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Yu YL. Current Marital Status and Epigenetic Clocks Among Older Adults in the United States: Evidence From the Health and Retirement Study. J Aging Health 2023; 35:71-82. [PMID: 35609241 DOI: 10.1177/08982643221104928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objectives: This study examines how current marital status is associated with epigenetic aging. Methods: Data from the 2016 Health and Retirement Study were used to examine marital status differences in the four epigenetic clocks, that is, GrimAge, DunedinPoAm, PhenoAge, and Zhang (N = 3765). Weighted ordinary least square regression models were estimated separately for men and women. Results: Remarried, cohabiting, divorced/separated and widowed older adults showed greater epigenetic aging than the continuously married similarly among men and women. Distinct sex difference was observed among the never married. While never-married women exhibited greater epigenetic aging than their continuously married counterparts, older men in lifelong singlehood showed comparable epigenetic aging to their continuously married peers. Discussion: The findings speak to the importance of marital context for epigenetic aging in later life and the biological risk associated with lifelong singlehood for older women in the US.
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Affiliation(s)
- Yan-Liang Yu
- Department of Sociology and Criminology, 8369Howard University, Washington, DC, USA
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Hong SK, Choe S, Yi NJ, Shin A, Choe EK, Yoon KC, Lee KW, Suh KS. Long-term Survival of 10,116 Korean Live Liver Donors. Ann Surg 2021; 274:375-382. [PMID: 31850982 DOI: 10.1097/sla.0000000000003752] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the long-term mortality of Korean live liver donors using data from a national donor registry by comparing it with the mortality of the general population. SUMMARY OF BACKGROUND DATA Although live liver donors generally have a healthy status, their long-term mortality has not been properly addressed in a large donor registry. METHODS Data of 10,116 live liver donors were drawn from a mandated national registry of Korean live liver donors between 2000 and 2015. Matched controls were selected from the Korean National Health Insurance System-National Sample Cohort (NHIS-NSC). Median (range) follow-up of liver donors was 5.7 (0-15.9) years. Donors were 1:3 individually matched to controls by sex and 5-year age group; potential controls were from the whole NHIS-NSC (Control 1) or from NHIS-NSC after excluding people with contraindications to be organ donors (Control 2) (donor, n = 7538; Control 1, n = 28,248; Control 2, n = 28,248). RESULTS Fifty-three deaths occurred after donation. Ten-year cumulative mortality of live liver donors was 0.9%. The most common cause of death was suicide (n = 19) followed by cancer (n = 9) and traffic accident (n = 7). In the matched control analysis, overall risk of death was significantly lower in donors than in Control 1 (P < 0.001), but higher than in Control 2 (P < 0.001). CONCLUSIONS Liver donors have increased long-term mortality risk compared to similar healthy controls without contraindications to be organ donors. Therefore, long-term follow-up, including psychosocial support, is needed for live liver donors.
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Affiliation(s)
- Suk Kyun Hong
- Department of Surgery, Seoul National University College of Medicine
| | - Sunho Choe
- Department of Preventive Medicine, Seoul National University College of Medicine
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University College of Medicine
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine
| | - Eun Kyung Choe
- Department of Surgery, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center
| | - Kyung Chul Yoon
- Department of Surgery, Division of HBP Surgery & Liver Transplantation, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Kwang-Woong Lee
- Department of Surgery, Seoul National University College of Medicine
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University College of Medicine
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Partnership and mortality in mid and late life: Protection or selection? Soc Sci Med 2021; 279:113971. [PMID: 33984691 DOI: 10.1016/j.socscimed.2021.113971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/21/2021] [Accepted: 04/24/2021] [Indexed: 11/22/2022]
Abstract
The main goal of this paper is to address how different partnership statuses impact the likelihood of death among mature adults and elderly persons in Spain circa 2012 using a massive new dataset of administrative registers linked to census data. First, gross and net effects of having a partner on mortality risks of partnered and non-partnered persons are evaluated; then the characteristics and the importance of selection and protection effects of marriage and partnership with regard to the likelihood of death are assessed. We make use of exact matching methods in order to avoid the selection bias associated with the non-random assignment of persons to different partnership statuses. Protection effects decline gradually with age, but always remain positive. Selection effects show a far more pronounced decline with age leading to a pattern in which selection is much stronger than protection during the mature adult ages, but then disappear entirely and even become negative as people age. While both sexes show similar patterns, the protection effect is slightly higher among men while the selection effect is much higher among women, especially before 65 years of age.
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Gray divorce and mental health in the United Kingdom. Soc Sci Med 2020; 256:113030. [DOI: 10.1016/j.socscimed.2020.113030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 01/07/2023]
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Gender Differences in Vulnerability to Socioeconomic Status on Self-Rated Health in 15 Countries. WOMEN’S HEALTH BULLETIN 2017. [DOI: 10.5812/whb.45280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Gender Differences in Vulnerability to Socioeconomic Status on Self-Rated Health in 15 Countries. WOMEN’S HEALTH BULLETIN 2017. [DOI: 10.5812/whb-45280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Murrell SA, Salsman NL, Meeks S. Positive and Negative Psychological States and Economic Status as Mediators of the Relationship of Education to Fatigue Among Older Adults. Res Aging 2016. [DOI: 10.1177/0164027504268490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective was to examine psychological and economic variables as differential mediators of the relationship of education to fatigue-related aspects of health. A probability sample of 1,175 older adults (aged 55+) were interviewed three times at 6-month intervals. Multiple regression was used to estimate mediation effects. The psychological measures had relatively stronger mediating effects on high fatigue symptoms than on low fatigue symptoms and had stronger effects on high fatigue than did economic mediators. Education contributions to fatigue appear to operate through both economic and psychological resources. Calmness (“peace of mind”) showed particular promise as a mediator. Positive psychological states appeared to have mediating effects independent of the effects of negative states. Findings suggest that different types of mediators may have differential effects for different aspects of health.
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Assari S, Lankarani MM. Does Multi-morbidity Mediate the Effect of Socioeconomics on Self-rated Health? Cross-country Differences. Int J Prev Med 2015; 6:85. [PMID: 26445632 PMCID: PMC4587073 DOI: 10.4103/2008-7802.164413] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 01/03/2015] [Indexed: 11/04/2022] Open
Abstract
Background: This study explored cross-country differences in how multi-morbidity explains the effects of socioeconomic characteristics on self-rated health. Methods: The study borrowed data from the Research on Early Life and Aging Trends and Effects. Participants were 44,530 individuals (age > 65 years) who were sampled from 15 countries (i.e. United States, China, India, Russia, Costa Rica, Puerto Rico, Mexico, Argentina, Barbados, Brazil, Chile, Cuba, Uruguay, Ghana and South Africa). Multi-morbidity was measured as number of chronic medical conditions. In Model I, main effects of socioeconomic factors on self-rated health were calculated using country-specific logistic regressions. In Model II, number of chronic conditions were also added to the models to find changes in coefficients for demographic and socioeconomic factors. Results: In the United States, number of chronic medical conditions explained the effect of income on subjective health. In Puerto Rico, number of chronic medical conditions explained the effect of marital status on subjective health. In Costa Rica, Argentina, Barbados, Cuba, and Uruguay, number of chronic medical conditions explained gender disparities in subjective health. In China, Mexico, Brazil, Russia, Chile, India, Ghana and South Africa, number of chronic medical conditions did not explain the effect of demographic or socioeconomic factors on subjective health. Conclusions: Multi-morbidity explains the effect of demographic and socioeconomic factors on subjective health in some but not other countries. Further research is needed.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Michigan, USA ; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Michigan, USA
| | - Maryam Moghani Lankarani
- Department of Psychiatry, School of Medicine, University of Michigan, Michigan, USA ; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Michigan, USA
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Kim JH, Park EC, Yeom H, Kwon JA, Lee SG. Effects of Offspring-Related Characteristics on Depressive Disorder among Cancer Patients and Survivors. Asian Pac J Cancer Prev 2015; 16:4531-6. [DOI: 10.7314/apjcp.2015.16.11.4531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Zhang YJ, Fan YG, Dai SY, Li BZ, Xu WD, Hu LF, Liu J, Su H, Ye DQ. HIV/AIDS stigma among older PLWHA in south rural China. Int J Nurs Pract 2014; 21:221-8. [DOI: 10.1111/ijn.12254] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Yu-Jing Zhang
- Department of Epidemiology and Biostatistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis; Anhui Medical University; Hefei Anhui China
| | - Yin-Guang Fan
- Department of Epidemiology and Biostatistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis; Anhui Medical University; Hefei Anhui China
| | - Se-Ying Dai
- Department of Epidemiology and Biostatistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis; Anhui Medical University; Hefei Anhui China
| | - Bao-Zhu Li
- Department of Epidemiology and Biostatistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis; Anhui Medical University; Hefei Anhui China
| | - Wang-Dong Xu
- Department of Epidemiology and Biostatistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis; Anhui Medical University; Hefei Anhui China
| | - Lin-Feng Hu
- Department of Epidemiology and Biostatistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis; Anhui Medical University; Hefei Anhui China
| | - Juan Liu
- Department of Epidemiology and Biostatistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis; Anhui Medical University; Hefei Anhui China
| | - Hong Su
- Department of Epidemiology and Biostatistics; School of Public Health; Anhui Medical University; Hefei Anhui China
| | - Dong-Qing Ye
- Department of Epidemiology and Biostatistics; School of Public Health; Anhui Medical University; Hefei Anhui China
- Anhui Provincial Laboratory of Population Health & Major Disease Screening and Diagnosis; Anhui Medical University; Hefei Anhui China
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Shirangi A, Fritschi L, Holman CDJ, Morrison D. Mental health in female veterinarians: effects of working hours and having children. Aust Vet J 2013; 91:123-30. [PMID: 23521096 DOI: 10.1111/avj.12037] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Personal, interpersonal and organisational factors have been suggested as possible causes of stress, anxiety and depression for veterinarians. We used established psychological scales to measure (1) levels of distress and work-related stress (anxiety and depression) and (2) the demographic and work characteristics of female veterinarians in relation to anxiety, depression and mental health. METHODS A national cross-sectional survey of a cohort population was conducted and self-administered questionnaires were received from 1017 female veterinarians who completed the mental health section of the survey. Using linear and logistic regression analyses, we examined demographic and work-related factors associated with overall stress measured by the General Health Questionnaire scale and the Affective Well-Being scale (Anxiety-Contentment Axis and Depression-Enthusiasm Axis). RESULTS More than one-third (37%) of the sample was suffering 'minor psychological distress', suggesting the stressful nature of veterinary practice. Women with two or more children had less anxiety and depression compared with those who had never been pregnant or were childless. Longer working hours were associated with increased anxiety and depression in female veterinarians overall and in stratified samples of women with and without children. CONCLUSION Among the work characteristics of veterinary practice, long working hours may have a direct effect on a veterinarian's health in terms of anxiety, depression and mental health. The finding also indicates that women with two or more children have less anxiety and depression than women who have never been pregnant or childless women.
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Affiliation(s)
- A Shirangi
- School of Population Health, Faculty of Medicine and Dentistry, The University of Western Australia, Crawley, Western Australia, 6009, Australia.
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Robards J, Evandrou M, Falkingham J, Vlachantoni A. Marital status, health and mortality. Maturitas 2012; 73:295-9. [PMID: 23007006 PMCID: PMC3635122 DOI: 10.1016/j.maturitas.2012.08.007] [Citation(s) in RCA: 195] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 08/13/2012] [Indexed: 11/06/2022]
Abstract
Marital status and living arrangements, along with changes in these in mid-life and older ages, have implications for an individual's health and mortality. Literature on health and mortality by marital status has consistently identified that unmarried individuals generally report poorer health and have a higher mortality risk than their married counterparts, with men being particularly affected in this respect. With evidence of increasing changes in partnership and living arrangements in older ages, with rising divorce amongst younger cohorts offsetting the lower risk of widowhood, it is important to consider the implications of such changes for health in later life. Within research which has examined changes in marital status and living arrangements in later life a key distinction has been between work using cross-sectional data and that which has used longitudinal data. In this context, two key debates have been the focus of research; firstly, research pointing to a possible selection of less healthy individuals into singlehood, separation or divorce, while the second debate relates to the extent to which an individual's transitions earlier in the life course in terms of marital status and living arrangements have a differential impact on their health and mortality compared with transitions over shorter time periods. After reviewing the relevant literature, this paper argues that in order to fully account for changes in living arrangements as a determinant of health and mortality transitions, future research will increasingly need to consider a longer perspective and take into account transitions in living arrangements throughout an individual's life course rather than simply focussing at one stage of the life course.
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Affiliation(s)
- James Robards
- EPSRC Care Life Cycle, Social Sciences, University of Southampton, Southampton, UK.
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Song L, Li S, Feldman MW. Out-migration of Young Adults and Gender Division of Intergenerational Support in Rural China. Res Aging 2012; 34:399-424. [PMID: 29353946 DOI: 10.1177/0164027511436321] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Using data from the baseline and follow-up surveys of "Well-being of Elderly in Anhui Province, China" conducted in 2001, in 2003 and in 2006, respectively, by the Institute for Population and Development Studies of Xi'an Jiaotong University, this paper employs random effects models to explore the gender division of intergenerational support in the elderly rural families. Analyses by parents' and children's gender suggest that there are gender differences in intergenerational support because of gender roles and division in family. Our analysis shows that older mothers receive more returns, which reciprocates their support, while older fathers benefit more from the out-migration of adult children. While sons take more responsibility for family support, daughters reciprocate support from their elderly parents more. Enhancement of the role and function of daughters in families has accompanied out-migration of young adults and suggests that gender differences in intergenerational supports between sons and daughters have decreased.
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Affiliation(s)
- Lu Song
- School of Social Science, Soochow University, Suzhou, Jiangsu Province, 215123, China
| | - Shuzhuo Li
- Institute for Population and Development Studies, Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710049, China
| | - Marcus W Feldman
- Morrison Institute for Population and Resource Studies, Stanford University, Stanford, CA 94305, USA
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Tamambang L, Auger N, Lo E, Raynault MF. Measurement of gender inequality in neighbourhoods of Québec, Canada. Int J Equity Health 2011; 10:52. [PMID: 22087586 PMCID: PMC3239849 DOI: 10.1186/1475-9276-10-52] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 11/16/2011] [Indexed: 11/10/2022] Open
Abstract
Introduction Few studies have measured gender inequality at levels lower than the country. We sought to develop neighbourhood indicators of gender inequality, and assess their ability to capture variability in gender inequality across Québec, Canada. Methods Aggregate 2001 census data for 11,564 neighbourhoods were obtained for men and women. Twelve indicators of gender inequality representing demographic/household characteristics, education, income, work/leisure, and political participation were selected. Neighbourhood-level gender inequality scores were computed for each indicator, and examined across parts of Québec (metropolitan areas, mid-sized cities, rural areas). Monte Carlo simulations were used to assess the ability of indicators to capture heterogeneity in gender inequality across neighbourhoods. Results Male-dominant neighbourhood-level gender inequality tended to be present for average employment income, labour force participation, employment rate, and employment in managerial positions. Female-dominant gender inequality tended to be present for divorce, single-headed households, and participation in unpaid housework, child and elderly care. Neighbourhood-level gender inequality tended to vary across metropolitan areas, mid-sized cities, and rural areas. Gender inequality scores also varied within these geographic areas. For example, there was greater income-related gender inequality in high than low income neighbourhoods. Monte Carlo simulations suggested that the variation in gender inequality across neighbourhoods was greater than expected with chance alone. Conclusion Neighbourhood-level gender inequality tended to be present in Québec, and varied across parts of the province. Greater awareness of and research on neighbourhood-level gender inequality may be warranted to inform gender policies in Québec and other nations.
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Affiliation(s)
- Lum Tamambang
- Department of Social and Preventive Medicine, University of Montréal, 1420 boulevard Mont-Royal, Montréal, Québec H2V 4P3, Canada.
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Va P, Yang WS, Nechuta S, Chow WH, Cai H, Yang G, Gao S, Gao YT, Zheng W, Shu XO, Xiang YB. Marital status and mortality among middle age and elderly men and women in urban Shanghai. PLoS One 2011; 6:e26600. [PMID: 22073174 PMCID: PMC3206811 DOI: 10.1371/journal.pone.0026600] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 09/29/2011] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Previous studies have suggested that marital status is associated with mortality, but few studies have been conducted in China where increasing aging population and divorce rates may have major impact on health and total mortality. METHODS We examined the association of marital status with mortality using data from the Shanghai Women's Health Study (1996-2009) and Shanghai Men's Health Study (2002-2009), two population-based cohort studies of 74,942 women aged 40-70 years and 61,500 men aged 40-74 years at the study enrollment. Deaths were identified by biennial home visits and record linkage with the vital statistics registry. Marital status was categorized as married, never married, divorced, widowed, and all unmarried categories combined. Cox regression models were used to derive hazard ratios (HR) and 95% confidence interval (CI). RESULTS Unmarried and widowed women had an increased all-cause HR = 1.11, 95% CI: 1.03, 1.21 and HR = 1.10, 95% CI: 1.02, 1.20 respectively) and cancer (HR = 1.17, 95% CI: 1.04, 1.32 and HR = 1.18, 95% CI: 1.04, 1.34 respectively) mortality. Never married women had excess all-cause mortality (HR = 1.46, 95% CI: 1.03, 2.09). Divorce was associated with elevated cardiovascular disease (CVD) mortality in women (HR = 1.47, 95% CI: 1.01, 2.13) and elevated all-cause mortality (HR = 2.45, 95% CI: 1.55, 3.86) in men. Amongst men, not being married was associated with excess all-cause (HR = 1.45, 95% CI: 1.12, 1.88) and CVD (HR = 1.65, 95% CI: 1.07, 2.54) mortality. CONCLUSIONS Marriage is associated with decreased all cause mortality and CVD mortality, in particular, among both Chinese men and women.
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Affiliation(s)
- Puthiery Va
- University of New England College of Osteopathic Medicine, Biddeford, Maine, United States of America
| | - Wan-Shui Yang
- State Key Laboratory of Oncogene and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Sarah Nechuta
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Wong-Ho Chow
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, United States of America
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Shan Gao
- State Key Laboratory of Oncogene and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Yong-Bing Xiang
- State Key Laboratory of Oncogene and Related Genes, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Windsor TD, Fiori KL, Crisp DA. Personal and neighborhood resources, future time perspective, and social relations in middle and older adulthood. J Gerontol B Psychol Sci Soc Sci 2011; 67:423-31. [PMID: 22042763 DOI: 10.1093/geronb/gbr117] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Aging-related changes in motivation and the availability of resources have been hypothesized to result in social network changes in later life. However, few studies have examined associations of both motivation and resources with different aspects of social network composition in the same analytical context. The present study examined associations of key motivational (future time perspective [FTP]) and resource variables (partner status, physical health, and perceived neighborhood cohesion) with social network size and positive and negative social exchanges. METHOD A population-based sample of midlife (aged 55-59 years, n = 169) young-old (aged 60-74 years, n = 306) and old-old (aged 75+ years, n = 77) adults completed a questionnaire. RESULTS Those who were partnered reported larger networks with family, whereas never-married individuals reported larger networks with neighbors. Perceived neighborhood cohesion was related to larger networks with family, neighbors, and friends. Open-ended FTP was associated with larger networks of friends and more frequent positive social exchanges. DISCUSSION Our results point to FTP and resources having different implications for social engagement across network domains.
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Affiliation(s)
- Tim D Windsor
- School of Psychology, Flinders University, Australia.
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Abstract
Abstract
The theory that marriage has protective effects for survival has itself lived for more than 100 years since Durkheim’s groundbreaking study of suicide (Durkheim 1951 [1897]). Investigations of differences in this protective effect by gender, by age, and in contrast to different unmarried statuses, however, have yielded inconsistent conclusions. These investigations typically either use data in which marital status and other covariates are observed in cross-sectional surveys up to 10 years before mortality exposure, or use data from panel surveys with much smaller sample sizes. Their conclusions are usually not based on formal statistical tests of contrasts between men and women or between never-married, divorced/separated, and widowed statuses. Using large-scale pooled panel survey data linked to death registrations and earnings histories for U.S. men and women aged 25 and older, and with appropriate contrast tests, we find a consistent survival advantage for married over unmarried men and women, and an additional survival “premium” for married men. We find little evidence of mortality differences between never-married, divorced/separated, and widowed statuses.
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Bourne PA, Charles CA, McGrowder DA. Ill-males in an English-speaking Caribbean society. JOURNAL OF MEN'S HEALTH 2011. [DOI: 10.1016/j.jomh.2010.09.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Sprehn GC, Chambers JE, Saykin AJ, Konski A, Johnstone PAS. Decreased cancer survival in individuals separated at time of diagnosis: critical period for cancer pathophysiology? Cancer 2009; 115:5108-16. [PMID: 19705348 DOI: 10.1002/cncr.24547] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND : It long has been recognized that married patients have improved cancer survival when compared with unmarried patients. This has been postulated as being due to increased support, potentially leading to better compliance with therapy. Conversely, some data exist pointing to a relationship between marital discord and decreased immunity. We examined whether unmarried patients have a different prognosis by whether they are 1) never married, 2) divorced, 3) widowed, or 4) separated at time of diagnosis. METHODS : The public access data of the Surveillance, Epidemiology and End Results (SEER) registry were queried for cancer survival across all 17 registries between 1973 and 2004. SEER last updated data in April 2007. Records of 3.79 million patients were included in the analysis. We specifically analyzed 5-year and 10-year relative survival (RS; 5yRS, 10yRS), defined as observed survival divided by observed survival of an age-matched, race-matched, and gender-matched population without disease, for all cancer patients by marital status, with specific subset analyses as indicated. RESULTS : Among unmarried patients, those separated at time of diagnosis had the lowest survival, followed by widowed, divorced, and never married patients. 5-year and 10-year RS of separated patients was 72% and 64% than that of married patients, respectively. This relationship persists when data are analyzed by gender. CONCLUSIONS : Separated marital status is associated with a significant decrement in cancer survival, even in comparison with other unmarried groups. While other socioeconomic variables could contribute to this phenomenon, further research into the immunologic correlates of the acutely stressful condition of marital separation should be conducted. Cancer 2009. (c) 2009 American Cancer Society.
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Affiliation(s)
- Gwen C Sprehn
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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Fothergill KE, Ensminger ME, Green KM, Thorpe RJ, Robertson J, Kasper JD, Juon HS. Living Arrangements during Childrearing Years and Later Health of African American Mothers. JOURNAL OF MARRIAGE AND THE FAMILY 2009; 71:848-861. [PMID: 20228963 PMCID: PMC2836726 DOI: 10.1111/j.1741-3737.2009.00639.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Using longitudinal data from the Woodlawn Project (N=680), this study examined how patterns of living arrangements among a community cohort of African American mothers were associated with later physical and emotional health. We identified eight patterns of stability and transition in living arrangements during the childrearing years. Health outcomes include SF-36 Physical Functioning, SF-36 Bodily Pain, depressed mood, and anxious mood. Specific patterns of living arrangements were related to later health, controlling for age, earlier health, education, and poverty. Poverty explained many, but not all, of the relationships between living arrangements and health. Findings underscored the benefits of social support and social integration and highlighted the negative effects of marital dissolution on health.
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Affiliation(s)
- Kate E Fothergill
- Johns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior, and Society, 624 North Broadway, Baltimore, MD 21205
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21
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Kposowa AJ, Breault KD. Motor Vehicle Deaths among Men: Marital Status, Gender and Social Integration. ACTA ACUST UNITED AC 2009. [DOI: 10.3149/jmh.0802.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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22
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A systematic literature review of studies analyzing the effect of sex, age, education, marital status, obesity, and smoking on health transitions. DEMOGRAPHIC RESEARCH 2009. [DOI: 10.4054/demres.2009.20.5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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McGovern P, Dowd B, Gjerdingen D, Dagher R, Ukestad L, McCaffrey D, Lundberg U. Mothers' health and work-related factors at 11 weeks postpartum. Ann Fam Med 2007; 5:519-27. [PMID: 18025489 PMCID: PMC2094033 DOI: 10.1370/afm.751] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Many new mothers return to work soon after childbirth. This study examines personal and work-related factors associated with the postpartum health of employed women 11 weeks after childbirth. METHODS Using a prospective cohort design, we recruited 817 Minnesota mothers into the study while they were hospitalized for childbirth in 2001. Telephone interviews were conducted at 5 and 11 weeks postpartum. Eligible women were 18 years or older, employed, and spoke English and gave birth to a singleton infant. Multivariate models using instrumental variables (2-stage least squares) were used to estimate personal and employment characteristics associated with women's physical and mental health and postpartum symptoms. RESULTS At 11 weeks postpartum, 661 participants (81% of enrollees) completed a full interview, and 50% of participants had returned to work. On average, women reported 4.1 (SD 3.2) childbirth-related symptoms, most frequently fatigue (43%). Factors significantly associated with better health outcomes included better preconception health, the absence of prenatal mood problems, more control over work and home activities, more social support at work and home, and less job stress. CONCLUSIONS The findings suggest postpartum women need to be evaluated regarding their fatigue levels and mental and physical symptoms. Women whose fatigue or postpartum symptoms limit daily role function may find it helpful to have health care clinicians counsel them on strategies to decrease job stress, increase social support at work and home, and certify their use of intermittent family and medical leave to help them manage their symptoms.
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Affiliation(s)
- Pat McGovern
- School of Public Health, University of Minnesota, Minneapolis, Minn, USA.
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Jaffe DH, Manor O, Eisenbach Z, Neumark YD. The Protective Effect of Marriage on Mortality in a Dynamic Society. Ann Epidemiol 2007; 17:540-7. [PMID: 17434751 DOI: 10.1016/j.annepidem.2006.12.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2006] [Revised: 12/27/2006] [Accepted: 12/27/2006] [Indexed: 11/19/2022]
Abstract
PURPOSE We sought to assess whether the protective effect of marriage on overall and cause-specific mortality has changed over time in a dynamic society. METHODS Data from the census-based Israel Longitudinal Studies (ILMS) I (1983-1992) and II (1995-2004) were analyzed. Cox proportional hazard modeling adjusting for sociodemographic factors was applied to 152,150 and 209,125 individuals, ages 45-89 years from the ILMS I and II, respectively. During each study period 31,749 (ILMS I) and 37,656 (ILMS II) deaths were reported. RESULTS Mortality inequalities by marital status remained significant and widened over time for middle-aged and elderly men and women. Changes in cause-specific mortality indicated a widening of cardiovascular disease mortality inequalities by marital status. An increasing trend was also noted for deaths from cancer (+25%) and other causes (+38%, p < 0.05) in middle-aged men, but not women (cancer = 0%; other causes = -3%). CONCLUSIONS The stronger beneficial effect of marriage over time may reflect societal changes that have differentially affected men and women.
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Affiliation(s)
- Dena H Jaffe
- Braun School of Public Health and Community Medicine, Hebrew University - Hadassah, Jerusalem, Israel.
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Abstract
According to previous studies, divorced individuals have increased risks of cancers related to alcohol and tobacco consumption and sexual habits, but the increases are balanced with decreased risks of many common cancers. In the present study, cancer risks were analyzed for 0-70-year-old offspring of divorced parents, on the basis the Swedish Family-Cancer Database with cancer data from the years 1958 to 2002. We calculated standardized incidence ratios for cancer among offspring of divorced parents (19,000 cancer patients) and compared them with offspring of stably married parents (121,000 cancer patients). Standardized incidence ratios were adjusted for many factors, including socio-economic status. Offspring of divorced parents were divided into groups depending on whether their mothers, fathers or both had had children with different partners. Offspring of divorced parents had an increased risk of upper aerodigestive tract, esophageal, anal, pancreatic, lung and cervical cancers. Decreased risks were noted for Hodgkin's disease and bone cancer. For Hodgkin's disease, the data suggest protective effects through early exposure to childhood pathogens but for bone cancer mechanisms remain to be established. The overall cancer risk for offspring of divorced parents was at or above unity. The results show that offspring of divorced parents have increased cancer risks at tobacco-related, alcohol-related and sex-related sites, in analogy to their parent, but they lack decreased risks at common sites, experienced by their parents. Divorce is becoming increasingly common in many countries and any deviant cancer patterns among offspring of divorced parents will have an impact on the population risk.
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Affiliation(s)
- Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Manzoli L, Villari P, M Pirone G, Boccia A. Marital status and mortality in the elderly: a systematic review and meta-analysis. Soc Sci Med 2006; 64:77-94. [PMID: 17011690 DOI: 10.1016/j.socscimed.2006.08.031] [Citation(s) in RCA: 338] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Indexed: 12/30/2022]
Abstract
Although a relationship between marital status and mortality has long been recognized, no summary estimates of the strength of the association are available. A meta-analysis of cohort studies was conducted to produce an overall estimate of the excess mortality associated with being unmarried in aged individuals as well as to evaluate whether and to what degree the effect of marriage differs with respect to gender, geographical/cultural context, type of non-married condition and study methodological quality. All included studies were published after the year 1994, used multivariate analyses and were written in English. Pooling 53 independent comparisons, consisting of more than 250,000 elderly subjects, the overall relative risk (RR) for married versus non-married individuals (including widowed, divorced/separated and never married) was 0.88 (95% Confidence Interval: 0.85-0.91). This estimate did not vary by gender, study quality, or between Europe and North America. Compared to married individuals, the widowed had a RR of death of 1.11 (1.08-1.14), divorced/separated 1.16 (1.09-1.23), never married 1.11 (1.07-1.15). Although some evidence of publication bias was found, the overall estimate of the effect of marriage was robust to several statistical approaches and sensitivity analyses. When the overall meta-analysis was repeated with an extremely conservative approach and including eight non-significant comparisons, which were initially excluded because of data unavailable, the marriage protective influence remained significant, although the effect size was reduced (RR=0.94; 0.92-0.95). Despite some methodological and conceptual limitations, these findings might be important to support health care providers in identifying individuals "at risk" and could be integrated into the current programs of mortality risk estimation for the elderly.
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Affiliation(s)
- Lamberto Manzoli
- Section of Epidemiology and Public Health, University G. d'Annunzio of Chieti, Italy.
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Conboy L, Patel S, Kaptchuk TJ, Gottlieb B, Eisenberg D, Acevedo-Garcia D. Sociodemographic determinants of the utilization of specific types of complementary and alternative medicine: an analysis based on a nationally representative survey sample. J Altern Complement Med 2006; 11:977-94. [PMID: 16398589 DOI: 10.1089/acm.2005.11.977] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To evaluate the relationships between selected sociodemographic factors and the use of particular types of complementary and alternative medicine (CAM) in the general U.S. population. CAMs make up a heterogeneous group of practices. Although it is well established that sociodemographic factors impact the use of conventional medicine, it is unclear which, if any, influence the use of particular types of CAM. DESIGN Data from a 1997-1998 nationally representative survey (n = 2055) was examined using descriptive and univariate analyses. RESULTS The impact of particular sociodemographic factors was found to vary by type of CAM considered. Whites used more CAM than non-Whites except in the case of prayer. Users of CAM tended to be better educated than nonusers with the exception of prayer, self-prayer, and use of a lay midwife. Women used more CAM than men, especially weight-change diet. CONCLUSIONS As with conventional medicine use, the patterns of CAM use vary by individual type of therapy considered. Analytically, grouping many heterogeneous practices into the CAM category hides important differences in use patterns.
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Affiliation(s)
- Lisa Conboy
- Osher Institute, Harvard Medical School, Boston, MA 02215, USA.
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Abstract
More older African American women are homeless, with this issue receiving little research attention. An exploratory study examined demographics and health characteristics of 100 women. Their mean age was 52.55 years (SD = 3.57) and ranged from 50 to 74 years. Most were unmarried, homeless more than three months, reported more than two diagnoses, and self-rated their health as fair or good. Length of time homeless did not significantly influence self-reported health. Medical diagnoses increased with time homeless, and rates of some chronic diseases were higher than domiciled African American elders 60 years of age and over Nearly half (48.5%) of women who were homeless more than 12 months reported emotional/mental illness.
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DesMeules M, Turner L, Cho R. Morbidity Experiences and Disability Among Canadian Women. BMC WOMENS HEALTH 2004; 4 Suppl 1:S10. [PMID: 15345073 PMCID: PMC2096699 DOI: 10.1186/1472-6874-4-s1-s10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Health Issue Women are more frequently affected by chronic conditions and disability than men. Although some of these sex differences have been in part attributed to biological susceptibility, social determinants of health and other factors, these gaps have not been fully explained in the current literature. This chapter presents comparisons of hospitalization rates, and the prevalence of chronic conditions and physical disability between Canadian women and men and between various subgroups of women, adjusting for selected risk factors. The Canadian Hospital Morbidity Database (2000–2001) and Canadian Community Health Survey (2000–2001) were used to examine inpatient hospital morbidity, prevalence of chronic conditions and disability. Key Findings Hospitalization rates were 20% higher among women than men. This was due to the large number of hospitalizations for pregnancies and childbirth. When "normal" deliveries were excluded, hospitalization rates remained higher among women. Women had slightly lower rates of hospitalizations for ambulatory-care sensitive conditions than men. Prevalence of activity limitation (mild and severe) was higher among women than men, and differences remained after adjusting for age, chronic conditions, socio-economic status, and smoking. Women who reported a disability were less likely than men to be in a partnered relationship, have less tangible social support, and have lower income and employment rates. Data Gaps and Recommendations The impact of morbidity and disability on Canadian women is substantial. These results identify areas for interventions among more vulnerable subgroups, and point to the need for further research in the area of risk factors for the prevention of morbidity and disability in the population.
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Affiliation(s)
- Marie DesMeules
- Centre for Chronic Disease Prevention and Control, Health Canada, 120 Colonnade Rd, Ottawa, Canada
| | - Linda Turner
- Canadian Institute for Health Information, Toronto, Canada
| | - Robert Cho
- Centre for Chronic Disease Prevention and Control, Health Canada, 120 Colonnade Rd, Ottawa, Canada
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Li X, Hemminki K. Cancer risks in men who had children with different partners from the Swedish Family-Cancer Database. Eur J Cancer Prev 2003; 12:355-8. [PMID: 14512798 DOI: 10.1097/00008469-200310000-00002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We used the nation-wide Swedish Family-Cancer Database to analyse cancer risks in men who had had children with more than one woman. Cancer cases were retrieved from the Swedish Cancer Registry from years 1961-1998. A total of 2.9 million men and 298,134 cancer cases were covered. For men having children with two, three or more women, increasing risk trends were shown for upper aerodigestive tract, lung, urinary bladder and oesophageal cancers. Decreasing trends were observed for tumours of the colon, skin (squamous cell and melanoma), nervous system and endocrine glands and against myeloma and non-Hodgkin's lymphoma. The present results indicated that men who had had children with multiple women showed an excess of smoking- and alcohol consumption-related cancers. The decreased risks for colon cancer, non-Hodgkin's lymphoma and melanoma were possibly related to lifestyle factors connected with economic deprivation, less obesity and physical fitness. These ill-defined protected factors may be a challenge to epidemiological studies.
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Affiliation(s)
- X Li
- Department of Biosciences at Novum, Karolinska Institute, 141 57 Huddinge, Sweden.
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31
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Affiliation(s)
- Kristi Williams
- Department of Sociology, The Ohio State University, Columbus, Ohio 43210, USA.
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Murrell SA, Meeks S. Psychological, economic, and social mediators of the education-health relationship in older adults. J Aging Health 2002; 14:527-50. [PMID: 12392025 DOI: 10.1177/089826402237182] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Mediators in the relationship of education to health were examined to further explicate education as a resource. METHODS Income, life satisfaction, services, and social support were assessed as mediators of the education-health relationship following criteria developed by Baron and Kenny and Holmbeck as applied to four aspects of health. A probability sample of 1,667 participants (age 55 and older) was interviewed in their homes. RESULTS Education was related to all health measures and to all mediators; all mediators were related to all health measures. Education continued to have significant relationships to all health measures after each mediator was entered, but its contribution was lower in each analysis. Life satisfaction was consistently a strong mediator. DISCUSSION Low-energy aspects of health may be more likely to be mediated by variables of a more psychological nature. Overall, educational attainment is a good investment for successful aging.
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Mishra GD, Ball K, Dobson AJ, Byles JE, Warner-Smith P. Which aspects of socio-economic status are related to health in mid-aged and older women? Int J Behav Med 2002; 9:263-85. [PMID: 12360841 DOI: 10.1207/s15327558ijbm0903_07] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A population-based study was conducted to validate gender- and age-specific indexes of socio-economic status (SES) and to investigate the associations between these indexes and a range of health outcomes in 2 age cohorts of women. Data from 11,637 women aged 45 to 50 and 9,510 women aged 70 to 75 were analyzed. Confirmatory factor analysis produced four domains of SES among the mid-aged cohort (employment, family unit, education, and migration) and four domains among the older cohort (family unit, income, education, and migration). Overall, the results supported the factor structures derived from another population-based study (Australian Bureau of Statistics, 1995), reinforcing the argument that SES domains differ across age groups. In general, the findings also supported the hypotheses that women with low SES would have poorer health outcomes than higher SES women, and that the magnitude of these effects would differ according to the specific SES domain and by age group, with fewer and smaller differences observed among older women. The main exception was that in the older cohort, the education domain was significantly associated with specific health conditions. Results suggest that relations between SES and health are highly complex and vary by age, SES domain, and the health outcome under study.
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Affiliation(s)
- Gita D Mishra
- School of Health Sciences, Deakin University, 221 Burwood Highway, Burwood VIC 3125, Australia
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McDonough P, Walters V, Strohschein L. Chronic stress and the social patterning of women's health in Canada. Soc Sci Med 2002; 54:767-82. [PMID: 11999492 DOI: 10.1016/s0277-9536(01)00108-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Existing research on the social patterning of women's health draws attention to the significance of social roles and socioeconomic position. Although we know a great deal about health differences according to the occupancy of these positions, we know a lot less about why such patterns exist. This paper addresses this gap by examining the pathways through which social structure is linked to health using data from a 1994 Canadian national probability sample of women, aged 25-64 years. We begin by charting differences in women's self-rated ill-health, distress, and reports of long-standing health conditions by socioeconomic position and social role occupation. We then assess the extent to which these patterns can be understood in relation to the chronic stress arising from these social locations. Socioeconomic position, assessed by housing tenure, education, and household income, was positively related to health. Employment enhanced women's health, as did being currently married and a mother living with children. The ongoing stressors that distinguish the experiences of various structural locations accounted for some of the health effects of social structure, particularly for socioeconomic position. However, chronic stress was largely irrelevant to the pathways linking social roles to health. In fact, employed women and parents living with children enjoyed better health despite their greater stress.
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Affiliation(s)
- Peggy McDonough
- Department of Sociology York University, Toronto, Ont, Canada.
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Gale L, Bennett PD, Tallon D, Brooks E, Munnoch K, Schreiber-Kounine C, Fowler C, Sammon A, Rayter Z, Farndon J, Vedhara K. Quality of partner relationship and emotional responses to a health threat. PSYCHOL HEALTH MED 2001. [DOI: 10.1080/13548500126534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
This study examines the impact of multiple roles and stressors on women of childbearing age, and compares the health status of women with and without children and their ability to access health care. Motherhood has many complex interactions with income level, availability of health insurance, and available social and income support. A cumulative burden of multiple stressors (eg, being poor, uninsured, less educated, employed full-time, or being a single mother) relates to worse health status, levels of depression, and opportunities for obtaining health care. Multiple stressors seem to have a stronger effect on mothers than on nonmothers. Research should focus on identifying vulnerable groups and combinations of stressors for women both with and without children, and how to mitigate adverse impacts on physical and mental health.
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Affiliation(s)
- A B Bernstein
- Development and Analysis Group, Division of Health Care Statistics, National Center for Health Statistics, Hyattsville, Maryland, USA
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Wilson SE. Socioeconomic status and the prevalence of health problems among married couples in late midlife. Am J Public Health 2001; 91:131-5. [PMID: 11189807 PMCID: PMC1446505 DOI: 10.2105/ajph.91.1.131] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study analyzed the association between socioeconomic status (SES) and the prevalence of mutually occurring health problems among married couples in late midlife. METHODS Data consisted of 4746 married couples aged 51 to 61 years from the 1992 US Health and Retirement Study. Two health measures were used: (1) self-assessed health status and (2) an index of functional limitations and activity restrictions. SES indicators were household income, education, and insurance coverage. RESULTS In general, after adjustment for age cohort, a strong association was found between the health of a married individual and the health of his or her spouse. SES was highly associated with the joint occurrence of health problems among marriage partners. CONCLUSIONS Public health policy should pay particular attention to the interaction between health, SES, and interpersonal relationships.
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Affiliation(s)
- S E Wilson
- Departments of Political Science and Economics, Brigham Young University, 732 SWKT, Provo, UT 84601, USA.
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Manor O, Eisenbach Z, Israeli A, Friedlander Y. Mortality differentials among women: the Israel Longitudinal Mortality Study. Soc Sci Med 2000; 51:1175-88. [PMID: 11037208 DOI: 10.1016/s0277-9536(00)00024-1] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The first aim of this study was to examine differentials in mortality among Israeli adult women with respect to ethnic origin, marital status, number of children and several measures of socio-economic status; the second was to compare mortality differentials among women with those found for Israeli men. Data are based on a linkage of records from a 20% sample of the 1983 census with the records of deaths occurring until the end of 1992. The study population includes 79,623 women and the number of deaths was 14,332. Measures of SES included education, number of rooms, household amenities and possession of a car. Results indicated higher mortality among women originating from North Africa compared with Asian and European women. Adjustment to SES eliminated the excess mortality among North African women and revealed a lower mortality of Asian women, relative to Europeans. Among women aged 45-69, substantial and consistent mortality differentials were evident for all SES indicators examined where mortality declined with improved socio-economic position. Mortality was related to women's childbearing history, with the highest mortality among childless women. Mortality differentials among women aged 70+ were generally narrower than those found for younger women. Gender differences in mortality differentials varied by the socio-demographic indicator and age.
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Affiliation(s)
- O Manor
- School of Public Health and Community Medicine, The Hebrew University-Hadassah Medical Organization, Ein Karem, Israel.
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Steptoe A, Lundwall K, Cropley M. Gender, family structure and cardiovascular activity during the working day and evening. Soc Sci Med 2000; 50:531-9. [PMID: 10641805 DOI: 10.1016/s0277-9536(99)00324-x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study applied psychophysiological methods to the investigation of social roles and well-being, using cardiovascular function over a working day and evening as an index of physiological activation. One hundred and sixty-two full-time school teachers (102 women and 60 men) were assessed using automated ambulatory blood pressure monitoring apparatus, with readings every 20 min through the working day (9.00 am-5.40 pm), and every 30 min in the evening (6.00-10.30 pm). The influence of gender, marital status and parenthood (defined as having at least one child living at home) on blood pressure during the working day and on day-evening differences was examined. There were no differences in blood pressure and heart rate across the working day in relation to marital roles or family structure. However, the decrease in blood pressure between working day and evening was greatest in parents, intermediate in married non-parents, and smallest in single participants without children. Differences in systolic pressure adjusted for age and body mass index averaged -4.46, -1.76 and +0.22 mmHg in the three groups, respectively. A similar pattern was observed for diastolic pressure but not heart rate. We also found that the day-evening fall in systolic pressure was moderated by social support, with the greatest change (mean adjusted difference -6.76 mmHg) in parents who reported high levels of social support. These blood pressure responses did not differ between men and women, and there was no indication of multiple role strain for full-time working mothers. The results were independent of concomitant physical activity, location during measurement, or reported job strain. We argue that findings are consistent with an enhancement model of multiple social roles, and with lower allostatic load on individuals who are working, married and parents. Psychophysiological studies of daily life can complement epidemiological and sociological investigations of social roles and health.
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Affiliation(s)
- A Steptoe
- Department of Psychology, St George's Hospital Medical School, London, UK.
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