of Demographic Studies, Paris, France
| | - Mauricio Avendano
- Department of Global Health and Social Medicine, King’s College London, London, United Kingdom
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Assari S, Caldwell CH, Zimmerman MA. Family Structure and Subsequent Anxiety Symptoms; Minorities' Diminished Return. Brain Sci 2018; 8:brainsci8060097. [PMID: 29857488 PMCID: PMC6025006 DOI: 10.3390/brainsci8060097] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 05/28/2018] [Accepted: 05/30/2018] [Indexed: 01/10/2023] Open
Abstract
Background: Minorities' Diminished Return (MDR) theory suggests that socioeconomic position (SEP) may have a smaller effect on health and well-being of members of the minority than the majority groups. Aim: Built on the MDR theory, this study compared Whites and African Americans for the effects of three family SEP indicators (family type, parental education, and parental employment) during adolescence on subsequent symptoms of anxiety 18 years later during young adulthood. Methods: Flint Adolescents Study (FAS), 1994⁻2012, followed 359 youth (ages 13 to 17, 295 African American and 64 Whites) for 18 years. The independent variables were family type, parental education, and parental employment during adolescence. The dependent variable was subsequent symptoms of anxiety, measured using the Brief Symptom Inventory (BSI), 18 years later. Age and gender were the covariates and race/ethnicity was the focal effect modifier (moderator). Four linear regression models were estimated to investigate the effects of the three family SEP indicators at age 15 on subsequent symptoms of anxiety at age 33 in the pooled sample and also by race/ethnicity. Results: In the pooled sample, having married parents at age 15 was inversely associated with symptoms of anxiety at age 33. We found an interaction between race/ethnicity and family type, indicating a smaller protective effect of having married parents against symptoms of anxiety for African American compared to White participants. The other two SEP indicators did not show any effect and did not interact with race/ethnicity on the outcome. Conclusion: In support of the MDR theory, marital status of parents during adolescence protects White but not African American young adults against anxiety symptoms. Diminished return of SEP is one of many underlying mechanisms involved in shaping racial and ethnic disparities in anxiety, however, that is often overlooked. Future research that examines economic and social policies and programs that can equalize the health gains that follow SEP resources among racial groups would be a useful next step.
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Affiliation(s)
- Shervin Assari
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
| | - Cleopatra Howard Caldwell
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Center for Research on Ethnicity, Culture, and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
| | - Marc A Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Prevention Research Center, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
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25
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Assari S. High Income Protects Whites but Not African Americans against Risk of Depression. Healthcare (Basel) 2018; 6:healthcare6020037. [PMID: 29690595 PMCID: PMC6023547 DOI: 10.3390/healthcare6020037] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 01/08/2023] Open
Abstract
Background: Built on the Blacks’ diminished return theory, defined as smaller effects of socioeconomic status (SES) on a wide range of health outcomes for African Americans compared to Whites, the current study compared African Americans and Whites for the association between household income and risk of lifetime, 12-month, and 30-day major depressive disorder (MDD). Methods: For the current cross-sectional study, we used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001–2003. With a nationally representative sampling, CPES included 4746 non-Hispanic African Americans and 7587 non-Hispanic Whites. The dependent variables were lifetime, 12-month, and 30-day MDD, measured using Composite International Diagnostic Interview (CIDI). The independent variable was household income. Age, gender, education, chronic medical conditions, and obesity were covariates. Race was the focal moderator. Logistic regression models were used to test the protective effects of household income against MDD in the overall sample and also by race. Results: In the overall sample, household income was inversely associated with the risk of 12-month and 30-day MDD. We found a significant interaction between race and household income on 12-month and 30-day MDD, suggesting a smaller protective effect of household income against MDD for African Americans compared to Whites. Conclusion: In line with the Blacks’ diminished return theory, household income better protects Whites than African Americans against MDD. The contribution of diminished return of SES as an underlying mechanism behind racial disparities in health in the United States is often overlooked. Additional research is needed on why and how SES resources generate smaller health gain among minority groups.
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Affiliation(s)
- Shervin Assari
- Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA.
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26
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Hessel P, Riumallo-Herl CJ, Leist AK, Berkman LF, Avendano M. Economic Downturns, Retirement and Long-Term Cognitive Function Among Older Americans. J Gerontol B Psychol Sci Soc Sci 2018; 73:744-754. [PMID: 28402464 DOI: 10.1093/geronb/gbx035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 03/09/2017] [Indexed: 11/13/2022] Open
Abstract
Objective Workers approaching retirement may be particularly vulnerable to economic downturns. This study assesses whether exposure to economic downturns around retirement age leads to poorer cognitive function in later life. Method Longitudinal data for 13,577 individuals in the Health and Retirement Study were linked to unemployment rates in state of residence. Random- and fixed-effect models were used to examine whether downturns at 55-64 years of age were associated with cognitive functioning levels and decline at ≥65 years, measured by the Wechsler Adult Intelligence Scale-Revised. Results Longer exposure to downturns at 55-64 years of age was associated with lower levels of cognitive function at ≥65 years. Compared to individuals experiencing only up to 1 year in a downturn at 55-64 years of age, individuals experiencing two downturns at these ages had 0.09 point (95% Confidence Interval [CI, -0.17, -0.02]) lower cognitive functioning scores at ≥65 years (3 years: b = -0.17, 95%CI [-0.29, -0.06]; 4 years: b = -0.14, 95%CI [-0.25, -0.02]; ≥5 years: b = -0.22, 95%CI [-0.38, -0.06]). Downturns at 55-64 years of age were not associated with rates of cognitive decline. Discussion Exposure to downturns around retirement is associated with a long-lasting decline in cognitive function in later life. Policies mitigating the impact of downturns on older workers may help to maintain cognitive function in later life.
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Affiliation(s)
- Philipp Hessel
- Harvard University, Center for Population and Development Studies, Cambridge, Massachusetts.,Universidad de los Andes, Escuela de Gobierno Alberto Lleras Camargo, Bogotá, Colombia
| | - Carlos J Riumallo-Herl
- Harvard T.H. Chan School of Public Health, Department of Global Health, Boston, Massachusetts
| | - Anja K Leist
- University of Luxembourg, PEARL Institute for Research on Socio-Economic Inequality, Luxembourg
| | - Lisa F Berkman
- Harvard University, Center for Population and Development Studies, Cambridge, Massachusetts.,Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts
| | - Mauricio Avendano
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, Massachusetts.,King's College London, Department of Global Health and Social Medicine, UK
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Reibling N, Beckfield J, Huijts T, Schmidt-Catran A, Thomson KH, Wendt C. Depressed during the depression: has the economic crisis affected mental health inequalities in Europe? Findings from the European Social Survey (2014) special module on the determinants of health. Eur J Public Health 2018; 27:47-54. [PMID: 28355641 DOI: 10.1093/eurpub/ckw225] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Economic crises constitute a shock to societies with potentially harmful effects to the mental health status of the population, including depressive symptoms, and existing health inequalities. Methods With recent data from the European Social Survey (2006–14), this study investigates how the economic recession in Europe starting in 2007 has affected health inequalities in 21 European nations. Depressive feelings were measured with the CES-D eight-item depression scale. We tested for measurement invariance across different socio-economic groups. Results Overall, depressive feelings have decreased between 2006 and 2014 except for Cyprus and Spain. Inequalities between persons whose household income depends mainly on public benefits and those who do not have decreased, while the development of depressive feelings was less favorable among the precariously employed and the inactive than among the persons employed with an unlimited work contract. There are no robust effects of the crisis measure on health inequalities. Conclusion Negative implications for mental health (in terms of depressive feelings) have been limited to some of the most strongly affected countries, while in the majority of Europe persons have felt less depressed over the course of the recession. Health inequalities have persisted in most countries during this time with little influence of the recession. Particular attention should be paid to the mental health of the inactive and the precariously employed.
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Affiliation(s)
- Nadine Reibling
- University of Siegen, Adolf-Reichwein-Str. 2, Siegen, Germany
| | - Jason Beckfield
- Department of Sociology, Harvard University, 33 Kirkland Street, Cambridge, MA, USA
| | - Tim Huijts
- Wentworth College, University of York, Heslington, York, UK
| | - Alexander Schmidt-Catran
- University of Cologne, Institute of Sociology and Social Psychology, Albertus-Magnus-Platz, Cologne
| | - Katie H Thomson
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, The Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, United Kingdom
| | - Claus Wendt
- University of Siegen, Adolf-Reichwein-Str. 2, Siegen, Germany
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The Benefits of Higher Income in Protecting against Chronic Medical Conditions Are Smaller for African Americans than Whites. Healthcare (Basel) 2018; 6:healthcare6010002. [PMID: 29315227 PMCID: PMC5872209 DOI: 10.3390/healthcare6010002] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 12/28/2017] [Accepted: 01/02/2018] [Indexed: 11/25/2022] Open
Abstract
Background: Blacks’ diminished return is defined as smaller protective effects of socioeconomic status (SES) on health of African Americans compared to Whites. Aim: Using a nationally representative sample, the current study aimed to examine if the protective effect of income on chronic medical conditions (CMC) differs for African Americans compared to Whites. Methods: With a cross-sectional design, the National Survey of American Life (NSAL), 2003, included 3570 non-Hispanic African Americans and 891 non-Hispanic Whites. The dependent variable was CMC, treated as a continuous measure. The independent variable was income. Race was the focal moderator. Age, education, and marital status were covariates. Linear regressions were used to test if the protective effect of income against CMC varies by race. Results: High income was associated with a lower number of CMC in the pooled sample. We found a significant interaction between race and income, suggesting that income has a smaller protective effect against CMC for African Americans than it does for Whites. Conclusion: Blacks’ diminished return also holds for the effects of income on CMC. Blacks’ diminished return is a contributing mechanism to the racial disparities in health in the United States that is often overlooked. More research is needed on the role of diminished health return of SES resources among other minority groups.
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Park MB, Nam EW, Kim CB, Lee HJ, Lee KS, Koh SB. Favorable and unfavorable health conditions within OECD countries: An exploratory study. SAGE Open Med 2018; 6:2050312117753847. [PMID: 35154747 PMCID: PMC8826091 DOI: 10.1177/2050312117753847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 12/21/2017] [Indexed: 11/26/2022] Open
Abstract
Objectives: This study compared the physical, mental, and social health levels among Organization for Economic Co-operation and Development countries. Methods: We sampled from 34 Organization for Economic Co-operation and Development member countries and divided physical, mental, and social health into three domains based on World Health Organization health definitions. Results: A multivariate hierarchical cluster analysis was conducted to group countries that were similar in terms of health. Regarding physical health, Japan, South Korea, Sweden, Switzerland, and ten more countries reported favorable health conditions. For mental health, Australia, Canada and eight more countries revealed favorable conditions. Finally, in terms of social health, Austria, Finland, Iceland, and seven more countries reported favorable conditions. Sweden and Switzerland reported the best health conditions aggregated across all three domains. Conversely, Estonia, Hungary, and Turkey reported comparatively poorer health across all three domains when compared with other Organization for Economic Co-operation and Development countries. Conclusions: We suggested that mental health policy should be further strengthened in cases of Korea and Japan. In case of the Eastern Bloc countries, health policies should be established focusing on health equity for effective improvement of indicators.
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Affiliation(s)
- Myung-Bae Park
- Department of Gerontal Health & Welfare, Pai Chai University, Daejeon, Republic of Korea
| | - Eun Woo Nam
- Department of Health Administration, College of Health Science, Yonsei University, Wonju, Republic of Korea
- Healthy City Research Center, Institute of Health and Welfare, Yonsei University, Wonju, Republic of Korea
| | - Chun-Bae Kim
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
- Institute for Poverty Alleviation and International Development, Yonsei University, Wonju-City, Gangwon-do, Republic of Korea
| | - Hae Jong Lee
- Department of Health Administration, College of Health Science, Yonsei University, Wonju, Republic of Korea
| | - Kwang-Soo Lee
- Department of Health Administration, College of Health Science, Yonsei University, Wonju, Republic of Korea
| | - Sang-Baek Koh
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
- Institute for Poverty Alleviation and International Development, Yonsei University, Wonju-City, Gangwon-do, Republic of Korea
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Axelrad H, Sabbath EL, Hawkins SS. The impact of the 2008 recession on the health of older workers: data from 13 European countries. Eur J Public Health 2017; 27:647-652. [PMID: 28961877 PMCID: PMC6251540 DOI: 10.1093/eurpub/ckx011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Fluctuations in the national economy shape labour market opportunities and outcomes, which in turn influence the health conditions of older workers. This study examined whether overall economic shifts during the 2008 recession was associated with four health indicators among older workers. Method Data came from 4917 respondents (16 090 contacts) aged 50-70 in 13 European countries (Austria, Belgium, Czech Republic, Denmark, France, Germany, Israel, Italy, Netherlands, Poland, Spain, Sweden, Switzerland) participating in the Survey of Health, Ageing and Retirement in Europe. Health and employment assessments from 2004-13 were linked to annual data on fluctuations in Gross Domestic Product (GDP) per capita, life expectancy and unemployment rates for each country. Using fixed effects models, we assessed the recession's implications on four individual health outcomes: body mass index (BMI), drinking alcohol, depression and general health, while isolating cyclical variation within countries and individual changes over time. Results Overall economic shifts had an effect on older workers: decreases in GDP were associated with a decline in average BMI, consumption of alcohol and deterioration in self-rated health; country-level unemployment rate had no effect on health outcomes, while life expectancy at birth was significant but not consistently across models. Being employed or retired were associated with fewer depressive symptoms and better self-rated health. Conclusions Overall economic shifts during recessions affect certain health outcomes of older workers, and better health conditions together with being employed or retired may limit the negative health consequences of a recession.
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Affiliation(s)
- Hila Axelrad
- Center on Aging and Work, Boston College, 140 Commonwealth Avenue Chestnut
Hill, MA 02467, USA
| | - Erika L. Sabbath
- School of Social Work, Boston College, Chestnut Hill, MA 02467, USA
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Life Expectancy Gain Due to Employment Status Depends on Race, Gender, Education, and Their Intersections. J Racial Ethn Health Disparities 2017. [PMID: 28634876 DOI: 10.1007/s40615-017-0381-x] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Despite the well-established health effects of socioeconomic status (SES), SES resources such as employment may differently influence health outcomes across sub-populations. This study used a national sample of US adults to test if the effect of baseline employment (in 1986) on all-cause mortality over a 25-year period depends on race, gender, education level, and their intersections. METHODS Data came from the Americans' Changing Lives (ACL) study, which followed 2025 Whites and 1156 Blacks for 25 years from 1986 to 2011. The focal predictor of interest was baseline employment (1986), operationalized as a dichotomous variable. The main outcome of interest was time to all-cause mortality from 1986 to 2011. Covariates included baseline age, health behaviors (smoking, drinking, and exercise), physical health (obesity, chronic disease, function, and self-rated health), and mental health (depressive symptoms). A series of Cox proportional hazard models were used to test the association between employment and mortality risk in the pooled sample and based on race, gender, education, and their intersections. RESULTS Baseline employment in 1986 was associated with a lower risk of mortality over a 25-year period, net of covariates. In the pooled sample, baseline employment interacted with race (HR = .69, 95% CI = .49-.96), gender (HR = .73, 95% CI = .53-1.01), and education (HR = .64, 95% CI = .46-.88) on mortality, suggesting diminished protective effects for Blacks, women, and individuals with lower education, compared to Whites, men, and those with higher education. In stratified models, the association was significant for Whites (HR = .71, 95%CI = .59-.90), men (HR = .60, 95%CI = .43-.83), and individuals with high education (HR = .66, 95%CI = .50-.86) but not for Blacks (HR = .77, 95%CI = .56-1.01), women (HR = .88, 95%CI = .69-1.12), and those with low education (HR = .92, 95%CI = .67-1.26). The largest effects of employment on life expectancy were seen for highly educated men (HR = .50, 95%CI = .32-.78), White men (HR = .55, 95%CI = .38-.79), and highly educated Whites (HR = .63, 95%CI = .46-.84). The effects were non-significant for Black men (HR = 1.10, 95%CI = .68-1.78), Whites with low education (HR = 1.01, 95%CI = .67-1.51), and women with low education (HR = 1.06, 95%CI = .71-1.57). CONCLUSION In the USA, the health gain associated with employment is conditional on one's race, gender, and education level, along with their intersections. Blacks, women, and individuals with lower education gain less from employment than do Whites, men, and highly educated people. More research is needed to understand how the intersections of race, gender, and education alter health gains associated with socioeconomic resources.
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Beckfield J, Balaj M, McNamara CL, Huijts T, Bambra C, Eikemo TA. The health of European populations: introduction to the special supplement on the 2014 European Social Survey (ESS) rotating module on the social determinants of health. Eur J Public Health 2017; 27:3-7. [PMID: 28355648 DOI: 10.1093/eurpub/ckw250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Abstract
This introduction summarizes the main findings of the Supplement 'Social inequalities in health and their determinants' to the European Journal of Public Health. The 16 articles that constitute this supplement use the new ESS (2014) health module data to analyze the distribution of health across European populations. Three main themes run across these articles: documentation of cross-national variation in the magnitude and patterning of health inequalities; assessment of health determinants variation across populations and in their contribution to health inequalities; and the examination of the effects of health outcomes across social groups. Social inequalities in health are investigated from an intersectional stance providing ample evidence of inequalities based on socioeconomic status (occupation, education, income), gender, age, geographical location, migrant status and their interactions. Comparison of results across these articles, which employ a wide range of health outcomes, social determinants and social stratification measures, is facilitated by a shared theoretical and analytical approach developed by the authors in this supplement.
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Affiliation(s)
- Jason Beckfield
- Department of Sociology, Harvard University, Cambridge, MA, USA
| | - Mirza Balaj
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Courtney L McNamara
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tim Huijts
- Department of Sociology, Wentworth College, University of York, York, UK
| | - Clare Bambra
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Terje A Eikemo
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
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Costa-Font J, Karlsson M, Øien H. Careful in the Crisis? Determinants of Older People's Informal Care Receipt in Crisis-Struck European Countries. HEALTH ECONOMICS 2016; 25 Suppl 2:25-42. [PMID: 27870299 DOI: 10.1002/hec.3385] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 05/27/2016] [Accepted: 06/10/2016] [Indexed: 05/25/2023]
Abstract
Macroeconomic downturns can have an important impact on the receipt of informal and formal long-term care, because recessions increase the number of unemployed and affect net wealth. This paper investigates how the market for informal care changed during and after the Great Recession in Europe, with particular focus on the determinants of care receipt. We use data from the Survey of Health, Ageing and Retirement in Europe, which includes a rich set of variables covering waves before and after the Great Recession. We find evidence of an increase in the availability of informal care after the economic downturn when controlling for year and country fixed effects. This trend is mainly driven by changes in care provision of individuals not cohabiting with the care recipient. We also find evidence of several determinants of informal care receipt changing during the crisis - such as physical needs, personal wealth, and household structures. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Joan Costa-Font
- London School of Economics and Political Science, London, UK
- CESIfo, Munich
| | | | - Henning Øien
- University of Oslo, Norway
- Akershus University College of Applied Sciences Oslo, Norway
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Avendano M, Moustgaard H, Martikainen P. Are some populations resilient to recessions? Economic fluctuations and mortality during a period of economic decline and recovery in Finland. Eur J Epidemiol 2016; 32:77-85. [PMID: 27730407 PMCID: PMC5331077 DOI: 10.1007/s10654-016-0152-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 04/22/2016] [Indexed: 12/24/2022]
Abstract
This paper uses individual-level longitudinal data on working-age Finns to examine the health effects of economic fluctuations during a period of economic decline (1989–1996) and recovery (1997–2007) in Finland. We used a nationally representative, longitudinal sample formed by linking population, employment and mortality registers (n = 698,484; 7,719,870 person-years). We implemented a region fixed-effect model that exploits within-regional variations over time in the unemployment rate to identify the effect of economic fluctuations on mortality, controlling for individual employment transitions. Unemployment rates increased from 5.2 % in 1989 to 19.8 % in 1996, declining gradually thereafter and reaching 9.7 % in 2007. Results indicate that these large fluctuations in the economy had no impact on the overall mortality of most working age Finns. The exception was highly educated men, who experienced an increase of 7 % (Rate ratio = 1.07, 95 % confidence interval 1.04, 1.10) for every one-point increase in the regional unemployment rate during the period 1989–1996 due to increased mortality from cardiovascular disease and suicide. This increase, however, was not robust in models that used the employment to population ratio as measure of the economy. Unemployment rates were unrelated to mortality among females, lower educated men, and among any group during economic recovery (1997–2007). For most Finns, we found no consistent evidence of changes in mortality in response to contractions or expansions in the economy. Possible explanations include the weak impact of the recession on wages, as well as the generous unemployment insurance and social benefit system in Finland.
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Affiliation(s)
- Mauricio Avendano
- Department of Global Health & Social Medicine, King's College London, East Wing, Strand Campus, Strand, London, WC2R 2LS, UK.
- Department Social and Behavioral Sciences, Harvard T.H. Chan School of Public health, Boston, MA, USA.
| | - Heta Moustgaard
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
- Centre for Health Equity Studies (CHESS), Stockholms Universitet and Karolinska Institutet, Stockholm, Sweden
- The Max Planck Institute for Demographic Research, Rostock, Germany
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Tran TV, Canfield J, Chan K. The association between unemployment status and physical health among veterans and civilians in the United States. SOCIAL WORK IN HEALTH CARE 2016; 55:720-731. [PMID: 27348549 DOI: 10.1080/00981389.2016.1191582] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study analyzed data from the 2012 Behavioral Risk Factor Surveillance System to examine the association between unemployment status and physical health among a sample of 170,924 civilians and 12,129 veterans (aged 18-50 years). Multivariate regression analysis was used to test the interaction effect between employment status and veteran/civilian status on physical health. Veterans who were unemployed long term (longer than 27 weeks) reported a significantly greater number of days with poor physical health than civilians who experienced long-term unemployment. Timely prevention and intervention efforts to integrate veterans into the workforce could lead to substantially improved physical health outcomes. Public health policies and programs that are funded to assist veterans in securing and maintaining gainful employment can have lasting implications for their overall improved health and physical well-being.
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Affiliation(s)
- Thanh V Tran
- a School of Social Work , Boston College , Chestnut Hill , Massachusetts , USA
| | - Julie Canfield
- a School of Social Work , Boston College , Chestnut Hill , Massachusetts , USA
| | - Keith Chan
- b SUNY School of Social Welfare , University at Albany , Albany , New York , USA
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Hessel P, Avendano M. Economic downturns during the life-course and late-life health: an analysis of 11 European countries. Eur J Public Health 2016; 26:766-771. [PMID: 27221605 DOI: 10.1093/eurpub/ckw063] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Research has shown that individual socio-economic circumstances throughout life affect health in older ages. However, little attention has been paid to the broad economic context affecting individual's life-chances. This paper examines whether economic downturns experienced during young and mid-adulthood have long-run effects on physical health. METHODS We exploit data on economic fluctuations in the period 1945-2010 in 11 European countries, linked to longitudinal data from three waves of the Survey of Health, Ageing and Retirement in Europe. We estimate a country fixed effect model assessing whether downturns experienced at 5-year intervals between ages 25 and 54 are associated with levels and onset of new limitations with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) in older age (55-80). RESULTS Experiencing an economic downturn at ages 45-59 is associated with increased risk of having at least one disability limitation in later-life (odds ratio [OR] for ADL = 1.66, 95% CI [Confidence Interval] 1.24, 2.22; OR for IADL = 1.46, 95% CI 1.10, 1.94). Economic downturns at ages 40-44 and 45-49 also increase the risk of a new functional limitation in later-life (OR for IADL ages 40-44 = 1.20, 95% CI 1.03, 1.40; OR for IADL ages 45-49 = 1.44, CI 1.10-1.88). Economic downturns experienced around these ages are also associated with significantly greater risks of smoking and excessive alcohol consumption as well as lower incomes in older age. CONCLUSIONS Exposure to an economic downturn at ages 40-49 is associated with poorer health in older ages, possibly by increasing risk of unhealthy behaviours and low incomes persisting into older age.
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Affiliation(s)
- Philipp Hessel
- Center for Population and Development Studies, Harvard University, Cambridge, MA, USA .,Department of Social Science, Health and Medicine, King's College London, London, UK
| | - Mauricio Avendano
- Center for Population and Development Studies, Harvard University, Cambridge, MA, USA.,Department of Social Science, Health and Medicine, King's College London, London, UK.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Chu WM, Liao WC, Li CR, Lee SH, Tang YJ, Ho HE, Lee MC. Late-career unemployment and all-cause mortality, functional disability and depression among the older adults in Taiwan: A 12-year population-based cohort study. Arch Gerontol Geriatr 2016; 65:192-8. [PMID: 27070503 DOI: 10.1016/j.archger.2016.03.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 03/29/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate whether late-career unemployment is associated with increased all-cause mortality, functional disability, and depression among older adults in Taiwan. METHOD In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was conducted from 1996 to 2007. The complete data from 716 men and 327 women aged 50-64 years were retrieved. Participants were categorized as normally employed or unemployed depending on their employment status in 1996. The cumulative number of unemployment after age 50 was also calculated. Logistic regression analysis was used to examine the effect of the association between late-career unemployment and cumulative number of late-career unemployment on all-cause mortality, functional disability, and depression in 2007. RESULTS The average age of the participants in 1996 was 56.3 years [interquartile range (IQR)=7.0]. A total of 871 participants were in the normally employed group, and 172 participants were in the unemployed group. After adjustment of gender, age, level of education, income, self-rated health and major comorbidities, late-career unemployment was associated with increased all-cause mortality [Odds ratio (OR)=2.79; 95% confidence interval (CI)=1.74-4.47] and functional disability [OR=2.33; 95% CI=1.54-3.55]. The cumulative number of late-career unemployment was also associated with increased all-cause mortality [OR=1.91; 95% CI=1.35-2.70] and functional disability [OR=2.35; 95% CI=1.55-3.55]. CONCLUSION Late-career unemployment and cumulative number of late-career unemployment are associated with increased all-cause mortality and functional disability. Older adults should be encouraged to maintain normal employment during the later stage of their career before retirement. Employers should routinely examine the fitness for work of older employees to prevent future unemployment.
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Affiliation(s)
- Wei-Min Chu
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wen-Chun Liao
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Rong Li
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Shu-Hsin Lee
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yih-Jing Tang
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Hsin-En Ho
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Armed Force General Hospital, Taichung, Taiwan
| | - Meng-Chih Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Instiute of Population Sciences, National Health Research Institutes, Miaoli County, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan.
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Margerison-Zilko C, Goldman-Mellor S, Falconi A, Downing J. Health Impacts of the Great Recession: A Critical Review. CURR EPIDEMIOL REP 2016; 3:81-91. [PMID: 27239427 DOI: 10.1007/s40471-016-0068-6] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The severity, sudden onset, and multipronged nature of the Great Recession (2007-2009) provided a unique opportunity to examine the health impacts of macroeconomic downturn. We comprehensively review empirical literature examining the relationship between the Recession and mental and physical health outcomes in developed nations. Overall, studies reported detrimental impacts of the Recession on health, particularly mental health. Macro- and individual-level employment- and housing-related sequelae of the Recession were associated with declining fertility and self-rated health, and increasing morbidity, psychological distress, and suicide, although traffic fatalities and population-level alcohol consumption declined. Health impacts were stronger among men and racial/ethnic minorities. Importantly, strong social safety nets in some European countries appear to have buffered those populations from negative health effects. This literature, however, still faces multiple methodological challenges, and more time may be needed to observe the Recession's full health impact. We conclude with suggestions for future work in this field.
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Affiliation(s)
- Claire Margerison-Zilko
- Department of Epidemiology and Biostatistics, Michigan State University, 909 Fee Rd., Rm 601, East Lansing, MI 48824, Ph: 517-353-8623
| | - Sidra Goldman-Mellor
- Department of Public Health, University of California, Merced, 5200 N. Lake Rd., Merced, CA 95342, Ph: (209) 228-2498
| | - April Falconi
- General Internal Medicine, Stanford University, Palo Alto, CA 94305, Ph: (703) 328-4851
| | - Janelle Downing
- School of Public Health, University of California, Berkeley, 545 University Hall, University of California, Berkeley, CA 94720-7360, Ph: (510) 643-8571
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Noelke C, Avendano M. Who suffers during recessions? Economic downturns, job loss, and cardiovascular disease in older Americans. Am J Epidemiol 2015; 182:873-82. [PMID: 26476283 DOI: 10.1093/aje/kwv094] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 04/01/2015] [Indexed: 12/28/2022] Open
Abstract
Job loss in the years before retirement has been found to increase risk of cardiovascular disease (CVD), but some studies suggest that CVD mortality among older workers declines during recessions. We hypothesized that recessionary labor market conditions were associated with reduced CVD risk among persons who did not experience job loss and increased CVD risk among persons who lost their jobs. In our analyses, we used longitudinal, nationally representative data from Americans 50 years of age or older who were enrolled in the Health and Retirement Study and surveyed every 2 years from 1992 to 2010 about their employment status and whether they had experienced a stroke or myocardial infarction. To measure local labor market conditions, Health and Retirement Study data were linked to county unemployment rates. Among workers who experienced job loss, recessionary labor market conditions at the time of job loss were associated with a significantly higher CVD risk (hazard ratio = 2.54, 95% confidence interval: 1.39, 4.65). In contrast, among workers who did not experience job loss, recessionary labor market conditions were associated with a lower CVD risk (hazard ratio = 0.50, 95% confidence interval: 0.31, 0.78). These results suggest that recessions might be protective in the absence of job loss but hazardous in the presence of job loss.
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Buffel V, Van de Velde S, Bracke P. The mental health consequences of the economic crisis in Europe among the employed, the unemployed, and the non-employed. SOCIAL SCIENCE RESEARCH 2015; 54:263-288. [PMID: 26463548 DOI: 10.1016/j.ssresearch.2015.08.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 08/10/2015] [Accepted: 08/21/2015] [Indexed: 06/05/2023]
Abstract
Applying a multi-level framework to the data from the European Social Survey's Round 3 (2006) and Round 6 (2012), we assessed the crisis by increases in rates of unemployment, while also controlling for countries' pre-crisis economic conditions. We found a positive relationship between depression and an increase in national unemployment rates. This relationship can be only partly ascribed to an increase in the number of unemployed and those employed in nonstandard job conditions-with the exception of the self-employed and women working part-time. The crisis effect is more pronounced among men and those between 35 and 49years of age. Moreover, in strongly effected countries, the crisis has changed the relationship between part-time work and depression, between depression and certain subcategories of the unemployed (looking for a job or not looking), and between depression and the non-employed.
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Affiliation(s)
- Veerle Buffel
- Ghent University, Department of Sociology, Research group HEDERA, Korte Meer 5, 9000 Ghent, Belgium.
| | - Sarah Van de Velde
- Ghent University, Department of Sociology, Research group HEDERA, Korte Meer 5, 9000 Ghent, Belgium
| | - Piet Bracke
- Ghent University, Department of Sociology, Research group HEDERA, Korte Meer 5, 9000 Ghent, Belgium
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Beckfield J, Bambra C, Eikemo TA, Huijts T, McNamara C, Wendt C. An institutional theory of welfare state effects on the distribution of population health. SOCIAL THEORY & HEALTH 2015. [DOI: 10.1057/sth.2015.19] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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