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.

The Importance of Biobehavioral Research to Examine the Physiological Effects of Racial and Ethnic Discrimination in the Latinx Population

A growing body of research is documenting how racial and ethnic populations embody social inequalities throughout the life course. Some scholars recommend the integration of biospecimens representing the hypothalamic-pituitary-adrenal axis, neurological and endocrinological processes, and inflammation to capture the embodiment of inequality. However, in comparison to other racial and ethnic groups, there has been little research examining how Hispanic/Latinx persons embody racial and ethnic discrimination, much less resulting from institutional and structural racism. We provide a rationale for expanding biobehavioral research examining the physiological consequences of racism among Latinx persons. We identify gaps and make recommendations for a future research agenda in which biobehavioral research can expand knowledge about chronic disease inequities among Latinx populations and inform behavioral and institutional interventions. We end by cautioning readers to approach the recommendations in this article as a call to expand the embodiment of racism research to include the diverse Latinx population as the United States addresses racial inequity.

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.

Sex-specific associations of adiposity with cardiometabolic traits in the UK: A multi–life stage cohort study with repeat metabolomics

Background Sex differences in cardiometabolic disease risk are commonly observed across the life course but are poorly understood and may be due to different associations of adiposity with cardiometabolic risk in females and males. We examined whether adiposity is differently associated with cardiometabolic trait levels in females and males at 3 different life stages. Methods and findings Data were from 2 generations (offspring, Generation 1 [G1] born in 1991/1992 and their parents, Generation 0 [G0]) of a United Kingdom population-based birth cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC). Follow-up continues on the cohort; data up to 25 y after recruitment to the study are included in this analysis. Body mass index (BMI) and total fat mass from dual-energy X-ray absorptiometry (DXA) were measured at mean age 9 y, 15 y, and 18 y in G1. Waist circumference was measured at 9 y and 15 y in G1. Concentrations of 148 cardiometabolic traits quantified using nuclear magnetic resonance spectroscopy were measured at 15 y, 18 y, and 25 y in G1. In G0, all 3 adiposity measures and the same 148 traits were available at 50 y. Using linear regression models, sex-specific associations of adiposity measures at each time point (9 y, 15 y, and 18 y) with cardiometabolic traits 3 to 6 y later were examined in G1. In G0, sex-specific associations of adiposity measures and cardiometabolic traits were examined cross-sectionally at 50 y. A total of 3,081 G1 and 4,887 G0 participants contributed to analyses. BMI was more strongly associated with key atherogenic traits in males compared with females at younger ages (15 y to 25 y), and associations were more similar between the sexes or stronger in females at 50 y, particularly for apolipoprotein B–containing lipoprotein particles and lipid concentrations. For example, a 1 standard deviation (SD) (3.8 kg/m2) higher BMI at 18 y was associated with 0.36 SD (95% confidence interval [CI] = 0.20, 0.52) higher concentrations of extremely large very-low-density lipoprotein (VLDL) particles at 25 y in males compared with 0.15 SD (95% CI = 0.09, 0.21) in females, P value for sex difference = 0.02. By contrast, at 50 y, a 1 SD (4.8 kg/m2) higher BMI was associated with 0.33 SD (95% CI = 0.25, 0.42) and 0.30 SD (95% CI = 0.26, 0.33) higher concentrations of extremely large VLDL particles in males and females, respectively, P value for sex difference = 0.42. Sex-specific associations of DXA-measured fat mass and waist circumference with cardiometabolic traits were similar to findings for BMI and cardiometabolic traits at each age. The main limitation of this work is its observational nature, and replication in independent cohorts using methods that can infer causality is required. Conclusions The results of this study suggest that associations of adiposity with adverse cardiometabolic risk begin earlier in the life course among males compared with females and are stronger until midlife, particularly for key atherogenic lipids. Adolescent and young adult males may therefore be high priority targets for obesity prevention efforts.

Developing an Anti-Racist Foundations Course in MCH for MPH Students

Introduction Over the past decade, foundational courses in MCH have been revised and revamped to integrate the life course perspective and social determinants of health in ways that bring these essential issues to the core of the learning experience. Yet the racial reckoning of 2020 and the racially disparate health impacts of the COVID-19 pandemic underscore that a deeper, more focused approach to anti-racist pedagogy is now imperative for MCH educators and others responsible for developing the MCH workforce. Methods In this paper, we discuss our experience of building a ‘community of practice’ of anti-racist MCH trainees through our course, ‘Foundations of Maternal and Child Health Policy, Practice, and Science.’ Results We identify four principles which guided our course: (1) building on students’ experience, knowledge, identities and social justice commitments; (2) creating a common purpose and shared vocabulary related to racism; (3) organizing classroom activities to reflect real-world problems and professional practices related to addressing structural racism as a root cause of health inequities; and (4) building students’ skills and confidence to recognize and address structural racism as MCH professionals. Discussion We hope that this description of our principles, along with examples of how they were put into practice, will be useful to MCH educators who seek to build anti-racist frameworks to guide MCH workforce development.

The Sense of Coherence in the Life Course

The development of the sense of coherence (SOC) is understood as a lifelong learning process. Among the important questions about this process are as follows: What are the crucial factors that contribute to build, enhance, and strengthen the SOC during the life course? Is the role of the SOC in coping stable during the life course, or does it have different functions at different life stages? For example, does the SOC open one to new GRRs at the beginning and facilitate access to GRRs later in life? Can salutogenic interventions strengthen the SOC during various phases in the lifespan? The chapters in this part of the Handbook tackle these questions with varying emphasis at different periods of life.