scholarly journals Does life-course socioeconomic position influence racial inequalities in the occurrence of uterine leiomyoma? Evidence from the Pro-Saude Study

2014 ◽  
Vol 30 (2) ◽  
pp. 305-317 ◽  
Author(s):  
Karine de Limas Irio Boclin ◽  
Eduardo Faerstein ◽  
Moyses Szklo
Keyword(s):  
Life Course ◽  
Socioeconomic Position ◽  
Skin Color ◽  
Access To Health Care ◽  
Parental Education ◽  
White Women ◽  
Proportional Hazards ◽  
Early Adulthood ◽  
Cox Proportional Hazards ◽  
Uterine Leiomyomas

We aimed to investigate whether life-course socioeconomic position mediates the association between skin color/race and occurrence of uterine leiomyomas. We analyzed 1,475 female civil servants with baseline data (1999-2001) of the Pró-Saúde Study in Rio de Janeiro State, Brazil. Life-course socioeconomic position was determined by parental education (early life socioeconomic position), participant education (socioeconomic position in early adulthood) and their combination (cumulative socioeconomic position). Gynecological/breast exams and health insurance status were considered markers of access to health care. Hazard ratios (HR) and 95% confidence intervals (95%CI) were estimated using Cox proportional hazards models. Compared with white women, black and parda (“brown”) women had higher risk of reporting uterine leiomyomas, respectively HR: 1.6, 95%CI: 1.2-2.1; HR: 1.4, 95%CI: 0.8-2.5. Estimates were virtually identical in models including different variables related to life-course socioeconomic position. This study corroborated previous evidence of higher uterine leiomyomas risk in women with darker skin color, and further suggest that life-course socioeconomic position adversity does not influence this association.

scholarly journals How intelligence and emotional control are related to suicidal behavior across the life course – A register-based study with 38-year follow-up

2019 ◽  
Vol 50 (13) ◽  
pp. 2265-2271 ◽  
Author(s):  
Nora Hansson Bittár ◽  
Daniel Falkstedt ◽  
Alma Sörberg Wallin
Keyword(s):  
Life Course ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Proportional Hazards ◽  
Early Adulthood ◽  
Cox Proportional Hazards ◽  
Emotional Control ◽  
Targeted Prevention ◽  
The Life Course

AbstractBackgroundBoth low intelligence and low emotional control have previously been linked to a higher risk of suicide, but it is unknown whether the associations apply consistently over the life course.MethodsThe study was based on data on intelligence and emotional control, collected from 48 738 Swedish men conscripted in 1969–1970, at ages 18–20 years. The data were linked to national registers giving information on subsequent suicidal behavior (completed and attempted suicide) up to the age of 59 years. The associations were investigated using logistic regression and Cox proportional hazards regression models, with adjustment for childhood socioeconomic status.ResultsIntelligence and emotional control assessed in late adolescence both showed robust inverse associations with suicidal behavior over the 38-year follow-up. However, while the association between lower intelligence and higher rate of suicidal behavior remained the same throughout (~40% increased hazard per unit on a five-level scale), the association between lower emotional control and suicidal behavior was substantially stronger in early adulthood (~100% increased hazard per unit) than in late middle age (~30% increased hazard per unit).ConclusionsThe study adds to previous research by showing that the association between poor emotional control and subsequent suicide risk in men becomes weaker over the life course, while the association between low intelligence and suicide risk seems to be constant. The particularly high suicide risk of young men with poor emotional control may motivate targeted prevention efforts.

Sex and Race Differences in the Risk of Ischemic Stroke Associated With Fasting Blood Glucose in REGARDS

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012296
Author(s):  
Tracy E. Madsen ◽  
D. Leann Long ◽  
April P. Carson ◽  
George Howard ◽  
Dawn O. Kleindorfer ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Blood Glucose ◽  
Black Women ◽  
Racial Differences ◽  
White Women ◽  
Proportional Hazards ◽  
Fasting Blood Glucose ◽  
Cox Proportional Hazards ◽  
Race Differences ◽  
Prospective Longitudinal

Background:To investigate sex and race differences in the association between fasting blood glucose (FBG) and risk of ischemic stroke (IS).Methods:This prospective longitudinal cohort study included adults age ≥45 years at baseline in the Reasons for Geographic And Racial Differences in Stroke Study, followed for a median of 11.4 years. The exposure was baseline FBG (mg/dL); suspected IS events were ascertained by phone every 6 months and were physician-adjudicated. Cox proportional hazards were used to assess the adjusted sex/race-specific associations between FBG (by category and as a restricted cubic spline) and incident IS.Results:Of 20,338 participants, mean age was 64.5(SD 9.3) years, 38.7% were Black, 55.4% were women, 16.2% were using diabetes medications, and 954 IS events occurred. Compared to FBG <100, FBG ≥150 was associated with 59% higher hazards of IS (95%CI 1.21-2.08) and 61% higher hazards of IS among those on diabetes medications (95%CI 1.12-2.31). The association between FBG and IS varied by race/sex (HR, FBG ≥ 150 vs. FBG <100: White women 2.05 (95% CI 1.23-3.42), Black women 1.71 (95%CI 1.10-2.66), Black men 1.24 (95%CI 0.75-2.06), White men 1.46 (95%CI 0.93-2.28), pFBG*race/sex=0.004). Analyses using FBG splines suggest that sex was the major contributor to differences by race/sex subgroups.Conclusions:Sex differences in the strength and shape of the association between FBG and IS are likely driving the significant differences in the association between FBG and IS across race/sex subgroups. These findings should be explored further and may inform tailored stroke prevention guidelines.

scholarly journals Life course socioeconomic inequalities and oral health status in later life

2019 ◽  
Vol 52 (Suppl 2) ◽  
pp. 7s ◽  
Author(s):  
Fabíola Bof de Andrade ◽  
José Leopoldo Ferreira Antunes ◽  
Paulo Roberto Borges de Souza Junior ◽  
Maria Fernanda Lima-Costa ◽  
Cesar De Oliveira
Keyword(s):  
Oral Health ◽  
Life Course ◽  
Socioeconomic Position ◽  
Tooth Loss ◽  
Parental Education ◽  
Later Life ◽  
Socioeconomic Inequalities ◽  
Dental Prostheses ◽  
Absolute And Relative Inequalities ◽  
Index Of Inequality

OBJECTIVE: To investigate the association between life course socioeconomic conditions and two oral health outcomes (edentulism and use of dental prostheses among individuals with severe tooth loss) among older Brazilian adults. METHODS: This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) which includes information on persons aged 50 years or older residing in 70 municipalities across the five great Brazilian regions. Regression models using life history information were used to investigate the relation between childhood (parental education) and adulthood (own education and wealth) socioeconomic circumstances and edentulism and use of dental prostheses. Slope index of inequality and relative index of inequality for edentulism and use of dental prostheses assessed socioeconomic inequalities in both outcomes. RESULTS: Approximately 28.8% of the individuals were edentulous and among those with severe tooth loss 80% used dental prostheses. Significant absolute and relative inequalities were found for edentulism and use of dental prostheses. The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position. Absolute and relative inequalities related to the use of dental prostheses were not related to childhood socioeconomic position. CONCLUSIONS: These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, although use of dental prostheses was not related to childhood socioeconomic position. The study also highlights the long-lasting relation between childhood socioeconomic inequalities and oral health through the life course.

scholarly journals Analysis of factors associated with changing general practice in the first 14 years of life in Wales using linked cohort and primary care records: implications for using primary care databanks for life course research

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Ashley Akbari ◽  
Ronan Lyons ◽  
Amrita Bandyopadhyay ◽  
Helen Bedford ◽  
Sinead Brophy ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Life Course ◽  
Rural Areas ◽  
Proportional Hazards ◽  
Survey Design ◽  
Mode Of Delivery ◽  
Cox Proportional Hazards ◽  
Housing Tenure ◽  
Factors Associated

IntroductionPrimary care electronic health records (pcEHRs) are a valuable resource for life course research, however loss to follow up due to changing practices has received little attention. We investigated factors associated with changes in registration and record continuity in the Secure Anonymised Information Linkage (SAIL) databank, with ~80% practice coverage. Objectives and ApproachWe analysed linked pcEHRs for 1834 (882 girls) Millennium Cohort Study (MCS) participants, resident in Wales and with parental consent to health record linkage at the age seven MCS interview. We studied time from first to next general practice (GP) registration in Wales by fitting Cox proportional hazards models, and estimated mutually-adjusted hazard ratios (aHRs) for the following factors: child (sex, ethnicity, mode of delivery, gestation, birthweight, neonatal illness, wheeze, longstanding illness); maternal (age, education, lone parent status); household (income, housing tenure, residential mobility, urban/rural residence); GP type (SAIL-contributing/-non-contributing). Analyses were weighted for survey design (Stata: Release 15; StataCorp LP). ResultsThere were 3065 Welsh GP registrations for 1834 children. By age 5 years, 25% of children changed GP at least once, with 1070 (58.3%), 477 (26.0%) and 287 (15.7%) registered with 1, 2, 3+ GPs respectively up to 14 years of age. Children with older mothers (aHRs; 95% CI: 0.96; 0.95, 0.98; per year) or those residing in rural areas (0.75;0.56,0.99) were less likely, and those whose first registration was not with a SAIL contributing GP (2.16;1.60,2.93), whose mothers had no educational qualifications (1.40;1.15,1.71), or had recently changed address (1.62;1.21,2.16) more likely, to change GP. 305 (16.6%) children had never registered with a SAIL-contributing GP. Of 403 children initially registered with a SAIL contributing GP who then changed GP, 66.7% re-registered with a SAIL contributing GP. Conclusion/ImplicationsGeographically contiguous primary care databanks, such as the SAIL databank, enable a high proportion of children to be reliably followed over time despite changing GP. Similar analyses of databases based on geographically disparate volunteer GPs are needed to quality assure their suitability for life course epidemiology research.

Racial disparities in cervical cancer mortality over time.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5604-5604
Author(s):  
Jose Alejandro Rauh-Hain ◽  
Marcela G del Carmen ◽  
John O. Schorge ◽  
David M. Boruta ◽  
Whitfield Board Growdon ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Marital Status ◽  
White Women ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Kaplan Meier ◽  
Significant Survival ◽  
Significant Difference ◽  
Over Time ◽  
Related Mortality

5604 Background: The aim of this study is to examine changes over time in survival for African-American (AA) and white women diagnosed with cervical cancer (CeCa). Methods: Surveillance, Epidemiology, and End Results (SEER) Program data 9 for 1983-2007 were used for this analysis. Kaplan–Meier and Cox proportional hazards survival methods were used to assess differences in survival by race at 5-year intervals. Results: The study included 23,722 women; including 19,777 whites and 3,945 AA. AAs were older (51.4 vs. 49 years; p<0.001), had a higher rate of regional (38.3% vs. 31.7; p<0.001) and distant metastasis (10.5% vs. 8.5; p<0.001). AAs received less frequently cancer-directed surgery (53.1% vs. 65.7%; p<0.001), and more frequently radiotherapy (56.9% vs. 47.3%; p<0.001). AAs had a hazard ratio (HR) of 1.40 (95% CI, 1.31-1.49) of CeCa mortality compared to whites. Adjusting for SEER registry, marital status, stage, age, surgery, radiotherapy, grade and histology, AA women had a HR of 1.15 (95% CI, 1.07-1.24) of CeCa related mortality. AAs had a higher HR of all cause mortality and CeCa related mortality for all the five-year diagnosis cohorts (Table). After adjusting for the same variables, there was a significant difference in survival in the 1988-1992 group (HR 1.26; 95% CI 1.09-1.47). Conclusions: The present data indicates significant survival differences by race for women with invasive CeCa. After adjusting for SEER registry, marital status, stage, age, surgery, radiotherapy, grade and histology, only between 1988-1992 there was a difference in survival between the groups. [Table: see text]

Abstract 16731: Early Onset of Menopause and Premature Cardiovascular Disease: The Coronary Artery Risk Development in Young Adults Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ruth Misha ◽  
Laura A Colangelo ◽  
Lucia Petito ◽  
Cora E Lewis ◽  
Pamela Schreiner ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Black Women ◽  
Early Onset ◽  
White Women ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Age At Menarche

Introduction: Cardiovascular disease (CVD) is the leading cause of death in women and early onset of menopause before the age of 40 years has been identified as a risk enhancer for future CVD events. Quantifying the magnitude of risk for premature CVD among women with early menopause may inform and guide the intensity of sex-specific preventive strategies. Methods: We included all women in the Coronary Artery Risk Development in Young Adults (CARDIA) study who attended a follow-up exam after the age of 40 years, had available data on menopausal status, and had not experienced premature CVD before 40 years. We performed multivariable Cox proportional hazards regression to examine the relationship between early onset of menopause defined as <40 years and incident CVD (coronary heart disease, peripheral arterial disease, stroke, and heart failure) prior to the age of 65 years. We performed Cox proportional hazards models and adjusted for risk factors levels at baseline: age, race, age at menarche, years of education, smoking status, body mass index, diabetes, hypertension, and total cholesterol: high-density lipoprotein ratio. Results: Among 2136 women with mean age of 43.0 (SD 3.0), 9.1% reported premature menopause before the age of 40 years (4.5% in white and 13.9% in black women). Over a median follow-up of 14.0 (IQR 11.5, 16.9) years, 81 premature CVD events occurred. Incidence rate (95% CI) of CVD was 6.46 (2.43, 17.22) and 1.41 (0.92, 2.17) per 1,000 per person-years for white women with and without early onset menopause, respectively; 4.94 (2.66, 9.16) and 3.92 (2.94, 5.24) per 1,000 person-years for black women with and without early onset menopause (FIGURE). Conclusions: In a population-based sample, white women with early onset of menopause had a 3-fold higher rate of premature CVD events, independent of perimenopausal risk factor levels. Interventions to intensify CVD prevention in at-risk women are needed following early onset of menopause.

Cardiovascular fitness in early adulthood and future suicidal behaviour in men followed for up to 42 years

2013 ◽  
Vol 44 (4) ◽  
pp. 779-788 ◽  
Author(s):  
M. A. I. Åberg ◽  
J. Nyberg ◽  
K. Torén ◽  
A. Sörberg ◽  
H. G. Kuhn ◽  
...  
Keyword(s):  
Suicide Attempt ◽  
Suicidal Behaviour ◽  
Proportional Hazards ◽  
Early Adulthood ◽  
Poor Performance ◽  
Cardiovascular Fitness ◽  
Cox Proportional Hazards ◽  
Future Attempt ◽  
Increased Risk ◽  
Future Risk

BackgroundCardiovascular fitness influences many aspects of brain function. However, the relationship between cardiovascular fitness and suicidal behaviour is unknown. Therefore, we aimed to determine whether cardiovascular fitness at age 18 years is associated with future risk of suicide attempt/death.MethodWe performed a population-based Swedish longitudinal cohort study of male conscripts with no previous or ongoing mental illness (n = 1 136 527). The conscription examination, which took place during 1968–2005, included the cycle ergonometric test and tests of cognitive performance. Future risk of suicide attempt/death over a 5- to 42-year follow-up period was calculated with Cox proportional hazards models controlling for several confounders including familial factors.ResultsAt least one suicide attempt was recorded for 12 563 men. Death by suicide without a prior attempt was recorded in 4814 additional individuals. In fully adjusted models low cardiovascular fitness was associated with increased risk for future attempt/death by suicide [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.64–1.94]. The HR changed only marginally after exclusion of persons who received in-patient care for depression (HR 1.76, 95% CI 1.61–1.94). Poor performance on both the cardiovascular fitness and cognitive tests was associated with a fivefold increased risk of suicide attempt or suicide death (HR 5.46, 95% CI 4.78–6.24).ConclusionsLower cardiovascular fitness at age 18 years was, after adjustment for a number of potential confounders, associated with an increased risk of attempt/death by suicide in adulthood. It remains to be clarified whether interventions designed to improve fitness in teens can influence the risk of suicidal behaviour later in life.

scholarly journals Life Course Pathways From Childhood SES to Age-Related Declines in Kidney Function Across Adulthood

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 832-832
Author(s):  
Agus Surachman ◽  
Alexis Santos ◽  
Jonathan Daw ◽  
Lacy Alexander ◽  
Christopher Coe ◽  
...  
Keyword(s):  
Life Course ◽  
Kidney Function ◽  
Parental Education ◽  
Strong Predictor ◽  
Early Adulthood ◽  
The United States ◽  
Age Related ◽  
Using Data ◽  
The Life Course ◽  
The Impact

Abstract Age is a strong predictor of declines in kidney function across adulthood. Using data from 2,045 adults (ages 25-84) in the Midlife in the United States (MIDUS) study, we examined the life course pathways through which low parental education, through adult SES and body mass index (BMI), was associated with faster age-related declines in kidney function. Kidney function declines by 0.8 mL/min/1.73 m2 per year across adulthood. Lower parental education, through adult SES and BMI, was associated with higher kidney function among younger adults (Est = -1.61, SE = 0.62, 95%CI = -2.62, -0.60), but lower kidney function among older adults (Est = 0.93, SE = 0.51, 95%CI = 0.11, 1.79). The impact of early socioeconomic adversity on kidney function is initiated by kidney hyperfiltration in early adulthood and followed by faster declines and development into disease state in later adulthood.

scholarly journals Incidence, Cause of Death, and Survival of Amyloidosis in Korea

2020 ◽  
Author(s):  
Shin Yi Jang ◽  
Darae Kim ◽  
JinO Choi ◽  
Eun-Seok Jeon
Keyword(s):  
Incidence Rate ◽  
Cause Of Death ◽  
Socioeconomic Position ◽  
Proportional Hazards ◽  
Metabolic Diseases ◽  
Circulatory System ◽  
Malignant Neoplasm ◽  
Cox Proportional Hazards ◽  
Risk Of Death ◽  
Nutritional And Metabolic Diseases

Abstract BackgroundWe sought to assess incidence and survival for amyloidosis.MethodsWe acquired data from newly diagnosed cases related to amyloidosis from the National Health Insurance Service in Korea from 2006 through 2017 (n=2,233; male 53.5%). We calculated the age-standardized incidence rate, analyzed the survival rate (SR) using the Kaplan-Meier method, and analyzed the death risk using Cox proportional hazards methods.ResultsThe mean age was 57.0 (±16.7) years in males and 56.8 (±15.6) years in females (p=non-significant). The proportion of death was 34.7%. The causes of death were endocrine, nutritional, and metabolic diseases (33.9%), malignant neoplasm (20.8%), diseases of the circulatory system (9.68%), and diseases of the genitourinary system (9.29%). The overall age-standardized incidence rate was 0.47 persons per 100,000 persons in 2017. Overall, the 10-year SR for amyloidosis was 57.7% (55.9% in males and 59.2% in females). Adjusted hazard ratios were 9.16 (95% confidence interval [CI] 2.23, 37.5) among 40-49 year-old, 16.1 (95% CI 4.00, 65.3) among 50-59 year-old, 30.3 (95% CI 7.53, 122.0) among 60-69 year-old, 48.7 (95% CI 12.1, 196.3) among 70-79 year-old, 80.1 (95% CI 19.6, 326.3) among people 80 years or older and 1.21 (95% CI 1.02, 1.44) in the medium-level socioeconomic position group. ConclusionsThe age-standardized incidence rate of amyloidosis was about 0.5 persons per 100,000 persons in 2017. The 10-year SR of amyloidosis was about 58%. The most common cause of death was endocrine, nutritional, and metabolic diseases. The risk of death from amyloidosis increased with age and medium socioeconomic position.

scholarly journals Body Habitus Across the Lifespan and Risk of Pituitary Adenoma

2021 ◽  
Author(s):  
David J Cote ◽  
Timothy R Smith ◽  
Ursula B Kaiser ◽  
Edward R Laws ◽  
Meir J Stampfer
Keyword(s):  
Pituitary Adenoma ◽  
Waist Circumference ◽  
Health Professionals ◽  
Proportional Hazards ◽  
Early Adulthood ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Health Study ◽  
Body Habitus

Abstract Context No studies have examined the association between body habitus and incidence of pituitary adenoma. Objective To determine if body mass index (BMI), waist circumference, body somatotype, or height are associated with risk of pituitary adenoma. Design Pooled analysis of 3 prospective cohort studies. Setting Population-based study. Participants Participants of the Nurses’ Health Study (NHS), Nurses’ Health Study II (NHSII), and the Health Professionals Follow-Up Study (HPFS), totaling 284 946 American health professionals. Exposures BMI, waist circumference, body somatotype, and height. Outcome Measures Self-reported incident pituitary adenoma. Multivariable (MV)-adjusted hazard ratios (HRs) of pituitary adenoma were estimated using Cox proportional hazards models. Results During 7 350 156 person-years of follow-up, 387 incident pituitary adenomas were reported. Comparing BMI of ≥30 to &lt;25 kg/m2, higher adult BMI was associated with higher risk of pituitary adenoma (MV HR = 1.74; 95% CI, 1.33-2.28), as was higher maximum adult BMI (MV HR = 1.76; 95% CI, 1.34-2.30), higher waist circumference (MV HR = 1.06; 95% CI, 1.04-1.09 per inch), and higher BMI during early adulthood (at age 18 to 21, MV HR = 2.65; 95% CI, 1.56-4.49). Taller adult height was associated with pituitary adenoma (MV HR = 1.05; 95% CI, 1.01-1.09 per inch). Overall findings were similar in women and men, although power was limited in men (n = 62 cases). Sensitivity analyses demonstrated that the association between adult BMI and pituitary adenoma extended to at least 14 years prior to diagnosis and that the results were not affected when analyses were restricted to participants with similar healthcare utilization. Conclusion Higher BMI and waist circumference, from early adulthood to the time of diagnosis, were associated with higher risk of pituitary adenoma.

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