scholarly journals Inequalities in all-cause and cause-specific mortality across the life course by wealth and income in Sweden: a register-based cohort study

2020 ◽  
Vol 49 (3) ◽  
pp. 917-925
Author(s):  
S Vittal Katikireddi ◽  
Claire L Niedzwiedz ◽  
Ruth Dundas ◽  
Naoki Kondo ◽  
Alastair H Leyland ◽  
...  
Keyword(s):  
Life Course ◽  
Health Inequalities ◽  
Adult Population ◽  
Early Adulthood ◽  
Age Groups ◽  
Adult Life ◽  
Unequal Distribution ◽  
Specific Mortality ◽  
Economic Position ◽  
Wealth Inequalities

Abstract Background Wealth inequalities are increasing in many countries, but their relationship to health is little studied. We investigated the association between individual wealth and mortality across the adult life course in Sweden. Methods We studied the Swedish adult population using national registers. The amount of wealth tax paid in 1990 was the main exposure of interest and the cohort was followed up for 18 years. Relative indices of inequality (RII) summarize health inequalities across a population and were calculated for all-cause and cause-specific mortality for six different age groups, stratified by sex, using Poisson regression. Mortality inequalities by wealth were contrasted with those assessed by individual and household income. Attenuation by four other measures of socio-economic position and other covariates was investigated. Results Large inequalities in mortality by wealth were observed and their association with mortality remained more stable across the adult life course than inequalities by income-based measures. Men experienced greater inequalities across all ages (e.g. the RII for wealth was 2.58 [95% confidence interval (CI) 2.54–2.63) in men aged 55–64 years compared with 2.29 (95% CI 2.24–2.34) for women aged 55–64 years), except among the over 85s. Adjustment for covariates, including four other measures of socio-economic position, led to only modest reductions in the association between wealth and mortality. Conclusions Wealth is strongly associated with mortality throughout the adult life course, including early adulthood. Income redistribution may be insufficient to narrow health inequalities—addressing the increasingly unequal distribution of wealth in high-income countries should be considered.

Life course analysis on income and incident AMI: a Danish register-based cohort study

2019 ◽  
Vol 73 (9) ◽  
pp. 810-816 ◽  
Author(s):  
Margit Kriegbaum ◽  
Charlotte Ørsted Hougaard ◽  
Ingelise Andersen ◽  
Henrik Brønnum-Hansen ◽  
Rikke Lund
Keyword(s):  
Life Course ◽  
Early Adulthood ◽  
Age Groups ◽  
Adult Life ◽  
Social Gradient ◽  
Relative Level ◽  
Gender And Age ◽  
The Social ◽  
The Life Course ◽  
The Impact

BackgroundSocial inequality in ischaemic heart disease has been related to socioeconomic position in childhood, early adulthood and late adulthood. However, the impact of relative level of accumulated income periods across adult life course and the potential gender and age differences have not been investigated. The aim was to investigate the association between relative level of accumulated income across the life course and acute myocardial infarction (AMI) from age 60+ years and to study if the associations differ by gender and in different age groups (30–39 years, 40–49 years and 50–59 years).MethodsAll Danes born 1935–1954 (N=1 235 139) were followed up in registers for incident AMI (42 669 cases). The accumulated proportional deviation from median equivalised income (APDMEI) for each gender/age/calendar year strata was constructed and divided in quartiles. The associations were analysed by means of Cox’s proportional hazard models.ResultsAmong men, those in the lowest APDMEI quartile had an HR 1.40 (1.35–1.45) of AMI compared with the highest quartile. Those in the second and third highest quartiles had HR of 1.24 (1.20–1.28) and 1.14 (1.10–1.18), respectively. Among women, the lowest quartile had an HR of 1.78 (1.69–1.88), the second 1.45 (1.37–1.53) and the third 1.19 (1.13–1.26). The social gradient was similar across the different age groups.ConclusionThe risk of AMI increased with lower levels of relative accumulated income across the life course. While men generally had a higher risk of AMI, the social gradient was steeper in women. There was no indication of a specific sensitive age period for exposure to relative level of accumulated income.

scholarly journals Association of Leisure-Time Physical Activity Across the Adult Life Course With All-Cause and Cause-Specific Mortality

2019 ◽  
Vol 2 (3) ◽  
pp. e190355 ◽  
Author(s):  
Pedro F. Saint-Maurice ◽  
Diarmuid Coughlan ◽  
Scott P. Kelly ◽  
Sarah K. Keadle ◽  
Michael B. Cook ◽  
...  
Keyword(s):  
Physical Activity ◽  
Life Course ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Adult Life ◽  
Specific Mortality

Depressive Symptoms Imputed Across the Life Course Are Associated with Cognitive Impairment and Cognitive Decline

2021 ◽  
pp. 1-11
Author(s):  
Willa D. Brenowitz ◽  
Adina Zeki Al Hazzouri ◽  
Eric Vittinghoff ◽  
Sherita H. Golden ◽  
Annette L. Fitzpatrick ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Life Course ◽  
Cognitive Decline ◽  
Early Adulthood ◽  
Adult Life ◽  
Late Life ◽  
Cognitive Outcomes ◽  
Life Stages ◽  
The Life Course

Background: Depressive symptoms may increase risk for dementia, but findings are controversial because late-life depression may be a prodromal dementia symptom. Life course data on depression and dementia risk may clarify this association; however, data is limited. Objective: To impute adult depressive symptoms trajectories across adult life stages and estimate the association with cognitive impairment and decline. Methods: Using a pooled study of 4 prospective cohorts (ages 20–89), we imputed adult life course depressive symptoms trajectories based on Center for Epidemiologic Studies Depression Scale-10 (CESD-10) and calculated time-weighted averages for early adulthood (ages 20–49), mid-life (ages 50–69), and late-life (ages 70–89) for 6,122 older participants. Adjusted pooled logistic and mixed-effects models estimated associations of imputed depressive symptoms with two cognitive outcomes: cognitive impairment defined by established criteria and a composite cognitive score. Results: In separate models, elevated depressive symptoms in each life stage were associated with cognitive outcomes: early adulthood OR for cognitive impairment = 1.59 (95%CI: 1.35,1.87); mid-life OR = 1.94 (95%CI:1.16, 3.26); and late-life OR = 1.77 (95%CI:1.42, 2.21). When adjusted for depressive symptoms in the other life-stages, elevated depressive symptoms in early adulthood (OR = 1.73; 95%CI: 1.42,2.11) and late-life (OR = 1.43; 95%CI: 1.08,1.89) remained associated with cognitive impairment and were also associated with faster rates of cognitive decline (p <  0.05). Conclusion: Imputing depressive symptom trajectories from pooled cohorts may help expand data across the life course. Our findings suggest early adulthood depressive symptoms may be a risk factor for cognitive impairment independent of mid- or late-life depressive symptoms.

Racial Disparities in Student Debt and the Reproduction of the Fragile Black Middle Class

2018 ◽  
Vol 5 (4) ◽  
pp. 562-577 ◽  
Author(s):  
Jason N. Houle ◽  
Fenaba R. Addo
Keyword(s):  
Young Adults ◽  
Middle Class ◽  
Life Course ◽  
Racial Disparities ◽  
Early Adulthood ◽  
Adult Life ◽  
Wealth Inequality ◽  
Black Middle Class ◽  
Student Debt ◽  
Early Adult Life

A nascent literature recognizes that student loan debt is racialized and disproportionately affects youth of color, especially black youth. In this study, the authors expand on this research and ask whether black-white disparities in student debt persist, decline, or increase across the early adult life course, examine possible mechanisms for changes in racial disparities in student debt across early adulthood, and ask whether racial disparities in student debt contribute to black-white wealth inequality among a recent cohort of college-going young adults. The authors address these questions using nationally representative data from the National Longitudinal Study of Youth 1997, multilevel growth curve models, and linear decomposition methods. There are three findings. First, black-white disparities in debt increase across the early adult life course, and previous research underestimated racial disparities in debt. Second, growth in this racial disparity is partially explained by differences in the social background, postsecondary experiences, and disparities in attained social and economic status of black and white young adults. As a result, the authors find that, compositionally, racial inequalities in student debt account for a substantial minority of the black-white wealth gap in early adulthood and that this contribution increases across the early adult life course. The authors conclude that debt trajectories are more informative than point-in-time estimates and that student debt may be a new mechanism of wealth inequality that creates fragility in the next generation of the black middle class.

scholarly journals Health situation and health care of women aged 50 years and older in rural regions in Germany

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
F Prütz ◽  
L Krause ◽  
E Nowossadeck ◽  
M Thißen ◽  
L Dini
Keyword(s):  
Health Care ◽  
Adult Population ◽  
Age Groups ◽  
Rural Regions ◽  
Unequal Distribution ◽  
Study Region ◽  
Gp Services ◽  
Northeastern Germany ◽  
Healthcare Situation ◽  
Health Situation

Abstract Background In many countries demographic changes and regional differences lead to inequalities in healthcare provision. In Germany, this applies especially to rural regions and could affect the healthcare situation of middle-aged and older women in particular. Our study, which is part of the project “Frauen 5.0”, explores the health and healthcare situation of women 50 years and older in Northeastern Germany, with focus on outpatient gynaecological and general medical care and reasons for healthcare utilisation. Methods Our analyses comprise the health situation of women aged 50 years and older, their utilisation of outpatient gynaecologists and general practitioners (GPs), reasons for utilisation, access barriers to outpatient care, the demographic situation and the spatial distribution of gynaecological and GP practices in Northeastern Germany. We use a variety of data sources; main data source is the German Health Interview and Examination Survey for Adults (DEGS1, 2008-2011), which was carried out by the Robert Koch Institute and is representative of the German adult population. Results There is an unequal distribution of gynaecologic and GP practices in Northeastern Germany, with the highest density in and around Berlin. About 30% of gynaecologists and GPs in the study region are aged 60 years and older. Whereas in all age groups at least 80% of women used GP services in the last 12 months, the use of gynaecologic services declines from 80% in 18- to 29 year-old to 45% in 70- to 79 year-old women. Most important reasons for seeking gynaecological treatment are menopause and early detection of cancer. Conclusions The analyses show that there is need to ensure adequate health care for women aged 50 and over in rural regions in Germany. Based on the results, within the project “Frauen 5.0” innovative solutions for this task, e.g. interprofessional cooperation, will be identified. Key messages Analyses of outpatient healthcare services show an unequal distribution of gynaecologic and GP practices in Northeastern Germany; about 30% of the gynaecologists and GPs are aged 60 years and older. Whereas in all age groups at least 80% of women used GP services in the last 12 months, the use of gynaecologic services declines from 80% in 18- to 29 year-old to 45% in 70- to 79 year-old women.

scholarly journals A life course analysis of income and incident AMI - a Danish register based cohort study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Lund ◽  
M Kriegbaum ◽  
I Andersen ◽  
C O Hougaard ◽  
H Brønnum-Hansen
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Low Income ◽  
Age Groups ◽  
Adult Life ◽  
Social Gradient ◽  
Relative Level ◽  
The Social ◽  
The Life Course ◽  
The Impact

Abstract Background Social inequality in ischemic heart disease has been related to socioeconomic position in childhood, early and late adulthood. However, the impact of relative level of accumulated income periods across adult life course and the potential gender and age differences has not been investigated. The aim was to investigate the association between relative level of accumulated income across the life course and Acute myocardial infarction (AMI) from age 60+ and to study if the associations differ by gender and exposure in different age groups (30-39 years, 40-49 years and 50-59 years). Methods All Danes born 1935-54 N = 1,235,139 were followed-up in registers for incident AMI (ICD8: 410, ICD10: I20, I21) from age 60+, (42,669 cases). The The Accumulated Proportional Deviation from Median Equivalized Income = APDMEI for each gender/age /calendar year strata was constructed and divided in quartiles. The analyses stratified by birth cohort included all Danes born in 1955-70 (alive and reached age 40) N = 1,144,264, 1945-64 (alive and reached age 50), N = 1,434,769, 1935-1954 (alive and reached age 60) N = 1,235,139 including outcomes in the following 10 year period. Cox’s proportional hazard models adjusted for educational level, ethnic background and birth cohort. Results Among men, those in the lowest APDMEI quartile had a HR 1.40 (1.35-1.45) of AMI compared to the highest quartile, second and third highest quartiles had HR of 1.24 (1.20-1.28) and 1.14 (1.10-1.18), respectively. Among women the lowest quartile had a HR of 1.78 (1.69-1.88), the second 1.45 (1.37-1.53) and the third 1.19 (1.13-1.26). The social gradient was similar across the different age-groups. Conclusions The risk of AMI increased with lower levels of relative accumulated income across the life course. While men generally had a higher risk of AMI, the social gradient was steeper in women. There was no indication of a specific sensitive age period for exposure to relative level of accumulated income. Key messages Accumulated low income is associated with higher AMI risk in both men and women, but with larger relative differences between high and low accumulated income in women. This study adds a new approach to the study of inequalities in AMI by integrating duration and extent of low income into a relative measure of accumulated income.

Folklore and Folklife of American Age Groups and Aging

2018 ◽  
pp. 844-866
Author(s):  
Mary L. Sellers
Keyword(s):  
Life Course ◽  
Group Identity ◽  
Age Groups ◽  
The United States ◽  
Childhood And Adolescence ◽  
Folk Traditions ◽  
Values And Beliefs ◽  
Infancy And Early Childhood ◽  
The Life Course ◽  
Pregnancy And Birth

Folklore occurs at every stage of a person’s life, and this chapter covers the way folklore and folklife across, and of, the life course has been studied. Six divisions in the life course that mark traditions of age groups as well as perceived stages in the United States are pregnancy and birth, infancy and early childhood, childhood and adolescence, adulthood, seniority, and death. Although much of the scholarship of age groups has been on the beginning and end of life, I demonstrate the conditions of aging in adolescence through the senior years that generate folklore and should be studied in relation to formation of age-group identity. This chapter emphasizes the use of folklore as an adaptation to aging. It examines the connection of folk traditions to the role that anxiety plays in the aging process, the formation of self and group identity, and the rites of passage that mark transitions from one stage to another. It shows that the presence of invented and emerging traditions indicates changing values and beliefs across the life course and encourages research in age-based research as a basic component of folklore and folklife studies.

scholarly journals ‘Too old to test?’: A life course approach to HIV-related risk and self-testing among midlife-older adults in Malawi

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheryl Johnson ◽  
Moses Kumwenda ◽  
Jamilah Meghji ◽  
Augustine T. Choko ◽  
Mackwellings Phiri ◽  
...  
Keyword(s):  
Older Adults ◽  
Life Course ◽  
Hiv Testing ◽  
Sexual Risk ◽  
Age Groups ◽  
Sub Saharan Africa ◽  
Treatment As Prevention ◽  
Sexual Risk Taking ◽  
Rural And Urban ◽  
Self Testing

Abstract Background Despite the aging HIV epidemic, increasing age can be associated with hesitancy to test. Addressing this gap is a critical policy concern and highlights the urgent need to identify the underlying factors, to improve knowledge of HIV-related risks as well as uptake of HIV testing and prevention services, in midlife-older adults. Methods We conducted five focus group discussions and 12 in-depth interviews between April 2013 and November 2016 among rural and urban Malawian midlife-older (≥30 years) men and women. Using a life-course theoretical framework we explored how age is enacted socially and its implications on HIV testing and sexual risk behaviours. We also explore the potential for HIV self-testing (HIVST) to be part of a broader strategy for engaging midlife-older adults in HIV testing, prevention and care. Thematic analysis was used to identify recurrent themes and variations. Results Midlife-older adults (30–74 years of age) associated their age with respectability and identified HIV as “a disease of youth” that would not affect them, with age protecting them against infidelity and sexual risk-taking. HIV testing was felt to be stigmatizing, challenging age norms, threatening social status, and implying “lack of wisdom”. These norms drove self-testing preferences at home or other locations deemed age and gender appropriate. Awareness of the potential for long-standing undiagnosed HIV to be carried forward from past relationships was minimal, as was understanding of treatment-as-prevention. These norms led to HIV testing being perceived as a threat to status by older adults, contributing to low levels of recent HIV testing compared to younger adults. Conclusions Characteristics associated with age-gender norms and social position encourage self-testing but drive poor HIV-risk perception and unacceptability of conventional HIV testing in midlife-older adults. There is an urgent need to provide targeted messages and services more appropriate to midlife-older adults in sub-Saharan Africa. HIVST which has often been highlighted as a tool for reaching young people, may be a valuable tool for engaging midlife-older age groups who may not otherwise test.

scholarly journals Evolution of the prevalence of obesity in the adult population in France, 2013–2016: the Constances study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sébastien Czernichow ◽  
Adeline Renuy ◽  
Claire Rives-Lange ◽  
Claire Carette ◽  
Guillaume Airagnes ◽  
...  
Keyword(s):  
Linear Trend ◽  
Adult Population ◽  
Age Groups ◽  
French Population ◽  
Obesity Prevalence ◽  
Point Change ◽  
Men And Women ◽  
Class 1 ◽  
Prevalence Of Obesity ◽  
Age And Sex

AbstractThis study provides trends in obesity prevalence in adults from 2013 to 2016 in France. 63,582 men and women from independent samples upon inclusion from the Constances cohort were included. Anthropometrics were measured at Health Screening Centers and obesity defined as a Body mass index (BMI) ≥ 30 kg/m2; obesity classes according to BMI are as follows: class 1 [30–34.9]; class 2 [35–39.9]; class 3 [≥ 40 kg/m2]. Linear trends across obesity classes by sex and age groups were examined in regression models and percentage point change from 2013 to 2016 for each age category calculated. All analyses accounted for sample weights for non-response, age and sex-calibrated to the French population. Prevalence of obesity ranged from 14.2 to 15.2% and from 14 to 15.3% in women and men respectively from 2013 to 2016. Class 1 obesity category prevalence was the only one to increase significantly across survey years in both men and women (p for linear trend = 0.04 and 0.01 in women and men respectively). The only significant increase for obesity was observed in the age group 18–29 y in both women and men (+ 2.71% and + 3.26% point increase respectively, equivalent to an approximate rise of 50% in women and 93% in men, p = 0.03 and 0.02 respectively). After adjustment for survey non-response and for age and sex distribution, the results show that class 1 obesity prevalence has significantly increased in both women and men from 2013 to 2016, and only in young adults in a representative sample of the French population aged 18–69 years old.

scholarly journals Analysing the impact of the COVID-19 outbreak on everyday travel behaviour in Germany and potential implications for future travel patterns

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Viktoriya Kolarova ◽  
Christine Eisenmann ◽  
Claudia Nobis ◽  
Christian Winkler ◽  
Barbara Lenz
Keyword(s):  
Public Transport ◽  
Online Survey ◽  
Adult Population ◽  
Activity Patterns ◽  
Age Groups ◽  
Travel Behaviour ◽  
German Population ◽  
Travel Patterns ◽  
Home Office ◽  
The Impact

Abstract Introduction The global Coronavirus (COVID-19) pandemic is having a great impact on all areas of the everyday life, including travel behaviour. Various measures that focus on restricting social contacts have been implemented in order to reduce the spread of the virus. Understanding how daily activities and travel behaviour change during such global crisis and the reasons behind is crucial for developing suitable strategies for similar future events and analysing potential mid- and long-term impacts. Methods In order to provide empirical insights into changes in travel behaviour during the first Coronavirus-related lockdown in 2020 for Germany, an online survey with a relative representative sample for the German population was conducted a week after the start of the nationwide contact ban. The data was analysed performing descriptive and inferential statistical analyses. Results and Discussion The results suggest in general an increase in car use and decrease in public transport use as well as more negative perception of public transport as a transport alternative during the pandemic. Regarding activity-related travel patterns, the findings show firstly, that the majority of people go less frequent shopping; simultaneously, an increase in online shopping can be seen and characteristics of this group were analysed. Secondly, half of the adult population still left their home for leisure or to run errands; young adults were more active than all other age groups. Thirdly, the majority of the working population still went to work; one out of four people worked in home-office. Lastly, potential implications for travel behaviour and activity patterns as well as policy measures are discussed.

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