Early life exposures and the occurrence and timing of heart disease among the older adult Puerto Rican population

Few studies have examined the effects of early life conditions on the timing of the onset of heart disease. We use the remarkable example of a representative sample of the population of older Puerto Ricans aged 60– 74 who lived in the countryside during childhood (n = 1,438) to examine the effects of seasonal exposures to poor nutrition and infectious diseases during late gestation on the timing of the onset and the probability of ever experiencing adult heart disease. Cox and log logistic hazard models controlling for childhood conditions (self-reported childhood health status and socioeconomic status [SES], rheumatic fever, and knee height) and adult risk factors (adult SES, obesity, smoking, texercise, and self-reported diabetes) showed that the risk of onset of heart disease was 65% higher among those born during high-exposure periods compared with unexposed individuals. However, there were no significant differences in median time of onset for those ever experiencing heart disease. As a comparison, we found that there were no significant seasonality effects for those who lived in urban areas during childhood. We conclude that early exposures in utero have important ramifications for adult heart disease among the older Puerto Rican population. We show, however, that while exposure is associated with the probability of ever experiencing adult heart disease, it is not associated with the timing of onset among those who do experience it.     

Decent Living Standards: Material Prerequisites for Human Wellbeing

Children whose parents experience adverse social, economic, or health-related living conditions are more likely to face similar types of disadvantage in their adult life. However, a limitation of many earlier studies is that they do not account for the multidimensionality of the concept of living conditions, and that the child generation’s life courses are targeted as static and independent from the societal context in which they are imbedded. The current investigation addressed these aspects by focusing on the complexity, duration, and timing of disadvantage with regard to how adverse circumstances in the family of origin are associated with trajectories of social, economic, and health-related living conditions across adulthood. We also examined the role of educational attainment for these associations. Analyses were based a Swedish cohort born in 1953 (n = 14,294). We first conducted sequence analysis, followed by hierarchical cluster analysis, to generate ‘outcome profiles’, i.e. trajectories of adult disadvantage. Second, several indicators of adverse circumstances in childhood were analysed by means of multinominal regression analysis, showing the odds of ending up in the different trajectories. The results indicated that individuals who grew up under adverse conditions were more likely to experience disadvantaged social, economic, and health-related trajectories. This was particularly the case for trajectories characterised by a high degree of complexity, i.e. coexisting disadvantages, and—among men only—by a longer duration of disadvantage. Educational attainment was identified as a powerful mediator, suggesting that efforts to increase equal educational opportunity may be a way of reducing the intergenerational transmission of disadvantage.     

Reproducing inequalities: Luck, wallets, and the enduring effects of childhood health

In this article, I argue that research on social stratification, on intergenerational transmission of inequalities, and on the theory of factor payments and wage determination will be strengthened by studying the role played by early childhood health. I show that the inclusion of such a factor requires researchers to integrate theories in each of these fields with new theories linking early childhood health conditions and events that occur at later stages in the life course of individuals, particularly physical and mental health as well as disability and mortality. The empirical evidence I gather shows that early childhood health matters for the achievement of or social accession to, adult social class positions. Even if the magnitude of associations is not overwhelming, it is not weaker than that found between adult social accession and other, more conventional and better-studied individual characteristics, such as educational attainment. It is very likely that the evidence presented in this article grossly underplays the importance of early childhood health for adult socioeconomic achievement.     

The Effects of Childhood,Adult, and Community Socioeconomic Conditions on Health and Mortality among Older Adults in China

Using a large, nationally representative longitudinal sample of Chinese aged 65 and older, this study examines the effects of childhood, adult, and community socioeconomic conditions on mortality and several major health outcomes. The role of social mobility is also tested. We find that childhood socioeconomic conditions exert long-term effects on functional limitations, cognitive impairment, self-rated health, and mortality independent of adult and community socioeconomic conditions. Achieved conditions matter for most outcomes as well, considering that adult and community socioeconomic conditions have additional impacts on health among Chinese elders. The majority of the effects of childhood conditions are not mediated by adult and community conditions. The results also show that social mobility and health in later life are linked in complex ways and that psychosocial factors have marginal explanatory power for the effects of socioeconomic conditions. Overall, this study provides new longitudinal evidence from China to support the notion that health and mortality at older ages are influenced by long-term and dynamic processes structured by the social stratification system. We discuss our findings in the context of the life course and ecological perspective, emphasizing that human development is influenced by a nexus of social experiences that impact individuals throughout life.     

Sex differences in morbidity and mortality

Women have worse self-rated health and more hospitalization episodes than men from early adolescence to late middle age, but are less likely to die at each age. We use 14 years of data from the U.S. National Health Interview Survey to examine this paradox. Our results indicate that the difference in self-assessed health between women and men can be entirely explained by differences in the distribution of the chronic conditions they face. This is not true, however, for hospital episodes and mortality. Men with several smoking-related conditions--including cardiovascular disease and certain lung disorders--are more likely to experience hospital episodes and to die than women who suffer from the same chronic conditions, implying that men may experience more-severe forms of these conditions. While some of the difference in mortality can be explained by differences in the distribution of chronic conditions, an equally large share can be attributed to the larger adverse effects of these conditions on male mortality. The greater effects of smoking-related conditions on men's health may be due to their higher rates of smoking throughout their lives.     

Women,Aging, and Schizophrenia

SUMMARY

Schizophrenia is a psychiatric disorder of unknown etiology that typically has an onset in early adulthood and persists for the remainder of the life span. For most affected individuals, the illness is recurrent with psychotic symptoms that tend to be episodic in nature. The illness has pervasive and disruptive effects on many life domains; for example, women with schizophrenia are less likely to marry, bear children, and raise their own children than are women in the general population. The age of onset of schizophrenia is later on average in women than men, and women are overrepresented among those who develop the illness after the age of 45. Among younger patients with schizophrenia, women tend to have less severe symptoms than men and better outcomes; however, there are fewer gender differences among older patients with schizophrenia. Older women with schizophrenia are vulnerable to problems of both schizophrenia and aging. Schizophrenia symptoms typically continue in later years and include ongoing psychotic symptoms. Problems of aging such as cognitive decline and chronic medical conditions may be exacerbated by schizophrenia and the disorder is associated with premature mortality. Older women with schizophrenia are at risk for neglect of psychiatric and other health needs that are further compounded by limited social support and low socioeconomic status. More research and clinical attention is needed for the problems of older women with schizophrenia.     

Women, aging, and schizophrenia

Schizophrenia is a psychiatric disorder of unknown etiology that typically has an onset in early adulthood and persists for the remainder of the lifespan. For most affected individuals, the illness is recurrent with psychotic symptoms that tend to be episodic in nature. The illness has pervasive and disruptive effects on many life domains; for example, women with schizophrenia are less likely to marry, bear children, and raise their own children than are women in the general population. The age of onset of schizophrenia is later on average in women then men, and women are over-represented among those who develop the illness after the age of 45. Among younger patients with schizophrenia, women tend to have less severe symptoms than men and better outcomes; however, there are fewer gender differences among older patients with schizophrenia. Older women with schizophrenia are vulnerable to problems of both schizophrenia and aging. Schizophrenia symptoms typically continue in later years and include ongoing psychotic symptoms. Problems of aging such as cognitive decline and chronic medical conditions may be exacerbated by schizophrenia and the disorder is associated with premature mortality. Older women with schizophrenia are at risk for neglect of psychiatric and other health needs that are further compounded by limited social support and low socioeconomic status. More research and clinical attention is needed to the problems of older women with schizophrenia.     

Gender differences in the experience of loneliness in U.S. Chinese older adults

This study aimed to explore the gender differences in the experiences of loneliness in the U.S. Chinese older population. The data were drawn from the PINE study, a population-based study of U.S. Chinese adults aged 60 years and older. The Revised–University of California at Los Angeles Loneliness Scale (R-UCLA) was used to measure loneliness. Overall, older Chinese women (28.3%) had a higher rate of loneliness than older men (23.3%, p < .001). In particular, women were more likely to sometimes or often experience a lack of companionship than men (22.9% vs. 17.3%, p < .001). Older women living with fewer people, with lower health status, poorer quality of life, and worsening health changes over the past year were more likely than men to experience any loneliness. This study indicates that gender differences exist in the prevalence, symptoms, and correlates of loneliness. Longitudinal studies should be undertaken to understand gender differences in risk factors and outcomes of loneliness.     

Intergenerational Profiles of Socioeconomic (Dis)advantage and Obesity During the Transition to Adulthood

Investigations of socioeconomic status (SES) and health during the transition to adulthood in the United States are complicated by the later and more varied transitions in residence, employment, schooling, and social roles compared with previous generations. Parental SES is an important influence during adolescence but cannot sufficiently capture the SES of the independent young adult. Typical, single SES indicators based on income or education likely misclassify the SES of young adults who have not yet completed their education or other training, or who have entered the labor force early with ultimately lower status attainment. We use a latent class analysis (LCA) framework to characterize five intergenerational SES groups, combining multidimensional SES information from two time points—that is, adolescent (parental) and young adult (self) SES data. Associations of these groups with obesity, a high-risk health outcome in young adults, revealed nuanced relationships not seen using traditional intergenerational SES measures. In males, for example, a middle-class upbringing in adolescence and continued material advantage into adulthood was associated with nearly as high obesity as a working poor upbringing and early, detrimental transitions. This intergenerational typology of early SES exposure facilitates understanding of SES and health during young adulthood.     

Mental health differences between men and women caregivers,BRFSS 2009

This study uses data from the 2009 Behavioral Risk Factors Surveillance System (BRFSS) to examine differences between male and female caregivers by demographics, health-related quality of life (HRQOL), and the effect of social support on HRQOL. Roughly two-thirds of caregivers were women, and demographic characteristics differed among men and women caregivers. Women caregivers reported significantly more mentally and physically unhealthy days than men, but there were no differences between men and women in general health or life satisfaction. Men were significantly more likely to report that they rarely or never received social support. Despite this, the effect of social support on HRQOL was stronger in men than in women. Implications of these findings for caregiver support programs are discussed.     

Fertility trajectories and later-life depression among parents in England

We examine pathways between indicators of fertility tempo/quantum and depressive symptoms among parents aged 55+ with at least two children, using three waves of the English Longitudinal Study of Ageing. Using standard regression approaches and path analysis within the structural equation framework, we also investigate whether fertility trajectories mediated the association between childhood disadvantage and later-life depression. Results provide limited support for direct influences of fertility trajectories on depression, but indicate indirect linkages for both women and men. Associations are mediated by partnership history, social support, wealth, later-life smoking, and functional limitation. Associations between childhood disadvantage and later-life depression are partially mediated by fertility stressors. Results confirm the influence of life course experiences on depression at older ages and demonstrate the interlinked role of family and other life course pathways on later-life well-being.     

From Childhood Deprivation to Adult Social Exclusion: Evidence from the 1970 British Cohort Study

This paper analyses the common trajectories leading to adult social exclusion that children from disadvantaged backgrounds experience during their life courses. Moreover, it provides an assessment of whether education is effective in breaking the vicious circle of disadvantages both across and within generations. Using data from the 1970 British Cohort Study, this empirical analysis is based on structural equation modelling techniques and proceeds in three steps. The measurement model is first tested to validate three groups of theoretical constructs (childhood disadvantages, adolescent deprivations and a multi-dimensional measure of social exclusion) and their indicators. Next, a path analysis is conducted for describing the trajectories linking childhood disadvantages to social exclusion. In the third step, the multi-faceted role of education is established by measuring the extent to which deprivations in the educational domain directly or indirectly affect all the relevant social exclusion dimensions.     

Gender Difference in Sleep Problems: Focused on Time Use in Daily Life of Korea

Korea is well-known as one of the most sleepless country on the globe. Given the fact that sleep is closely connected with various health outcomes, we examined which group is more likely to experience sleep disorder problems within the context of time use. This study sets out to describe the differences in sleep disorder patterns between Korean men and women. In this study, we also tried to identify important socio-demoraphic factors and wake activity time use factors that might account for the sleep problem (short sleep/oversleep) and gender differences in sleep. Data from the original 2004 Korean Time Use Survey were used for this study (n = 16,958). Fifty-two percent of the respondents were women; the age range of the sample was 25–59 years. Results showed us that there was no gender differences found in dimension of short sleep. Still, women were less likely to be over sleeper rather than men, implying the existence of gender inequality in rest/free time. Results from the multinomial regression model showed that, although there were similarities in the impact of relevant factors, men’s sleep was more likely to be disturbed by their work role, while women’s sleep was affected by their work and family role. In this study, it was found that the gender difference in sleep problems was associated with time use, and especially the social roles that men and women occupied.     

Childhood Circumstances and the Intergenerational Transmission of Socioeconomic Status

A large literature has documented the intergenerational transmission of socioeconomic status (SES). However, the mechanisms by which SES transmits across generations are still little understood. This article investigates whether characteristics determined in childhood play an important role in the intergenerational transmission. Using data from the Cebu Longitudinal Health and Nutrition Survey, I document the extent to which childhood human capital accounts for the intergenerational SES correlation. My results imply that childhood health and nutrition, cognitive and noncognitive abilities, and early schooling account for between one-third and one-half of the relationship between parents' SES and their offspring's SES.     

Older women on the U.S.-Mexico border: exploring the health of Hispanics and non-Hispanics Whites

Research on ethnicity and socioeconomic status (SES) suggests that Hispanics are more likely than non-Hispanic Whites to experience poverty and low levels of education, which may relate to poorer health status. This study used a health survey to examine income, education, ethnicity, birthplace, and age on self-reported health factors of women age 60 and older on the U.S.-Mexico border. Results show that income, age, and education were significantly associated with several health factors (Physical Health, Emotional Health, General Health, Energy Level, and Activity Potential). Older women with lower SES, regardless of ethnicity, reported poorer health than younger-old women with higher SES.     

Unpacking Self-Rated Health and Quality of Life in Older Adults and Elderly in India: A Structural Equation Modelling Approach

The Study on global AGEing and adult health (SAGE) aims at improving empirical understanding of the health and well-being of older adults in low- and middle-income countries. A total of 321 adults aged 50 years and older were interviewed in rural Pune district, India, in 2007. We used Structural Equation Modelling (SEM) to examine the pathways through which social factors, functional disability, risk behaviours, and chronic disease experience influence self-rated health (SRH) and quality of life (QOL) amongst older adults in India. Both SRH and QOL worsened with increased age (indirect effect) and limitations in functional ability (direct effect). QOL, socio-economic status (SES), and social networking had no significant effect on SRH. Smoking was associated with the presence of at least one chronic illness, but this did not have a statistically significant effect on SRH. Higher social networking was seen amongst the better educated and those with regular income, which in turn positively affected the QOL rating. QOL had a direct, but statistically not significant, effect on SRH. In conclusion, the indirect effects of age on SRH mediated through functional ability, and the effects of SES on QOL mediated through social networking, provide new understanding of how age and socio-economic status affect SRH and QOL. By allowing for measurement errors, solving for collinearity in predictor variables by integrating them into measurement models, and specifying causal dependencies between the underlying latent constructs, SEM provides a strong link between theory and empirics.     

Older Women on the U.S.-México Border: Exploring the Health of Hispanics and Non-Hispanic Whites

ABSTRACT

Research on ethnicity and socioeconomic status (SES) suggests that Hispanics are more likely than non-Hispanic Whites to experience poverty and low levels of education, which may relate to poorer health status. This study used a health survey to examine income, education, ethnicity, birthplace, and age on self-reported health factors of women age 60 and older on the U.S.-México border. Results show that income, age, and education were significantly associated with several health factors (Physical Health, Emotional Health, General Health, Energy Level, and Activity Potential). Older women with lower SES, regardless of ethnicity, reported poorer health than younger-old women with higher SES.     

Premature Birth and Asthma Among Young Puerto Rican Children

Puerto Rican children are more likely to have asthma than children in any other racial/ethnic group in the United States, yet little research has examined the factors contributing to childhood asthma among Puerto Ricans. Using data from a representative sample of mainland Puerto Rican children, the present study investigates the relationship between preterm birth and early-childhood asthma (i.e., in the first years of life). The roles of other risk factors (i.e., socioeconomic and demographic characteristics, environmental conditions, and maternal health behavior) in the development of asthma in early childhood also are considered. The analysis reveals a relatively high rate of asthma for preterm children as well as differences between term and preterm children in the risk factors for early-childhood asthma. Measures of socioeconomic status and the cleanliness of the home environment are related to asthma for term, but not preterm, children; in contrast, demographic characteristics and maternal health behavior are important risk factors for asthma among preterm children.     

Gender differences in positive and negative self-assessments of health status in a national epidemiological study of Israeli aged

The literature in subjective health appraisals frequently notes that elderly women, more so than men, generally experience a lower quality of life in all major indicators (physical health status, functional ability, perceived income adequacy, social contacts, psychological distress, and cognitive ability). The current epidemiological study, of 1,352 reporting Israeli subjects between the ages of 75-94, was undertaken in order to obtain reliable estimates of "poor" and "excellent/good" self assessments of health in a national sample of aged; to identify the most significant correlates of "poor" and "excellent/good" assessments; and to ascertain whether the models of "poor" and "good/excellent" subjective health are different for elderly men and women. While it was found that women indeed rate their health as being poorer than men, of greater theoretical interest was the finding that the pattern of variables predicting to "poor" and "good/excellent" health are different for men and women. The findings point to the fact that the simple health self-evaluation question is not a unitary construct, but rather a complex attitudinal measure which yields different structural and conceptual results when controlling for the subjective health outcome ("poor" or "good/excellent") and when analyzing gender-dichotomized models.     

Age at Arrival and Life Chances Among Childhood Immigrants

This study examines the causal relationship between childhood immigrants’ age at arrival and their life chances as adults. I analyze panel data on siblings from Norwegian administrative registries, which enables me to disentangle the effect of age at arrival on adult socioeconomic outcomes from all fixed family-level conditions and endowments shared by siblings. Results from sibling fixed-effects models reveal a progressively stronger adverse influence of immigration at later stages of childhood on completed education, employment, adult earnings, occupational attainment, and social welfare assistance. The persistence of these relationships within families indicates that experiences related to the timing of childhood immigration have causal effects on later-life outcomes. These age-at-arrival effects are considerably stronger among children who arrive from geographically distant and economically less-developed origin regions than among children originating from developed countries. The age-at-arrival effects vary less by parental education and child gender. On the whole, the findings indicate that childhood immigration after an early-life formative period tends to constrain later human capital formation and economic opportunities over the life course.