Intergenerational Mobility in Relative Educational Attainment and Health-Related Behaviours

Hazardous alcohol consumption in slow- and fast-privatized Russian industrial towns

Hazardous drinking, defined as the consumption of homemade, unofficially made alcohol and non-beverages, is prevalent and accounts for a high proportion of alcohol-related deaths in Russia. Individual-level characteristics are important explanations of hazardous drinking, but they are unlikely to explain spatial variation in this type of alcohol consumption. Areas that attracted insufficient attention in the research of hazardous drinking are the legacy of industrialization and the speed of economic reforms, mainly through the privatization policy of major enterprises in the 1990s. Applying mixed-effects logistic regressions to a unique dataset from 30 industrial towns in the European part of Russia, we find that in addition to individual-level characteristics such as gender, age, marital status, education, social isolation, labor market status, and material deprivation, the types of towns where informants' relatives resided such as industrial structure and speed of privatization also accounted for the variance in hazardous alcohol consumption among both male and female populations of the analyzed towns.

Economic development, intergenerational mobility, and health in South Korea

A growing number of studies reported the association between social mobility and health. However, few studies investigated whether the association varies by age group. Drawing on the economic environment that facilitated social mobility in South Korea, we postulate each age group had a different extent of social mobility, which would vary with the extent of economic growth and affect the association between social mobility and health. We used data from KDI National Happiness Survey 2018 and measured perceived mobility using respondents' perceived social position and their parents' social position. We examined whether social mobility was associated with self-rated health and psychological well-being. The upwardly mobile individuals were more likely than the stable ones to report 'happy'. Such a positive association between upward mobility and happiness was consistently found when the sample was restricted to the ages 30-59 and 40-49. For self-rated health, the downwardly mobile individuals were less likely to report good health. However, no significant difference in self-rated health was found after the youngest and oldest age groups were excluded. We found that perceived social mobility was strongly associated with psychological well-being rather than self-rated health. Moreover, we found a stronger association between upward mobility and happiness among the aged 40-49, who had the largest proportion of upwardly mobile individuals and spent their adolescence during rapid economic growth. The findings underscore the importance of the economic and social context in which individuals perceive their social position and shape their well-being.

Association between adolescent smoking and subsequent college completion by parent education - A national longitudinal study

BACKGROUND

Educational attainment is a social determinant of health associated with better quality of life and health outcomes. Current understanding of the association between adolescent smoking and college completion is limited. This study examined the association between adolescent smoking and subsequent college completion and how it varied by parent education in a longitudinal study of U.S. adolescents followed into young adulthood.

METHODS

Data were collected annually from a nationally representative cohort of 10th graders who participated in the NEXT Generation Health Study (2009 -2017; N = 1407). Participants reported if they smoked during 10th-12th grades (2009-2013). Self-report college completion was assessed in 2017. Parent reported their educational attainment at baseline. Weighted logistic regression models were used to assess the association between adolescent smoking during 10th-12th grades and subsequent college completion in the entire sample and stratified by parent educational attainment, adjusting for demographics, depressive symptoms, alcohol use, and parental monitoring.

RESULTS

Overall, adolescents who smoked during 10th-12th grade had lower odds of subsequently completing college compared to those who did not smoke (AOR=0.33, 95%CI=0.20-0.57). This association was stronger among those whose parents had ≤high school education (AOR=0.08, 95% CI=0.02-0.31) and some college education (AOR=0.18, 95%CI=0.08-0.39).

DISCUSSION

Adolescents from lower educational attainment households showed disproportionately stronger association between adolescent smoking and subsequent college completion. Future research needs to determine whether and how strategies to reduce adolescent smoking may promote educational attainment especially among adolescents whose parents have less than a college education.

Social Mobility, Health and Wellbeing in Poland

Recently there has been a surge of interest in the consequences of intergenerational social mobility on individuals' health and wellbeing outcomes. However, studies on the effects of social mobility on health, using high-quality panel survey data, have almost exclusively been conducted in Western welfare democracies. To account for this gap, and using empirical data from one of the largest and most eventful post-communist countries, Poland, in this study we investigate how individuals' origin and destination socio-economic position and social mobility are linked to self-rated health and reported psychological wellbeing. We use the Polish Panel Survey (POLPAN) data to construct self-rated health and psychological wellbeing measures, origin, destination and occupational class mobility variables, and account for an extensive set of sociodemographic determinants of health. We employ diagonal reference models to distinguish social mobility effects from origin and destination effects, and account for possible health selection mechanisms. Our results suggest that there is an occupational class gradient in health in Poland and that both parental and own occupational class matter for individual health outcomes. We also find a positive reported psychological wellbeing effect for upward social mobility from the working to the professional class.

Intergenerational social mobility and self-rated health in Canada

A growing body of research seeks to reveal the health effects of 'falling from grace' or 'rising from rags,' i.e., experiencing downward or upward mobility relative to one's family socioeconomic background. In this study, we mobilized a unique dataset, the 2012 Longitudinal and International Study of Adults linked to historical income data from the Canada Revenue Agency, to investigate associations between both educational and income mobility and self-rated health in a national sample of approximately 2500 women and 2300 men aged 25 to 50. Compared to educational immobility, extreme downward educational mobility corresponded to elevated odds of reporting good/fair/poor health among women (OR = 3.053; 95% CI = 0.991 … 9.393). Compared to income immobility, downward income mobility in general (OR = 1.533; 95% CI = 1.115 … 2.106) and extreme downward income mobility in particular (OR = 2.389; 95% CI = 1.481 … 3.854) both corresponded to elevated odds of reporting good/fair/poor health among women. Among men, extreme upward income mobility (OR = 0.674; 95% CI = 0.463 … 0.984) corresponded to reduced odds of reporting good/fair/poor health and extreme downward income mobility (OR = 2.237; 95% CI = 1.157 … 4.323) corresponded to elevated odds of reporting good/fair/poor health, compared to men with immobile incomes. In summary, upward income mobility was beneficial for men's self-rated health, downward educational mobility was detrimental to the self-rated health of women, and downward income mobility was detrimental to the self-rated health of both women and men in this Canadian study.

Socioeconomic position, social mobility, and health selection effects on allostatic load in the United States

The contemporaneous association between higher socioeconomic position and better health is well established. Life course research has also demonstrated a lasting effect of childhood socioeconomic conditions on adult health and well-being. Yet, little is known about the separate health effects of intergenerational mobility-moving into a different socioeconomic position than one's parents-among early adults in the United States. Most studies on the health implications of mobility rely on cross-sectional datasets, which makes it impossible to differentiate between health selection and social causation effects. In addition, understanding the effects of social mobility on health at a relatively young age has been hampered by the paucity of health measures that reliably predict disease onset. Analysing 4,713 respondents aged 25 to 32 from the National Longitudinal Study of Adolescent Health's Waves I and IV, we use diagonal reference models to separately identify the effects of socioeconomic origin and destination, as well as social mobility on allostatic load among individuals in the United States. Using a combined measure of educational and occupational attainment, and accounting for individuals' initial health, we demonstrate that in addition to health gradient among the socially immobile, individuals' socioeconomic origin and destination are equally important for multi-system physiological dysregulation. Short-range upward mobility also has a positive and significant association with health. After mitigating health selection concerns in our observational data, this effect is observed only among those reporting poor health before experiencing social mobility. Our findings move towards the reconciliation of two theoretical perspectives, confirming the positive effect of upward mobility as predicted by the "rags to riches" perspective, while not contradicting potential costs associated with more extensive upward mobility experiences as predicted by the dissociative thesis.

Intergenerational social mobility and body mass index trajectories - A follow-up study from Finland

Evidence remains unclear on how intergenerational social mobility is associated with body mass index (BMI) and its long-term changes. Our study identified BMI trajectories from middle to older age by intergenerational social mobility groups and stratified the analyses by gender and two birth cohorts (birth years 1940‒1947 and 1950–1962). We used questionnaire-based cohort data that consists of four survey phases: 2000–2002, 2007, 2012, and 2017. In Phase 1, participants were 40–60-year-old employees of the City of Helsinki, Finland. Our analytical sample consisted of 6,971 women and 1,752 men. Intergenerational social mobility was constructed based on self-reported parental and own education—both divided into high and low—yielding four groups: stable high socioeconomic position (SEP) (high-high), upward social mobility (low-high), downward social mobility (high-low), and stable low SEP (low-low). BMI was calculated from self-reported height and weight from all four phases. Using mixed-effects linear regression, we found increasing BMI trajectories in all four social mobility groups until the age of 65. Women and men with stable high SEP had lower BMI trajectories compared to those with stable low SEP. In the younger birth cohort, women with upward social mobility had a lower BMI trajectory than women with stable low SEP. Additionally, women and men with downward social mobility had higher BMI trajectories than those with stable high SEP. In the older birth cohort, however, the BMI trajectories of upward and downward social mobility groups were somewhat similar and settled between the BMI trajectories of stable high and stable low SEP groups. Our results indicate that the associations between intergenerational social mobility and BMI may depend on gender and birth cohort. Nevertheless, to reduce socioeconomic inequalities in unhealthy weight gain, obesity prevention actions that focus on people who are likely to remain in low SEP might be worthwhile.

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Few studies exist on social mobility and long-term body mass index (BMI) changes.

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Rising BMI trajectories were found in all social mobility groups.

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Stable low socioeconomic position (SEP) was related to higher BMI trajectories.

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Stable high SEP and upward social mobility may protect from excessive weight gain.

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Social mobility–BMI associations differed by gender and birth cohort.

Intergenerational educational mobility and smoking: a study of 20 European countries using diagonal reference models

OBJECTIVES

Intergenerational educational mobility can be particularly relevant for smoking because it implies moving from individuals' family background to a new position in the social hierarchy. Existing research, however, does not provide an answer as to how the process of mobility, per se, is associated with the likelihood of smoking.

STUDY DESIGN

We used cross-nationally comparable survey data for 20 countries collected within the health module of the European Social Survey in 2014. The analytical sample consisted of 22,336 respondents aged 25-64 years.

METHODS

Smoking was operationalized by daily and occasional smoking, while the intergenerational educational mobility variable was derived from a comparison of respondents' and their parents' highest levels of educational attainment. We employed diagonal reference models to examine the association of intergenerational educational mobility and smoking.

RESULTS

In the country- and age-adjusted analysis, intergenerational downward mobility was associated with odds ratios of 1.34 (CI95 1.07, 1.68) and 1.61 (CI95 1.34, 1.93) for smoking, respectively, among men and women. Intergenerational upward mobility, on the other hand, was negatively associated with smoking but only among women.

CONCLUSION

Our findings provide new evidence that the process of intergenerational educational mobility is associated with individuals' likelihood of smoking and that this effect cannot be explained by conventional covariates of smoking.

Coping with healthcare costs for chronic illness in low-income and middle-income countries: a systematic literature review

BACKGROUND

Experiencing illness in low-income and middle-income countries (LMICs) can incur very high out-of-pocket (OOP) payments for healthcare and, while the existing literature typically focuses on levels of expenditure, it rarely examines what happens when households do not have the necessary money. Some will adopt one or more 'coping strategies', such as borrowing money, perhaps at exorbitant interest rates, or selling assets, some necessary for their future income, with detrimental long-term effects. This is particularly relevant for chronic illnesses that require consistent, long-term OOP payments. We systematically review the literature on strategies for financing OOP costs of chronic illnesses in LMICs, their correlates and their impacts on households.

METHODS

We searched MEDLINE, EconLit, EMBASE, Global Health and Scopus on 22 October 2018 for literature published on or after 1 January 2000. We included qualitative or quantitative studies describing at least one coping strategy for chronic illness OOP payments in a LMIC context. Our narrative review follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines.

RESULTS

Forty-seven papers were included. Studies identified coping strategies for chronic illness costs that are not traditionally addressed in financial risk protection research (eg, taking children out of school, sending them to work, reducing expenditure on food or education, quitting work to give care). Twenty studies reported socioeconomic or other correlates of coping strategies, with poorer households and those with more advanced disease more vulnerable to detrimental strategies. Only six studies (three cross-sectional and three qualitative) included evidence of impacts of coping strategies on households, including increased labour to repay debts and discontinuing treatment.

CONCLUSIONS

Monitoring of financial risk protection provides an incomplete picture if it fails to capture the effect of coping strategies. This will require qualitative and longitudinal research to understand the long-term effects, especially those associated with chronic illness in LMICs.

Intergenerational Educational Pathways and Self-Rated Health in Adolescence and Young Adulthood: Results of the German KiGGS Cohort

Health differences in social mobility are often analysed by income differences or different occupational positions. However, in early adulthood many young people still have very diffuse income situations and are not always fully integrated into the labour market despite many having finished school. This article focusses on the link between intergenerational educational pathways and self-rated health (SRH) among young adults considering their SRH in adolescence. The data source used is the German KiGGS cohort study. The analysis sample comprises 2175 young people at baseline (t0: 2003⁻2006 age 14⁻17) and first follow-up (t1: 2009⁻2012 age 19⁻24). Combining parent's and young people's highest school degree, the data can trace patterns of intergenerational educational pathways (constant high level of education, upward mobility, downward mobility, constant low level of education). Young people's SRH was recorded at t0 and t1. During adolescence and young adulthood, participants were less likely to report poor SRH if they had a constant high intergenerational education or if they were upwardly mobile. The differences were particularly striking among young adults: average marginal effects (AME) for poor SRH showed much higher risk among downwardly mobile compared to peers with an intergenerational constant high education (AME: 0.175 [0.099; 0.251]), while the upwardly mobile had a significantly lower risk for less than good SRH than peers with an intergenerational constant low level of education (AME: -0.058 [-0.113; -0.004]). In the context of great societal demands and personal developmental needs, educational differences in health tend to increase in young adulthood. Public Health should pay more attention to educational and health inequalities in young adulthood.

Intergenerational social mobility and allostatic load in Great Britain

BACKGROUND

Intergenerational social mobility is hypothesised to be a stressful process that has a negative effect on health. By examining the relationship between own socioeconomic position, parental socioeconomic position and allostatic load (AL) in a representative sample of the British population, we test this hypothesis.

METHODS

Our study uses cross-sectional data from 9851 adult participants of waves 2 and 3 of Understanding Society. The relationship between parental occupational class at age 14 years, respondents' social class at the time of the interview and AL is explored by means of diagonal reference models, which allow us to disentangle the effects of parental social class, own social class and the mobility process. The AL score comprises the following biomarkers: (1) total cholesterol, (2) high-density lipoprotein cholesterol, (3) triglycerides, (4) glycated haemoglobin, (5) C-reactive protein, (6) fibrinogen, (7) systolic blood pressure, (8) diastolic blood pressure, (9) resting heart rate, (10) body mass index and (11) waist circumference.

RESULTS

AL is particularly high among the stable working class and low among the stable upper class. On average, current class and origin class exert about equal weight on current AL. However, social mobility-regardless of whether upwards or downwards-is not detrimental for AL. Furthermore, we find evidence that class of origin may be less important among those outside the labour market for reasons other than retirement.

CONCLUSION

Both own social class and parental social class influence AL to a similar extent. However, we find no evidence that mobility trajectories exert any effects, good or bad, on AL.

Parental transmission of smoking among middle-aged and older populations in Russia and Belarus

OBJECTIVES

The very high rates of smoking among men and the rapid changes among women in the Post-Soviet countries mean that this region offers an opportunity to understand better the intergenerational role of parental influences on smoking.

METHODS

In this study, we exploit a unique data set, the PrivMort cohort study conducted in 30 Russian and 20 Belarusian towns in 2014-2015, which collects information on behaviours of middle-aged and older individuals and their parents, including smoking. We explored the associations between smoking by parents and their offspring using multiply imputed data sets and multilevel mixed-effect Poisson regressions.

RESULTS

Adjusting for a wide array of social origin, socio-demographic, and socio-economic variables, our analysis suggests that sons of regularly smoking fathers have prevalence ratios of 1.35 [95% confidence intervals (CI) 1.21-1.50] and 1.39 (CI 1.23-1.58) of smoking, while the figures for daughters of regularly smoking mothers are 1.91 (CI 1.40-2.61) and 2.30 (CI 1.61-3.28), respectively, in Russia and Belarus.

CONCLUSIONS

Intergenerational paternal and maternal influences on smoking should be taken into account in studies seeking to monitor the rates of smoking and the impact of tobacco control programmes.