Association between life-course cigarette smoking and metabolic syndrome: a discovery-replication strategy

Background The relation between cigarette smoking and metabolic syndrome (MetS) remains unclear, and previous studies focusing on MetS are limited in sample size. We investigated the association between life-course smoking and MetS with independent discovery and replication samples. Methods Preliminary analysis utilized data from an annual cross-sectional survey of 15,222 participants aged ≥ 60 years in Tianjin, China. Suggestive associations were followed-up in 8565 adults from the China Health and Nutrition Survey. MetS was identified according to the criteria of the Chinese Diabetes Society in 2013. Life-course smoking was assessed by a comprehensive smoking index (CSI), based on information on smoking intensity, duration, and time since cessation across life-course, collected through standard questionnaires. Participants were divided into four groups: non-smokers; and the tertiles of CSI in ever smokers. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between life-course smoking and MetS. Results In the discovery sample, ORs of MetS were 2.01 (95%CI: 1.64–2.47) and 1.76 (95%CI: 1.44–2.16) for smokers in the highest and second tertile of CSI compared with never smokers. Potential interaction was shown for age, with increased ORs for MetS associated with smoking limited to individuals who aged < 70 years (Pinteraction = 0.015). We were able to replicate the association between cigarette smoking and MetS in an independent adult sample (second tertile vs. never: OR = 1.30, 95%CI: 1.04–1.63). The interaction of smoking with age was also replicated. Conclusions Life-course cigarette smoking is associated with an increased odds of MetS, especially among individuals who aged < 70 years.

A life course perspective: young people's trajectories and transitions in Colombia

This paper aims to describe, from the standpoint of the life course, how young people's trajectories are shaped through the articulation between history and biography, emphasizing the changes associated with the meaning of the family and, from an economic standpoint, how the growing uncertainty resulting partly from the impact of the globalization of the labor market, social changes and cultural transformations, causing young people to stop experiencing linear trajectories, leaving current itineraries and collective identities at risk.

Further decoding the mystery of American pain: The importance of work

A recent paper showed that, whereas we expect pain to rise with age due to accumulated injury, physical wear and tear, and disease, the elderly in America report less pain than those in midlife. Further exploration revealed this pattern was confined to the less educated. The authors called this the ‘mystery of American pain’ since pain appears to rise with age in other countries irrespective of education. Revisiting this issue with the same cross-sectional data we show that what matters in explaining pain through to age 65 is whether one is working or not. The incidence of pain across the life-course is nearly identical for workers in America and elsewhere, but it is greater for non-working Americans than it is for non-workers elsewhere. As in other countries, pain is hump-shaped in age among those Americans out of work but rises a little over the life-course for those in work. Furthermore, these patterns are apparent within educational groups. We show that, if one ascribes age-specific employment rates from other OECD countries to Americans, the age profile of pain in the United States is more similar to that found elsewhere in the OECD. This is because employment rates are lower in the United States than elsewhere between ages 30 and 60: the simulation reduces the pain contribution of these non-workers to overall pain in America, so it looks somewhat similar to pain elsewhere. We conclude that what matters in explaining pain over the life-course is whether one is working or not and once that is accounted for, the patterns are consistent across the United States and the rest of the OECD.

How to Be a Man Differently: Intersectionality of Gender and Disability in the Life Course of a Powerchair Athlete

This article focuses on the intersection of gender, dis/ability and other social forces in the life course of a young man who has had physical impairments from an early age. Drawing on interactionist theories and applying an ethnographic approach, we analyze the life experiences taking place in multiple social spheres throughout the life phases of Simon, a Swiss powerchair hockey player with cerebral palsy. During his childhood and adolescence, Simon was not in a position to embody the familial ways of performing hegemonic masculinity, and he was functionally dependent on women. Through his ongoing transition to adulthood, his commitment to sport and the process of technologizing his body enabled him doing gender differently and emancipate himself from the familial masculine figure, while remaining reliant on the care provided by women. Thus, we show how the body, context, and life phases contribute to the performances of gender and dis/ability.

Epidemiologic Trends, Social Determinants, and Brain Health: The Role of Life Course Inequalities

Brain health as expressed in our mental health and occurrence of specific disorders such as dementia and stroke is vitally important to quality of life, functional independence, and risk of institutionalization. Maintaining brain health is, therefore, a societal imperative, and public health challenge, from prevention of acquisition of brain disorders, through protection and risk reduction to supporting those with such disorders through effective societal and system approaches. To identify possible mechanisms that explain the differential effect of potentially modifiable risk factors, and factors that may mitigate risk, a life course approach is needed. This is key to understanding how poor health can accumulate from the earliest life stages. It also allows us to integrate and investigate key material, behavioral, and psychological factors that generate health inequalities within and across communities and societies. This review provides a narrative on how brain health is intimately linked to wider health determinants, thus importance for clinicians and societies alike. There is compelling evidence accumulated from research over decades that socioeconomic status, higher education, and healthy lifestyle extend life and compress major morbidities into later life. Brain health is part of this, but collective action has been limited, partly because of the separation of disciplines and focus on highly reductionist approaches in that clinicians and associated research have focused more on mitigation and early detection of specific diseases. However, clinicians could be part of the drive for better brain health for all society to support life courses that have more protection and less risk. There is evidence of change in such risks for conditions such as stroke and dementia across generations. The evidence points to the importance of starting with parental health and life course inequalities as a central focus.

Family policies’ long-term effects on poverty: a comparative analysis of single and partnered mothers

This study investigates whether generous family policies at the transition to parenthood reduce single and partnered mothers’ economic disadvantages later in the life course. Previous research usually focused on the immediate effects of family policies and disregards potential longer-term effects. In this study, we suggest taking a life-course perspective to study the relationships between family policy and mothers’ poverty risks. We empirically investigate how investment in child benefits, childcare services and parental leave measures at the transition to parenthood are associated with poverty outcomes at later life stages and whether these associations hold over time. We draw on pooled EU-SILC data, and an original policy dataset based on OECD expenditure data for child benefits, childcare and parental leave from 1994 to 2015. We find that mothers’ observed increase in poverty over time is slower in countries with high levels of spending for childcare at the transition to parenthood than in lower spending countries. The gap between partnered and single mothers was also diminishing in contexts of high childcare expenditure. For the other two policies, we did not find these links. These results do lend support to the claim that childcare is a prime example of a social investment policy with returns later in the life course and represents a life-course policy that seems to be able to disrupt economic path dependencies. The results for the other two policies suggest, however, a limited potential of family policy spending at transition to parenthood to reduce the poverty gap between partnered and single mothers over the course of life.