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Taouk Y, Aitken Z, LaMontagne AD, King T. Persistent low job control and subsequent major depression: A prospective cohort study of Australian working males. Soc Sci Med 2024; 359:117283. [PMID: 39232379 DOI: 10.1016/j.socscimed.2024.117283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 08/27/2024] [Accepted: 08/29/2024] [Indexed: 09/06/2024]
Abstract
Workers' perception of control over work is a key construct in the relationship between the psychosocial work environment and health. While exposure to low job control has been prospectively linked to poor mental health including depression and anxiety, there is less research examining the impact of prolonged exposure to low job control on mental health. Data from 5054 employed men from 2013 to 2021 in the Australian Longitudinal Study on Male Health was used to examine persistent and intermittent low job control and subsequent major depression symptoms. Persistent low job control was based on consecutive self-reports of low job control over waves 1 and 2. Combinations of low and high job control were classified as intermittent exposure and continuous high job control exposure over both waves was classified as persistent high job control. Major depression symptoms, derived from the Patient Health Questionnaire-9, was measured in wave 3. Generalised linear models and augmented inverse probability weighting were undertaken. There was a strong stepwise relationship between low job control and major depression. Compared to persistent high job control, intermittent low job control was associated with an increased risk of subsequent major depression symptoms by 32% (RR 1.32, 95% CI 0.82, 2.15); and persistent low job control by 103% (RR 2.03, 95% CI 1.21, 3.41). Compared to men exposed to persistent high job control, the average treatment effect for persistent low job control was 0.036 (95%CI 0.014, 0.058) and intermittent low job control 0.019 (95%CI 0.006, 0.032) equating to a risk ratio of 2.46 (95%CI 1.43, 3.50) and 1.79 (95% CI 1.14, 2.45) respectively. This study's findings have implications for public health and occupational policies, as they underscore the importance of reducing prolonged exposure to low job control to protect against the risk of major depression in the working population.
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Affiliation(s)
- Yamna Taouk
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, 3010, Australia.
| | - Zoe Aitken
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Anthony D LaMontagne
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, 3010, Australia; Institute for Health Transformation, Deakin University, Burwood, Victoria, 3125, Australia
| | - Tania King
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, 3010, Australia
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O’Campo P, Gunn V, Perri M, Buhariwala P, Rasoulain E, Daneshvardfard M, Ma RW, Lewchuck W, Baron S, Bodin T, Muntaner C. Working Conditions, Worker Rights, and Managerial Domination During the COVID-19 Pandemic: Assessing Their Toll on Precariously Employed Workers and Family Well-Being. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2024; 54:233-246. [PMID: 38813773 PMCID: PMC11157980 DOI: 10.1177/27551938241253789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/01/2024] [Accepted: 02/28/2024] [Indexed: 05/31/2024]
Abstract
Precarious Employment (PE) is characterized by job, income, and benefit insecurities. Studies surrounding PE and well-being have been predominantly quantitative, leaving a gap in rich descriptions of employment experiences. We recruited a sample of 40 adults aged 25-55 who were involved in PE during the beginning of the COVID-19 pandemic or lost employment due to the pandemic. Semi-structured interviews were administered. Employment and income insecurities were common and had negative impacts on the well-being of participants and their families. Uncertainty about future employment prospects and job and income loss resulted in chronic distress. Other insecurities-access to benefits, violation of worker rights, worker safety-was also reported as impacting well-being. The COVID-19 pandemic deepened insecurities, hardships, and distress among workers with PE conditions. Given the myriad insecurities experienced by those engaged in PE, the focus of precarious work research should also include working conditions, violation of worker rights, and managerial domination.
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Affiliation(s)
- Patricia O’Campo
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Virginia Gunn
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Cape Breton University, Halifax, NS, Canada
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Melissa Perri
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Pearl Buhariwala
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Elham Rasoulain
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | | | - Rachel W Ma
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wayne Lewchuck
- Department of Economics and School of Labour Studies, McMaster University, Hamilton, ON, Canada
| | - Sherry Baron
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, NY, USA
| | - Theo Bodin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm Region, Stockholm, Sweden
| | - Carles Muntaner
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Lawrence S. Bloomberg School of Nursing, University of Toronto, Toronto, ON, Canada
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Hernandez SM, Halpern CT, Conron KJ. Sexual orientation, gender expression and socioeconomic status in the National Longitudinal Study of Adolescent to Adult Health. J Epidemiol Community Health 2023; 78:jech-2022-220164. [PMID: 38053260 PMCID: PMC10850725 DOI: 10.1136/jech-2022-220164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 10/17/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Socioeconomic status (SES) is a fundamental contributor to health, yet it is rarely examined relative to gender expression, particularly gender non-conformity and sexual orientation. METHODS We use data from 11 242 Wave V respondents (aged 33-44) in the National Longitudinal Study of Adolescent to Adult Health (2016-2018) to examine associations between socially assigned gender expression, sexual orientation and SES, in logistic and multinomial regression models stratified by sex assigned at birth. RESULTS Among both women and men a general pattern of heightened risk for lower SES among gender non-conforming sexual minorities relative to gender conforming heterosexuals was observed. Gender non-conforming heterosexuals were also at elevated risk of lower SES compared with their conforming heterosexual peers. CONCLUSION Socioeconomic differences by sexual orientation and gender expression have important implications for understanding health disparities among gender non-conforming sexual minorities and their gender conforming heterosexual counterparts.
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Affiliation(s)
- Stephanie M Hernandez
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Carolyn T Halpern
- Department of Maternal & Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kerith J Conron
- The Williams Institute, University of California School of Law, Los Angeles, California, USA
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Muntaner C, Benach J. Tribute to Barbara Ehrenreich: Fighting for Labor Through Critical Research Journalism. INTERNATIONAL JOURNAL OF SOCIAL DETERMINANTS OF HEALTH AND HEALTH SERVICES 2023; 53:568-569. [PMID: 37872664 PMCID: PMC10631257 DOI: 10.1177/27551938231208339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 10/25/2023]
Abstract
This is a short commentary to accompany the article "Hospital Workers: Class Conflicts in the Making" by Barbara Ehrenreich and John H. Ehrenreich. The article was originally published in the International Journal of Health Services in 1975. We are revisiting it in the current issue of the International Journal of Social Determinants of Health and Health Services due to its continued relevance and significance in the twenty-first Century.
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Affiliation(s)
- Carles Muntaner
- Public Health, Nursing & Psychiatry, University of Toronto, Toronto, Canada
| | - Joan Benach
- Research Group on Health Inequalities, Environment and Employment Conditions, Universitat Pompeu Fabra, Barcelona, Spain
- Johns Hopkins University-Universitat Pompeu Fabra Public Policy Center (UPF-BSM), Barcelona, Spain
- Ecological Humanities Research Group (GHECO), Universidad Autónoma de Madrid, Madrid, Spain
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Gonzalez-Casals H, Vives J, Bosque-Prous M, Folch C, Drou-Roget G, Muntaner C, Vives-Cases C, Barbaglia MG, Colom J, Espelt A. Gender inequalities in the prevalence of low mood and related factors in schooled adolescents during the 2019-2020 school year: DESKcohort project. J Affect Disord 2023; 333:305-312. [PMID: 37084966 DOI: 10.1016/j.jad.2023.04.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/03/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Mood disorders are the second most prevalent mental disorders in childhood and adolescence. Many undiagnosed people manifest subthreshold symptoms, like low mood, and present worse prognoses than asymptomatic healthy subjects. The aim of this study was to estimate the prevalence of low mood, gender inequalities, and associated factors, in 12- to 18-year-old adolescents in the rural and medium-sized urban areas of Central Catalonia during the 2019-2020 academic year. METHODS Cross-sectional study with data from a cohort of high-schooled students (2019-2020), with a convenience sample of 6428 adolescents from the Central region of Catalonia (48.3 % boys and 51.7 % girls). Prevalence of low mood was estimated by gender and exposure variables, and ratios were obtained using Poisson regression models, adjusting for several exposure variables one by one, and for all of them jointly. RESULTS The prevalence of low mood was 18.6 %, with statistically significant differences between genders (11.6 %, 95 % CI: 10.5-12.8 in boys and 25.1 %, 95 % CI: 23.7-26.6 in girls). Being an immigrant, dieting, and daily tobacco smoking were only associated with low mood in girls, whereas risky alcohol consumption was only associated in boys. Sexual violence was found to account for 36.2 % of low mood problems in girls. LIMITATIONS The main limitation of the study is its cross-sectional design, which means that no casual relationships can be extracted of this study. CONCLUSIONS The prevalence of low mood varies between the sexes, highlighting the importance of developing gender-specific interventions to reduce its incidence in young people, considering the factors associated with this condition.
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Affiliation(s)
- Helena Gonzalez-Casals
- Department of Epidemiology and Methodology of Social and Health Sciences, Faculty of Health Sciences of Manresa, Universitat de Vic - Universitat Central de Catalunya (UVic-UCC), Av. Universitària, 4-6, 08242 Manresa, Spain
| | - Jaume Vives
- Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona (UAB), C/de Ca n'Altayó, s/n, 08193 Bellaterra, Spain
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou, 156, 08018 Barcelona, Spain; Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona (UAB), C/de Ca n'Altayó, s/n, 08193 Bellaterra, Spain.
| | - Cinta Folch
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Carretera de Canyet, s/n, 08916 Badalona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Gemma Drou-Roget
- Department of Epidemiology and Methodology of Social and Health Sciences, Faculty of Health Sciences of Manresa, Universitat de Vic - Universitat Central de Catalunya (UVic-UCC), Av. Universitària, 4-6, 08242 Manresa, Spain
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON M6H 1B7, Canada
| | - Carmen Vives-Cases
- Department of Community Nursing, Preventive Medicine and Public Health and Science History, Universidad de Alicante, Ctra. De San Vicente del Raspeig, s/n, 03690 Alicante, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - María Gabriela Barbaglia
- Agència de Salut Pública de Barcelona, Pl. de Lesseps, 1, 08023 Barcelona, Spain; Department de Experimental and Health Sciences, Univeristat Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain
| | - Joan Colom
- Sub-Direcció General d'Addiccions, VIH, Infeccions de Transmissió Sexual i Hepatitis Víriques, Agència de Salut Pública de Catalunya, Departament de Salut, Generalitat de Catalunya, Carrer de Roc Boronat, 81-95, 08005 Barcelona, Spain
| | - Albert Espelt
- Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona (UAB), C/de Ca n'Altayó, s/n, 08193 Bellaterra, Spain; Department of Epidemiology and Methodology of Social and Health Sciences, Faculty of Health Sciences of Manresa, Universitat de Vic - Universitat Central de Catalunya (UVic-UCC), Av. Universitària, 4-6, 08242 Manresa, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
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Machlitt-Northen S, Keers R, Munroe PB, Howard DM, Pluess M. Polygenic risk scores for schizophrenia and major depression are associated with socio-economic indicators of adversity in two British community samples. Transl Psychiatry 2022; 12:477. [PMID: 36376270 PMCID: PMC9663827 DOI: 10.1038/s41398-022-02247-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
Schizophrenia (SCZ) and major depressive disorder (MDD) are complex psychiatric disorders which contribute substantially to the global burden of disease. Both psychopathologies are heritable with some genetic overlap between them. Importantly, SCZ and MDD have also been found to be associated with environmental risk factors. However, rather than being independent of genetic influences, exposure to environmental risk factors may be under genetic control, known as gene-environment correlation (rGE). In this study we investigated rGE in relation to polygenic risk scores for SCZ and MDD in adults, derived from large genome-wide association studies, across two different British community samples: Understanding Society (USoc) and the National Child Development Study (NCDS). We tested whether established environmental risk factors for SCZ and/or MDD are correlated with polygenic scores in adults and whether these associations differ between the two disorders and cohorts. Findings partially overlapped between disorders and cohorts. In NCDS, we identified a significant correlation between the genetic risk for MDD and an indicator of low socio-economic status, but no significant findings emerged for SCZ. In USoc, we replicated associations between indicators of low socio-economic status and the genetic propensity for MDD. In addition, we identified associations between the genetic susceptibility for SCZ and being single or divorced. Results across both studies provide further evidence that the genetic risk for SCZ and MDD were associated with common environmental risk factors, specifically MDD's association with lower socio-economic status.
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Affiliation(s)
- Sandra Machlitt-Northen
- grid.4868.20000 0001 2171 1133Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
| | - Robert Keers
- grid.4868.20000 0001 2171 1133Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
| | - Patricia B. Munroe
- grid.4868.20000 0001 2171 1133Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - David M. Howard
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, UK ,grid.4305.20000 0004 1936 7988Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Michael Pluess
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK.
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Macmillan R, Shanahan MJ. Explaining the Occupational Structure of Depressive Symptoms: Precarious Work and Social Marginality across European Countries. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:446-469. [PMID: 35135376 PMCID: PMC9420889 DOI: 10.1177/00221465211072309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The idea that socioeconomic differences are a "fundamental cause" of health and well-being is the basis for large volumes of research. However, one of the challenges in this area is that of linking socioeconomic positions to etiological mechanisms in theoretically informative ways. The situation is doubly challenging because the expression and meaning of socioeconomic positions and the mechanisms they activate change over time. Focusing on depression and applying mediation analysis to data from a large multinational sample from European countries, we find strong support for a three-stage model where occupational differences are largely mediated by exposure to precarious work, which itself is mediated by social marginality. The model is largely robust across welfare state regimes. Ultimately, the research extends fundamental cause perspectives by highlighting connections between "old" and "new" dimensions of socioeconomic status and the social and social psychological sequelae that connect them to psychological well-being.
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Neally SJ, Tamura K, Langerman SD, Claudel SE, Farmer N, Vijayakumar NP, Curlin K, Andrews MR, Ceasar JN, Baumer Y, Powell-Wiley TM. Associations between neighborhood socioeconomic deprivation and severity of depression: Data from the National Health and Nutrition Examination Survey, 2011-2014. SSM Popul Health 2022; 18:101111. [PMID: 35601220 PMCID: PMC9118884 DOI: 10.1016/j.ssmph.2022.101111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/31/2022] [Accepted: 04/27/2022] [Indexed: 11/23/2022] Open
Abstract
Neighborhood socioeconomic disadvantage may contribute to depression. This study examined associations between neighborhood socioeconomic disadvantage, measured as deprivation, and depression severity within a broadly representative sample of the U.S. adult population. The sample (n = 6308 U.S. adults) was from the 2011-2014 National Health and Nutrition Examination Survey. Neighborhood deprivation was calculated using the 2010 U.S. Census and shown in tertile form. Depression severity was calculated from responses to the Patient Health Questionnaire-9 (PHQ-9) as a continuous depression severity score and binary Clinically Relevant Depression (CRD). Multilevel modeling estimated the relationship between deprivation and depression (reference = low deprivation). Models were additionally stratified by gender and race/ethnicity. U.S. adults living in high deprivation neighborhoods were more likely to have a higher PHQ-9 score (p < 0.0001). In unadjusted models, living in high deprivation neighborhoods associated with higher PHQ-9 (β = 0.89, SE = 0.15, p < 0.0001) and higher odds of CRD (OR = 1.35, 95% CI = 1.20-1.51). Living in medium deprivation neighborhoods associated with higher PHQ-9 (β = 0.49, SE = 0.16, p = 0.0019). Associations between deprivation and depression severity lost significance after adjusting for individual-level SES. The results suggest that, for U.S. adults, the relationship between neighborhood-level disadvantage and depression may be attenuated by individual-level SES.
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Affiliation(s)
- Sam J. Neally
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kosuke Tamura
- Neighborhood Social and Geospatial Determinants of Health Disparities Laboratory, Population and Community Health Sciences Branch, Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Steven D. Langerman
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sophie E. Claudel
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nicole Farmer
- Translational Biobehavioral and Health Disparities Branch, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Nithya P. Vijayakumar
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kaveri Curlin
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marcus R. Andrews
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joniqua N. Ceasar
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Yvonne Baumer
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Mezzina R, Gopikumar V, Jenkins J, Saraceno B, Sashidharan SP. Social Vulnerability and Mental Health Inequalities in the "Syndemic": Call for Action. Front Psychiatry 2022; 13:894370. [PMID: 35747101 PMCID: PMC9210067 DOI: 10.3389/fpsyt.2022.894370] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/12/2022] [Indexed: 12/16/2022] Open
Abstract
Covid-19 is referred to as a "syndemic," i.e., the consequences of the disease are exacerbated by social and economic disparity. Poor housing, unstable work conditions, caste, class, race and gender based inequities and low incomes have a profound effect on mental health and wellbeing. Such disparities are increasing between, among and within countries and are exacerbated by human rights violations, in institution and in society, stigma and discrimination. Social capital can mediate health outcomes, through trust and reciprocity, political participation, and by mental health service systems, which can be coercive or more open to demand of emancipation and freedom. Societal inequalities affect especially vulnerable groups, and Covid itself had a wider impact on the most socially vulnerable and marginalized populations, suffering for structural discrimination and violence. There are complex relations among these social processes and domains, and mental health inequalities and disparity. Participation and engagement of citizens and community organizations is now required in order to achieve a radical transformation in mental health. A Local and Global Action Plan has been launched recently, by a coalition of organizations representing people with lived experience of mental health care; who use services; family members, mental health professionals, policy makers and researchers, such as the International Mental Health Collaborating Network, the World Federation for Mental Health, the World Association for Psychosocial Rehabilitation, the Global Alliance of Mental Illness Advocacy Networks (GAMIAN), The Mental Health Resource Hub in Chennai, India, The Movement for Global Mental Health (MGMH) and others. The Action Plan addresses the need for fundamental change by focusing on social determinants and achieving equity in mental health care. Equally the need for the politics of wellbeing has to be embedded in a system that places mental health within development and social justice paradigm, enhancing core human capabilities and contrasting discriminatory practices. These targets are for people and organizations to adopt locally within their communities and services, and also to indicate possible innovative solutions to Politics. This global endeavor may represent an alternative to the global mental discourse inspired by the traditional biomedical model.
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Affiliation(s)
- Roberto Mezzina
- World Federation for Mental Health, Woodbridge, VA, United States
| | - Vandana Gopikumar
- The Banyan Academy of Leadership in Mental Health, Chennai, India
- Madras School of Social Work, Chennai, India
| | - John Jenkins
- International Mental Health Collaborating Network, Exeter, United Kingdom
| | | | - S. P. Sashidharan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
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10
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Eisenberg-Guyot J, Prins SJ, Muntaner C. Free agents or cogs in the machine? Classed, gendered, and racialized inequities in hazardous working conditions. Am J Ind Med 2022; 65:92-104. [PMID: 34796514 PMCID: PMC8752498 DOI: 10.1002/ajim.23314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/01/2021] [Accepted: 11/06/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Few epidemiologic studies have used relational social class measures based on control over productive assets and others' labor to analyze inequities in health-affecting working conditions. Moreover, these studies have often neglected the gendered and racialized dimensions of class relations, dimensions which are essential to understanding population patterns of health inequities. Our study fills these gaps. METHODS Using data from the 2002-2018 U.S. General Social Survey, we assigned respondents to the worker, manager, petit bourgeois, or capitalist classes based on their supervisory authority and self-employment status. Next, we estimated class, class-by-gender, and class-by-race inequities in compensation/safety, the labor process, control, and conflict, using Poisson models. We also estimated gender-by-race inequities among workers. RESULTS We identified substantial class inequities, with worse conditions for workers, which is the largest class within genders and racialized groups, but also disproportionately consists of women and people of color (POC), particularly women of color (WOC). For example, relative to workers, capitalists were less likely to report that safety is not a priority (prevalence ratio [PR]: 0.41, 95% confidence interval [CI]: 0.21, 0.82), repetitive tasks (PR: 0.36, 95% CI: 0.21, 0.61), and lacking freedom (PR: 0.11, 95% CI: 0.05, 0.24). We also identified inequities among workers, with women and POC, particularly WOC, reporting worse conditions than white male workers, especially greater discrimination/harassment (WOC PR: 1.70, 95% CI: 1.36, 2.13). CONCLUSION We identified substantial inequities in working conditions across intersecting classes, genders, and racialized groups. These inequities threaten workers' health, particularly among women and POC.
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Affiliation(s)
- Jerzy Eisenberg-Guyot
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, NY
| | - Seth J. Prins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, NY,Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, NY, NY
| | - Carles Muntaner
- Social & Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON,Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON
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11
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Reynolds MM. Health Power Resources Theory: A Relational Approach to the Study of Health Inequalities. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:493-511. [PMID: 34846187 PMCID: PMC10497238 DOI: 10.1177/00221465211025963] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Link and Phelan's pioneering 1995 theory of fundamental causes urged health scholars to consider the macro-level contexts that "put people at risk of risks." Allied research on the political economy of health has since aptly demonstrated how institutions contextualize risk factors for health. Yet scant research has fully capitalized on either fundamental cause or political economy of health's allusion to power relations as a determinant of persistent inequalities in population health. I address this oversight by advancing a theory of health power resources that contends that power relations distribute and translate the meaning (i.e., necessity, value, and utility) of socioeconomic and health-relevant resources. This occurs through stratification, commodification, discrimination, and devitalization. Resurrecting historical sociological emphases on power relations provides an avenue through which scholars can more fully understand the patterning of population health and better connect the sociology of health and illness to the central tenets of the discipline.
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Affiliation(s)
- Megan M. Reynolds
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
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12
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Ding R, He P. Associations between childhood adversities and late-life cognitive function: Potential mechanisms. Soc Sci Med 2021; 291:114478. [PMID: 34649168 DOI: 10.1016/j.socscimed.2021.114478] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 09/08/2021] [Accepted: 10/08/2021] [Indexed: 12/27/2022]
Abstract
RATIONALE Childhood adversity, which is related to negative cognitive consequences, is highly prevalent across the world. Nonetheless, there is still a scarcity of research on late-life cognitive function that accounted for multiple aspects of adverse events as well as the potential mediating mechanism of social context and individual's wellbeing in adulthood. OBJECTIVE This study aimed to investigate the relationship between childhood adversities and late-life cognitive function among the middle-aged and older Chinese population and to determine the mediating role of education attainment, marital status, financial status, and self-rated health in adulthood. METHODS We used three waves of data from China Health and Retirement Longitudinal Study from 2011 to 2015, which consisted of 23 807 participants aged 45 years and older. Generalized Estimating Equation and Structural Equation Model were applied to examine the association between childhood adversities and cognitive function (mental intactness and episodic memory) and the corresponding potential mechanisms. RESULTS Overall, 77.25%, 64.55%, 38.38%, and 15.03% of respondents experienced socioeconomic disadvantage, parental involved trauma, maladaptive parental trauma, and other trauma in childhood, respectively. Multivariate analyses suggest that all four types of childhood adversities were associated with a lower score of mental intactness and the first three were associated with episodic memory. A large proportion of the associations between childhood adversity and cognitive function was mainly mediated by education attainment, self-rated health and marital status in adulthood. CONCLUSION There are negative linkages between childhood adversities and cognitive function in the middle-aged and older Chinese population. Such associations were primarily functioning indirectly through adult social context and health conditions.
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Affiliation(s)
- Ruoxi Ding
- China Center for Health Development Studies, Peking University, Beijing, 100191, China.
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, 100191, China.
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13
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Pena-Gralle APB, Talbot D, Trudel X, Aubé K, Lesage A, Lauzier S, Milot A, Brisson C. Validation of case definitions of depression derived from administrative data against the CIDI-SF as reference standard: results from the PROspective Québec (PROQ) study. BMC Psychiatry 2021; 21:491. [PMID: 34620134 PMCID: PMC8496029 DOI: 10.1186/s12888-021-03501-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Administrative data have several advantages over questionnaire and interview data to identify cases of depression: they are usually inexpensive, available for a long period of time and are less subject to recall bias and differential classification errors. However, the validity of administrative data in the correct identification of depression has not yet been studied in general populations. The present study aimed to 1) evaluate the sensitivity and specificity of administrative cases of depression using the validated Composite International Diagnostic Interview - Short Form (CIDI-SF) as reference standard and 2) compare the known-groups validity between administrative and CIDI-SF cases of depression. METHODS The 5487 participants seen at the last wave (2015-2018) of the PROQ cohort had CIDI-SF questionnaire data linked to hospitalization and medical reimbursement data provided by the provincial universal healthcare provider and coded using the International Classification of Disease. We analyzed the sensitivity and specificity of several case definitions of depression from this administrative data. Their association with known predictors of depression was estimated using robust Poisson regression models. RESULTS Administrative cases of depression showed high specificity (≥ 96%), low sensitivity (19-32%), and rather low agreement (Cohen's kappa of 0.21-0.25) compared with the CIDI-SF. These results were consistent over strata of sex, age and education level and with varying case definitions. In known-groups analysis, the administrative cases of depression were comparable to that of CIDI-SF cases (RR for sex: 1.80 vs 2.03 respectively, age: 1.53 vs 1.40, education: 1.52 vs 1.28, psychological distress: 2.21 vs 2.65). CONCLUSION The results obtained in this large sample of a general population suggest that the dimensions of depression captured by administrative data and by the CIDI-SF are partially distinct. However, their known-groups validity in relation to risk factors for depression was similar to that of CIDI-SF cases. We suggest that neither of these data sources is superior to the other in the context of large epidemiological studies aiming to identify and quantify risk factors for depression.
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Affiliation(s)
- Ana Paula Bruno Pena-Gralle
- CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC, Canada. .,Faculty of Medicine, Laval University, Québec, QC, Canada.
| | - Denis Talbot
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Medicine, Laval University, Québec, QC Canada
| | - Xavier Trudel
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Medicine, Laval University, Québec, QC Canada
| | - Karine Aubé
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Medicine, Laval University, Québec, QC Canada
| | - Alain Lesage
- grid.14848.310000 0001 2292 3357Département de Psychiatrie et d’addictologie, Université de Montréal, Montréal, Canada
| | - Sophie Lauzier
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Pharmacy, Laval University, Québec, QC Canada
| | - Alain Milot
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Medicine, Laval University, Québec, QC Canada
| | - Chantal Brisson
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Medicine, Laval University, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Centre de recherche sur les soins et les services de première ligne de l’Université Laval, Québec, QC Canada
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Gunn V, Håkansta C, Vignola E, Matilla-Santander N, Kreshpaj B, Wegman DH, Hogstedt C, Ahonen EQ, Muntaner C, Baron S, Bodin T. Initiatives addressing precarious employment and its effects on workers' health and well-being: a protocol for a systematic review. Syst Rev 2021; 10:195. [PMID: 34193280 PMCID: PMC8244669 DOI: 10.1186/s13643-021-01728-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 06/01/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Precarious employment is a significant determinant of population health and health inequities and has complex public health consequences both for a given nation and internationally. Precarious employment is conceptualized as a multi-dimensional construct including but not limited to employment insecurity, income inadequacy, and lack of rights and protection in the employment relation, which could affect both informal and formal workers. The purpose of this review is to identify, appraise, and synthesize existing research on the effectiveness of initiatives aiming to or having the potential to eliminate, reduce, or mitigate workers' exposure to precarious employment conditions and its effects on the health and well-being of workers and their families. METHODS The electronic databases searched (from January 2000 onwards) are Scopus, Web of Science Core Collection, and PubMed, along with three institutional databases as sources of grey literature. We will include any study (e.g. quantitative, qualitative, or mixed-methods design) evaluating the effects of initiatives that aim to or have the potential to address workers' exposure to precarious employment or its effects on the health and well-being of workers and their families, whether or not such initiatives were designed specifically to address precarious employment. The primary outcomes will be changes in (i) the prevalence of precarious employment and workers' exposure to precarious employment and (ii) the health and well-being of precariously employed workers and their families. No secondary outcomes will be included. Given the large body of evidence screened, the initial screening of each study will be done by one reviewer, after implementing several strategies to ensure decision-making consistency across reviewers. The screening of full-text articles, data extraction, and critical appraisal will be done independently by two reviewers. Potential conflicts will be resolved through discussion. Established checklists will be used to assess a study's methodological quality or bias. A narrative synthesis will be employed to describe and summarize the included studies' characteristics and findings and to explore relationships both within and between the included studies. DISCUSSION We expect that this review's findings will provide stakeholders interested in tackling precarious employment and its harmful health effects with evidence on effectiveness of solutions that have been implemented to inform considerations for adaptation of these to their unique contexts. In addition, the review will increase our understanding of existing research gaps and enable us to make recommendations to address them. Our work aligns with the sustainable development agenda to protect workers, promote decent work and economic growth, eliminate poverty, and reduce inequalities. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020187544 .
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Affiliation(s)
- Virginia Gunn
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm Region, Sweden.
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
| | - Carin Håkansta
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm Region, Sweden
- Working Life Science, Karlstad University, Karlstad, Sweden
| | - Emilia Vignola
- CUNY Graduate School of Public Health & Health Policy, New York, USA
| | - Nuria Matilla-Santander
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm Region, Sweden
| | - Bertina Kreshpaj
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm Region, Sweden
| | | | - Christer Hogstedt
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm Region, Sweden
| | - Emily Q Ahonen
- Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
| | - Carles Muntaner
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sherry Baron
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, New York, USA
| | - Theo Bodin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm Region, Sweden
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15
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Prins SJ, McKetta S, Platt J, Muntaner C, Keyes KM, Bates LM. The Serpent of Their Agonies: Exploitation as Structural Determinant of Mental Illness. Epidemiology 2021; 32:303-309. [PMID: 33252438 PMCID: PMC7872213 DOI: 10.1097/ede.0000000000001304] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Social stratification is a well-documented determinant of mental health. Traditional measures of stratification (e.g., socioeconomic status) reduce dynamic social processes to individual attributes downstream of mechanisms that generate stratification. In this study, we measure one process theorized to generate and reproduce social stratification-economic exploitation-and explore its association with mental health. METHODS Data are from the 1983 to 2017 waves of the Panel Study of Income Dynamics, a nationally representative cohort study (baseline N = 3059). We operationalized "unconcealed exploitation" as the percentage of individuals' labor income they were hypothetically not paid for productive hours. We ascertained psychologic distress and mental illness with the Kessler-6 (K6) scale. RESULTS We fit inverse probability-weighted marginal structural models and found that for each unit increase in unconcealed exploitation, psychologic distress increased by 1.6 points (95% confidence interval = 0.71, 2.5) on the K6 scale and the odds of mental illness tripled (odds ratio = 3.0, 95% confidence interval = 1.5, 6.1). Results were not driven entirely by overwork and were robust to different inverse probability-weighted estimation strategies and sensitivity analyses. CONCLUSIONS Exploitation is associated with mental illness. Focusing on exploitation rather than its consequences (e.g., socioeconomic status), shifts attention to a structural process that may be a more appropriate explanatory mechanism, and a more pragmatic intervention target, for mental illness.
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Affiliation(s)
- Seth J. Prins
- Columbia University, Departments of Epidemiology and Sociomedical Sciences, New York, NY, United States
| | - Sarah McKetta
- Columbia University, Department of Epidemiology, New York, NY, United States
| | - Jonathan Platt
- Columbia University, Department of Epidemiology, New York, NY, United States
| | - Carles Muntaner
- University of Toronto, Lawrence S Bloomberg Faculty of Nursing, Toronto, ON, Canada
| | - Katherine M. Keyes
- Columbia University, Department of Epidemiology, New York, NY, United States
| | - Lisa M. Bates
- Columbia University, Department of Epidemiology, New York, NY, United States
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16
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Kang S, Kim HC. Effects of Income Level on the Association Between Hypertension and Depression: 2010-2017 Korea National Health and Nutrition Examination Survey. J Prev Med Public Health 2020; 53:439-446. [PMID: 33296584 PMCID: PMC7733750 DOI: 10.3961/jpmph.20.337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/18/2020] [Indexed: 11/09/2022] Open
Abstract
Objectives This study analyzed the associations of hypertension (HTN) with symptoms and diagnosis of depression by income level among Korean adults. Methods This study was based on the 2010-2017 Korea National Health and Nutrition Examination Survey data; a total of 29 425 adults (aged 20 years or older) were analyzed. HTN was defined as a systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or use of hypertensive medications. Depression symptoms were evaluated based on a questionnaire about depression-related symptoms. A depression diagnosis was defined based on questionnaire responses indicating that a participant had been diagnosed with depression. Household income was divided into higher or lower income ranges based on the median income of the participants. Multiple logistic regression analyses were performed to assess the associations between HTN and depression symptoms/diagnosis in the higher-income and lower-income groups. Results In the higher-income group, the odds ratio (OR) for the association between HTN and depression symptoms was 1.15 (95% confidence interval [CI], 0.97 to 1.37), and the OR for the association between HTN and depression diagnosis was 1.41 (95% CI, 1.13 to 1.76). In the lower-income group, the OR for the association between HTN and depression symptoms was 1.18 (95% CI, 1.04 to 1.34), whereas the OR for the association between HTN and depression diagnosis was 0.82 (95% CI, 0.70 to 0.97). Conclusions The associations of HTN with symptoms and diagnosis of depression differed by income level.
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Affiliation(s)
- San Kang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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17
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Achieving complete mental health despite a history of generalized anxiety disorders: Findings from a large, nationally representative Canadian survey. J Affect Disord 2020; 265:687-694. [PMID: 32090786 DOI: 10.1016/j.jad.2019.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 01/06/2023]
Abstract
Ideally, the clinical goal for individuals with a history of anxiety disorder is not only to remit from the disorder, but also to reach optimal well-being. This broader concept of recovery aligns with Keyes' concept of complete mental health (CMH), including presence of happiness or life satisfaction, and social and psychological well-being, and absence of any past year mental illness including anxiety disorders, depressive disorders, substance dependence and suicidal ideation. This study's aim was to identify factors associated with CMH in a population-based sample of Canadians with a previous diagnosis of Generalized Anxiety Disorder (GAD) (n = =2128), of whom 40% are currently in CMH. Data were from the 2012 Canadian Community Health Survey-Mental Health (response rate=68.9%). The World Health Organization version of the Composite International Diagnostic Interview (WHOCIDI) scales were used to define lifetime and past-year GAD. Factors associated with complete mental health include female gender, older age, being married, reporting good to excellent physical health, being free of chronic insomnia, being able to manage household activities without difficulties, using religion or spirituality to cope, having a confidant, and never having had a major depressive disorder nor substance dependence. Results of this study suggest many with a history of anxiety disorders can achieve CMH and point to factors that appear to facilitate this process.
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18
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Ghezzi P. Environmental risk factors and their footprints in vivo - A proposal for the classification of oxidative stress biomarkers. Redox Biol 2020; 34:101442. [PMID: 32035921 PMCID: PMC7327955 DOI: 10.1016/j.redox.2020.101442] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/13/2020] [Accepted: 01/22/2020] [Indexed: 01/06/2023] Open
Abstract
Environmental agents, including socioeconomic condition, and host factors can act as causal agents and risk factors in disease. We use biomarkers and sociomarkers to study causal factors, such as overproduction of reactive oxygen species (ROS) which could play a role in disease through oxidative stress. It is therefore important to define the exact meaning of the biomarker we measure. In this review we attempt a classification of biomarkers related to oxidative stress based on their biological meaning. We define as type zero biomarkers the direct measurement of ROS in vivo in patients. Type 1 biomarkers are the most frequently used indicators of oxidative stress, represented by oxidized lipids, proteins or nucleic acids and their bases. Type 2 biomarkers are indicators of the activation of biochemical pathways that can lead to the formation of ROS. Type 3 biomarkers are host factors such as small-molecular weight antioxidants and antioxidant enzymes, while type 4 biomarkers measure genetic factors and mutations that could modify the susceptibility of an individual to oxidative stress. We also discuss whether biomarkers are actionable or not, that is if the specific blockade of these molecules can ameliorate disease or if they are just surrogate markers. The proposed classification of biomarkers of oxidative stress based on their meaning and ambiguities, within the theoretical framework of the oxidative stress theory of disease may help identify those diseases, and individuals, where oxidative stress has a causal role, to allow targeted therapy and personalized medicine.
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Affiliation(s)
- Pietro Ghezzi
- Department of Clinical Medicine, Brighton and Sussex Medical School, Brighton, BN19RY, United Kingdom.
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Kokkinen L, Muntaner C, Koskinen A, Väänänen A. Occupational class, capitalist class advantage and mortality among working-age men. J Epidemiol Community Health 2019; 74:3-6. [PMID: 31615892 DOI: 10.1136/jech-2019-212952] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/21/2019] [Accepted: 09/28/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Disparities in mortality have been firmly established across occupational grades and the incomes they earn, but this line of research has failed to include individuals' relationships to capital, as suggested by class analysists. METHODS According to Wright's classification, the research generated 10 mutually exclusive classes based on occupation and investment income: worker; capitalist worker; professional; capitalist professional; supervisor; capitalist supervisor; manager; capitalist manager; self-employed; and capitalist self-employed. The study participants (n=268 239) were randomly selected from the Statistics Finland population database and represent 33% of Finnish men aged 30-64 years. The mortality data were monitored over the 1995-2014 period. RESULTS The sociodemographic-adjusted HRs for mortality were lowest for capitalist managers (HR 0.50; 95% CI 0.36 to 0.69) as compared with that for workers without a capitalist class advantage. A positive occupational class gradient was found from managers to supervisors to workers. The capitalist class advantage independently affected the disparities in mortality within this occupational hierarchy. CONCLUSION Different occupational class locations protect against premature death differently, and the capitalist class advantage widens the premature-death disparities among the occupational classes. To monitor and explain social inequalities in health in a more nuanced way, future research on investment income as well as the operationalisation of the capitalist class advantage is encouraged.
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Affiliation(s)
- Lauri Kokkinen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Carles Muntaner
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ari Väänänen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Gender, Depression, and Blue-collar Work: A Retrospective Cohort Study of US Aluminum Manufacturers. Epidemiology 2019; 30:435-444. [PMID: 30964814 DOI: 10.1097/ede.0000000000000993] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Industrial blue-collar workers face multiple work-related stressors, but evidence regarding the burden of mental illness among today's blue-collar men and women remains limited. METHODS In this retrospective cohort study, we examined health and employment records for 37,183 blue- and white-collar workers employed by a single US aluminum manufacturer from 2003 to 2013. Using Cox proportional hazards regression, we modeled time to first episode of treated depression by gender and occupational class. Among cases, we modeled rates of depression-related service utilization with generalized gamma regression. RESULTS Compared with their white-collar counterparts, blue-collar men were more likely to be treated for depression (hazard ratio [HR] = 1.3; 95% confidence interval [CI] = 1.1, 1.4) as were blue-collar women (HR = 1.4; 1.2, 1.6). Blue-collar women were most likely to be treated for depression as compared with white-collar men (HR = 3.2; 95% CI = 2.1, 5.0). However, blue-collar workers used depression-related services less frequently than their white-collar counterparts among both men (rate ratio = 0.91; 95% CI = 0.84, 0.98) and women (rate ratio = 0.82; 95% CI = 0.77, 0.88). CONCLUSIONS Blue-collar women were more likely to be treated for depression than white-collar workers, and blue-collar women were most likely to be treated for depression compared with white-collar men. However, blue-collar men and women used depression-related healthcare services less frequently than white-collar workers. These findings underscore that blue-collar women may be uniquely susceptible to depression, and suggest that blue-collar workers may encounter barriers to care-seeking related mental illness other than their insurance status.
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Kwon I, Shin O, Park S, Kwon G. Multi-Morbid Health Profiles and Specialty Healthcare Service Use: A Moderating Role of Poverty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1956. [PMID: 31159464 PMCID: PMC6604021 DOI: 10.3390/ijerph16111956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 05/27/2019] [Accepted: 05/30/2019] [Indexed: 11/17/2022]
Abstract
Increasing life expectancy in the USA makes a better understanding of the heterogeneous healthcare needs of the aging population imperative. Many aging studies have discovered multimorbid health problems focusing mainly on various physical health conditions, but not on combined mental or behavioral health problems. There is also a paucity of studies with older adults who use professional healthcare services caring for their mental and substance-related conditions. This study aims to enhance the knowledge of older peoples' complex healthcare needs involving physical, mental, and behavioral conditions; examine the relationship between multi-morbid health profiles and specialty healthcare service utilization; and investigate its association to poverty. The study data were derived from the National Survey on Drug Use and Health (NSDUH) in 2013 (n = 6296 respondents aged 50 years and older). To identify overall health conditions, nine indicators, including physical, mental, and substance/alcohol, were included. Healthcare service utilization was measured with four mutually exclusive categories: No treatment, mental health treatment only, substance use treatment only, and both. We identified four health profiles: Healthy (82%), having physical health problems (6%), physical and mental health problems (4%), and behavioral problems (8%). Older people's health profiles were differentially associated with healthcare use. Those living in poverty with both physical and mental health problems or substance/alcohol health problems were less likely to receive mental health and substance use treatments than those with more financial resources. Implications for geriatric healthcare practices and policy are discussed.
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Affiliation(s)
- Ilan Kwon
- School of Social Work at Michigan State University, Baker Hall, 655 Auditorium Road, East Lansing, MI 48824, USA.
| | - Oejin Shin
- School of Social Work at University of Illinois Urbana-Champaign, 1010 W Nevada St, Urbana, IL 61801, USA.
| | - Sojung Park
- Brown School of Social Work at Washington University, 1 Brookings Drive, Saint Louis, MO 63130, USA.
| | - Goeun Kwon
- Brown School of Social Work at Washington University, 1 Brookings Drive, Saint Louis, MO 63130, USA.
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22
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Whither Occupational Class Health Gradients?: Why We Need More Social Class Theory, Mechanisms, Indicators, and Scientific Realism. Epidemiology 2019; 30:445-448. [PMID: 30964815 DOI: 10.1097/ede.0000000000000994] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Self-Rated Health and Relative Socioeconomic Deprivation in the Palestinian Refugee Communities of Lebanon. J Immigr Minor Health 2019; 21:1257-1265. [PMID: 30850941 DOI: 10.1007/s10903-019-00869-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Most Palestinian refugees in Lebanon are marginalized as refugees, poor, and targets of discrimination. This study seeks to understand deprivation among these refugees through an exploration of the relationship between indicators of general health and economic deprivation. A nationally representative sample of 2501 Palestinian refugee households were randomly selected and surveyed in 2010. Social workers interviewed the homemaker in each household using a questionnaire on health, economic, and socio-demographic information. This data was analyzed to understand the associations between health and levels of deprivation. 31% of respondents reported poor health and nearly 52% of households had two or more poverty indicators. The logistic regression found each degree of deprivation associated with a 33% increase in poor health (OR 1.33; CI 1.20-1.47). This study suggests understanding deprivation among impoverished communities requires a nuanced approach. Generalizations about experiences of poverty will generate ineffective policy and intervention strategies.
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Muntaner C, Gunn V. In Defense of Class Wars in Population Health: The New Landscape of Social Class With Bourdieu, Neo-Marxists, and the Kohn/Schooler/Wright Integrative Models. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2019; 49:102-107. [PMID: 30798685 DOI: 10.1177/0020731418818409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The field of social inequalities in health has been dominated by an individual attributes approach with a small number of indicators, namely occupation, income, and education. We review the weakness of this approach and detail the emergence of sociological alternatives tied to the writings of Bourdieu, Marx, and Weber. A particularly rich theoretical development stems from the integration of Weberian and Marxian approaches, associated with sociologists Melvin Kohn, Carmi Schooler, and Erik Olin Wright.
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Affiliation(s)
- Carles Muntaner
- 1 Lawrence S. Bloomberg Faculty of Nursing, Dalla Lana School of Public Health, University of Toronto, ON, Canada
| | - Virginia Gunn
- 2 Lawrence S. Bloomberg Faculty of Nursing, Global Health Collaborative Specialization, Dalla Lana School of Public Health, University of Toronto, ON, Canada
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Novrinda H, Han DH, Jung-Choi K, Ryu JI. Neo-Marxian social class inequalities in oral health among the South Korean population. Community Dent Oral Epidemiol 2018; 47:162-170. [PMID: 30548668 DOI: 10.1111/cdoe.12439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/27/2022]
Abstract
AIM The aims of this study were to examine inequalities in periodontitis and tooth loss among South Korean adults using the Wright's Neo-Marxian social class (NMSC) indicator and to assess the impact of material, psychosocial, health behavioural and workplace environmental factors in the association of social class with oral health. METHODS This study used the data from the 4th Korea National Health and Nutrition Examination Survey with 6710 participants aged 19-54 years old. Participants were classified into 12 social class positions based on the Wright's social class map. Healthy gum and absence of tooth loss were the health outcomes. Mediating factors were material (M), psychosocial (PS), health behavioural (HB) and workplace environmental (WPE) factors. A series of logistic regressions were performed to analyse the data. Odds ratio (OR) and 95% confidence interval (CI) were used to report the results. RESULTS For the absence of periodontal pockets status, expert supervisors were the healthiest periodontal group among the social classes (OR = 2.15 95% CI 1.59-2.90) in the age and gender adjusted model. For the absence of tooth loss, skilled workers had the highest OR for absence of tooth loss (OR = 1.64 95% CI 1.31-2.05) in the age- and gender-adjusted model. For absence of periodontal pockets, the explanatory power of the M factor was the highest in all social class positions except for nonskilled supervisors followed by the HB factor. Additionally, the absence of tooth loss had a fairly similar pattern. The explanatory power of the M factor was the highest in all social class positions except for the petty bourgeoisie (highest: HB) and nonskilled supervisors (highest: WPE) followed by the HB and WPE factors. CONCLUSION There were nongradient oral health inequalities among the South Korean population according to the NMSC. Oral health promotion programmes that focus on changing the socioeconomic environment and health behaviours should be implemented.
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Affiliation(s)
- Herry Novrinda
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Department of Dental Public Health and Preventive Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
| | - Kyunghee Jung-Choi
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jae-In Ryu
- Department of Preventive and Social Dentistry, Kyung Hee University, Seoul, Korea
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Conron KJ, Goldberg SK, Halpern CT. Sexual orientation and sex differences in socioeconomic status: a population-based investigation in the National Longitudinal Study of Adolescent to Adult Health. J Epidemiol Community Health 2018; 72:1016-1026. [PMID: 30190439 PMCID: PMC6698380 DOI: 10.1136/jech-2017-209860] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 06/22/2018] [Accepted: 07/04/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Socioeconomic status (SES) is a fundamental contributor to health; however, limited research has examined sexual orientation differences in SES. METHODS 2008-2009 data from 14 051 participants (ages 24-32 years) in the US-based, representative, National Longitudinal Study of Adolescent to Adult Health were analysed using multivariable regressions that adjusted for age, race-ethnicity, childhood SES, urbanicity and Census region, separately for females and males. Modification by racial minority status (black or Latino vs white, non-Hispanic) was also explored. RESULTS Among females, sexual minorities (SM) (10.5% of females) were less likely to graduate college, and were more likely to be unemployed, poor/near poor, to receive public assistance and to report economic hardship and lower social status than heterosexuals. Adjusting for education attenuated many of these differences. Among males, SM (4.2% of males) were more likely than heterosexuals to be college graduates; however, they also had lower personal incomes. Lower rates of homeownership were observed among SM, particularly racial minority SM females. For males, household poverty patterns differed by race-ethnicity: among racial minority males, SM were more likely than heterosexuals to be living at >400% federal poverty level), whereas the pattern was reversed among whites. CONCLUSIONS Sexual minorities, especially females, are of lower SES than their heterosexual counterparts. SES should be considered a potential mediator of SM stigma on health. Studies of public policies that may produce, as well as mitigate, observed SES inequities, are warranted.
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Affiliation(s)
- Kerith J Conron
- The Williams Institute, UCLA School of Law, Los Angeles, California, USA
- The Fenway Institute, Boston, Massachusetts, USA
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shoshana K Goldberg
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Carolyn T Halpern
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
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Unpacking the link between socioeconomic status and behavior problems: A second-order meta-analysis. Dev Psychopathol 2018; 30:1889-1906. [PMID: 30259823 DOI: 10.1017/s0954579418001141] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Substantial evidence links socioeconomic status to internalizing and externalizing behavior problems. However, it is unclear how these two categories of behavior problems relate to specific components of socioeconomic status (e.g., income, educational attainment, and occupational prestige) or overall social status. In this study, we conducted a second-order meta-analysis to estimate the average associations of income, education, occupation, and overall socioeconomic status with internalizing and externalizing behavior problems, and to examine if age, sex, and race/ethnicity moderated these associations. Our systematic search in PsycINFO, PubMed, Google Scholar, Web of Science, and ProQuest Dissertations and Theses Global identified 12 meta-analyses (17% unpublished), including approximately 474 primary studies and 327,617 participants. In relation to internalizing, we found small average associations with income, r+ = -.18, 95% confidence interval (CI) [-.31, -.04], and education, r+ = -.12, 95% CI [-.15, -.09]. In relation to externalizing, we found smaller associations with income, r+ = -.02, 95% CI [-.15, .10], education, r+ = -.03, 95% CI [-.16, .10], and overall socioeconomic status, r+ = -.05, 95% CI [-.11, .01], but these CIs included zero. Only sex composition of the samples moderated the latter association. We provide recommendations for best practices and future research directions.
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Zang E, Bardo AR. Objective and Subjective Socioeconomic Status, Their Discrepancy, and Health: Evidence from East Asia. SOCIAL INDICATORS RESEARCH 2018; 143:765-794. [PMID: 32982014 PMCID: PMC7517660 DOI: 10.1007/s11205-018-1991-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/30/2018] [Indexed: 06/11/2023]
Abstract
Socioeconomic status (SES) is largely understood to be a fundamental determinant of health. Recently, subjective socioeconomic status (SSS) has emerged as a potentially important predictor of health above and beyond traditional (i.e., objective) SES indicators (OSS). The current study adds to this emerging body of research by examining the potentially important role of status discrepancies for health outcomes. We used nationally representative data from three East Asian countries (China, Japan, and South Korea) (2010 East Asian Social Survey) and a non-linear statistical technique (i.e., diagonal mobility model) to simultaneously model the independent contributions of OSS and SSS and their discrepancy for three health outcomes. Findings showed that SSS does, in fact, explain additional variation in health net of OSS in most cases, and status discrepancy is not associated with any of the three health outcomes. While status discrepancy was not found to be a driving factor in determining the predictive power of SSS net of OSS (at least in East Asia), the present study adds robustness to the accumulating evidence that challenges the social inequality hypothesis and provides a basis from which future research can build and contribute further to the understanding surrounding socioeconomic status and health outcomes.
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Affiliation(s)
- Emma Zang
- Sanford School of Public Policy, Duke University, Durham, USA
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Guo L, Li S, Lu R, Yin L, Gorson-Deruel A, King L. The research topic landscape in the literature of social class and inequality. PLoS One 2018; 13:e0199510. [PMID: 29965983 PMCID: PMC6028105 DOI: 10.1371/journal.pone.0199510] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 06/09/2018] [Indexed: 11/19/2022] Open
Abstract
The literature of social class and inequality is not only diverse and rich in sight, but also complex and fragmented in structure. This article seeks to map the topic landscape of the field and identify salient development trajectories over time. We apply the Latent Dirichlet Allocation topic modeling technique to extract 25 distinct topics from 14,038 SSCI articles published between 1956 to 2017. We classified three topics as "hot", eight as "stable" and 14 as "cold", based on each topic's idiosyncratic temporal trajectory. We also listed the three most cited references and the three most popular journal outlets per topic. Our research suggests that future effort may be devoted to Topics "urban inequalities, corporate social responsibility and public policy in connected capitalism", "education and social inequality", "community health intervention and social inequality in multicultural contexts" and "income inequality, labor market reform and industrial relations".
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Affiliation(s)
- Liang Guo
- Institute of Computational Social Science, Shandong University, Weihai, China
| | - Shikun Li
- Institute of Computational Social Science, Shandong University, Weihai, China
| | - Ruodan Lu
- Engineering Department, Cambridge University, Cambridge, United Kingdom
| | - Lei Yin
- Institut Supérieur de Management et Communication, Paris, France
| | | | - Lawrence King
- Department of Economics, University of Massachusetts, Amherst, MA, United States
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Uncovering the hidden impacts of inequality on mental health: a global study. Transl Psychiatry 2018; 8:98. [PMID: 29777100 PMCID: PMC5959880 DOI: 10.1038/s41398-018-0148-0] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/28/2018] [Accepted: 04/03/2018] [Indexed: 01/26/2023] Open
Abstract
Women are nearly twice as likely as men to suffer from mental illness. This gender disparity in depressive disorders may relate to social inequalities and living standards across nations. Currently, these disparities were not reflected at the level of health policies. This study utilized global data for depressive disorders and socioeconomic data from the United Nations' World Bank databases and Global Burden of Disease database to demonstrate the correlation between social inequality and gender disparities in mental health. This study investigated the association among the ratio of female to male depressive disorder rates, gross domestic product, the GINI Index, and the gender inequality index for 122 countries. The research yielded some major findings. First, there exists a significant correlation between gender inequality and gender disparities in mental health. Second, the GINI index is significantly associated with male-but not female-depressive disorder rates. Third, gender disparities in depressive disorders are associated with a country's wealth. These findings can help to inform society, policy-makers, and clinicians to improve the overall health level globally.
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Kinnunen L, Niemelä M, Hakko H, Miettunen J, Merikukka M, Karttunen V, Ristikari T, Gissler M, Räsänen S. Psychiatric diagnoses of children affected by their parents’ traumatic brain injury: the 1987 Finnish Birth Cohort study. Brain Inj 2018; 32:933-940. [DOI: 10.1080/02699052.2018.1470331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Lotta Kinnunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mika Niemelä
- Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marko Merikukka
- Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Vesa Karttunen
- Department of Neurology, Oulu University Hospital, Oulu, Finland
| | - Tiina Ristikari
- Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Mika Gissler
- Information Services Department, National Institute for Health and Welfare, Helsinki, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
| | - Sami Räsänen
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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Dowdall N, Ward CL, Lund C. The association between neighbourhood-level deprivation and depression: evidence from the south african national income dynamics study. BMC Psychiatry 2017; 17:395. [PMID: 29228912 PMCID: PMC5725901 DOI: 10.1186/s12888-017-1561-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 11/28/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Depression contributes substantially to the burden of disease in South Africa. Little is known about how neighbourhoods affect the mental health of the people living in them. METHODS Using nationally representative data (N=11,955) from the South African National Income Dynamics Study and the South African Indices of Multiple Deprivation (SAIMD) modelled at small-area level, this study tested associations between neighbourhood-level deprivation and depression, after controlling for individual-level covariates. RESULTS Results showed a significant positive association between neighbourhood-level deprivation and depression using the composite SAIMD (β = 0.31 (0.15); p=0.04) as well as the separate deprivation domains. Living environment deprivation (β =0.53 (0.16); p=0.001) and employment deprivation (β = 0.38 (0.13); p=0.004), respectively, were the two most salient domains in predicting this relationship. CONCLUSIONS Findings supported the hypothesis that there is a positive association between living in a more deprived neighbourhood and depression, even after controlling for individual-level covariates. This study suggests that alleviating structural poverty could reduce the burden of depression in South Africa.
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Affiliation(s)
- Nicholas Dowdall
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Catherine L. Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Nguyen LH, Tran BX, Hoang Le QN, Tran TT, Latkin CA. Quality of life profile of general Vietnamese population using EQ-5D-5L. Health Qual Life Outcomes 2017. [PMID: 29020996 DOI: 10.1186/s12955-017-0771-0.pmid:29020996;pmcid:pmc5637080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Health-related quality of life (HRQOL) is a vital benchmark to assess the effects of health interventions and policies. Measuring HRQOL of the general population is essential to establish a reference for health outcomes evaluations. However, evidence on HRQOL of general populations in low and middle income countries is very limited. This study aimed to measure HRQOL of the Vietnamese population by using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) instrument and determine its associated factors. METHODS A cross-sectional study was performed in Hanoi with 1571 residences in Hanoi, the capital city of Vietnam. EQ-5D-5L and EQ- visual analogue scale (EQ-VAS) were used to assess HRQOL. Potential covariates included socio-demographic characteristics, having acute symptoms in the last four weeks, chronic diseases in the last three months, having multiple health issues, and health service utilisation in the last twelve months. A generalized linear model was employed to identify the association between HRQOL and covariates. RESULTS Overall, the mean EQ-5D utility index was 0.91 (SD = 0.15), and the mean EQ-VAS score was 87.4 (SD = 14.3). The highest proportion of respondents reporting any problems was in Usual activities (24.3%), followed by Anxiety/Depression (15.2%) and Pain/Discomfort (10.0%), while the lowest percentage was in Self-care (2.5%). Lower HRQOL composite scores were related to unemployment, lower income, higher education, living in urban areas, having chronic diseases, having multiple health issues and using health service. For any health problem self-reported by respondents, the health utility reduced by 0.02 (respiratory diseases) to 0.15 (musculoskeletal diseases). CONCLUSIONS Health utility of the general population and reductions for self-reported health problems in this study are useful for future population health evaluations and comparisons. It also informs the development of interventions to reduce health problems of the general population.
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Affiliation(s)
- Long Hoang Nguyen
- School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Johns Hopkins Bloomberg School of Public Health, United States of America, Baltimore, MD, USA
| | | | - Tung Thanh Tran
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.
| | - Carl A Latkin
- Johns Hopkins Bloomberg School of Public Health, United States of America, Baltimore, MD, USA
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Quality of life profile of general Vietnamese population using EQ-5D-5L. Health Qual Life Outcomes 2017; 15:199. [PMID: 29020996 PMCID: PMC5637080 DOI: 10.1186/s12955-017-0771-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/27/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Health-related quality of life (HRQOL) is a vital benchmark to assess the effects of health interventions and policies. Measuring HRQOL of the general population is essential to establish a reference for health outcomes evaluations. However, evidence on HRQOL of general populations in low and middle income countries is very limited. This study aimed to measure HRQOL of the Vietnamese population by using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) instrument and determine its associated factors. METHODS A cross-sectional study was performed in Hanoi with 1571 residences in Hanoi, the capital city of Vietnam. EQ-5D-5L and EQ- visual analogue scale (EQ-VAS) were used to assess HRQOL. Potential covariates included socio-demographic characteristics, having acute symptoms in the last four weeks, chronic diseases in the last three months, having multiple health issues, and health service utilisation in the last twelve months. A generalized linear model was employed to identify the association between HRQOL and covariates. RESULTS Overall, the mean EQ-5D utility index was 0.91 (SD = 0.15), and the mean EQ-VAS score was 87.4 (SD = 14.3). The highest proportion of respondents reporting any problems was in Usual activities (24.3%), followed by Anxiety/Depression (15.2%) and Pain/Discomfort (10.0%), while the lowest percentage was in Self-care (2.5%). Lower HRQOL composite scores were related to unemployment, lower income, higher education, living in urban areas, having chronic diseases, having multiple health issues and using health service. For any health problem self-reported by respondents, the health utility reduced by 0.02 (respiratory diseases) to 0.15 (musculoskeletal diseases). CONCLUSIONS Health utility of the general population and reductions for self-reported health problems in this study are useful for future population health evaluations and comparisons. It also informs the development of interventions to reduce health problems of the general population.
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Kong KA, Khang YH, Cho HJ, Jang SM, Jung-Choi K. Neo-Marxian social class inequalities in self-rated health among the employed in South Korea: the role of material, behavioral, psychosocial, and workplace environmental factors. BMC Public Health 2017; 17:345. [PMID: 28427359 PMCID: PMC5397726 DOI: 10.1186/s12889-017-4269-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 04/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the pattern of social inequality in self-rated health among the employed using the Wright's social class location indicator, and to assess the roles of material, behavioral, psychosocial, and workplace environmental factors as mediating factors in explaining the social class inequality in self-rated health in South Korea. METHODS This study used data from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Study subjects included the employed population of 4392 men and 3309 women aged 19-64 years. Subjects were classified into twelve social class positions based on the Wright's social class map. The health outcome was self-rated health. Material, psychosocial, behavioral, and workplace environmental factors were considered as potential mediators in explaining social class health inequality. We calculated prevalence ratios of poor self-rated health according to social class, adjusted for age and mediating factors using Poisson regression models. RESULTS Nonskilled workers and petty bourgeoisie reported worse self-rated health than other social classes among men. The age-adjusted prevalence of petty bourgeoisie and nonskilled workers were about four-fold greater than that of managers. Expert supervisors in the contradictory class location had a greater prevalence of poor self-rated health than experts in men. In women, the prevalence of poor self-rated health was greater in most social classes than their male counterparts, while the differences among social classes within women were not statistically significant. Workplace environmental factors explained the social class inequality by from 24 to 31% in nonskilled and skilled workers and nonskilled supervisors, respectively, and material factors showed an explanatory ability of about 8% for both nonskilled workers and petty bourgeoisie in men. CONCLUSIONS We showed the inequality in self-rated health according to the Wright's social class in an industrialized Asian country. Policy efforts to improve workplace environments in nonskilled and skilled workers and nonskilled supervisors would have a moderate effect on reducing the magnitude of social class inequality in self-rated health. Furthermore, the means to improve power relations in the workplace should be devised to further reduce the social class inequalities in health.
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Affiliation(s)
- Kyoung Ae Kong
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Young-Ho Khang
- Department of Health Policy and Management and Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Hong-Jun Cho
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Mi Jang
- Department of Occupational and Environmental Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kyunghee Jung-Choi
- Department of Occupational and Environmental Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
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Quality of life and healthcare service utilization among methadone maintenance patients in a mountainous area of Northern Vietnam. Health Qual Life Outcomes 2017; 15:77. [PMID: 28427471 PMCID: PMC5399322 DOI: 10.1186/s12955-017-0633-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/17/2017] [Indexed: 02/02/2023] Open
Abstract
Background The expansion of methadone maintenance treatment in mountainous areas in still limited and little is known about its health impacts on drug users. This study aimed to examine health-related quality of life (HRQOL) and health care access among patients engaging in methadone maintenance treatment (MMT) in Tuyen Quang, a mountainous province in Vietnam. Methods We conducted a cross-sectional survey with 241 patients conveniently recruited in two MMT clinics (Son Duong and Tuyen Quang). EuroQol-5 Dimensions – 5 levels (EQ-5D-5 L) and Visual analogue scale (VAS) were employed to measure HRQOL. Multivariate logistic and tobit regressions were used to determine the factors associated with HRQOL and health care utilization. Results The overall mean score of the EQ-5D index and EQ-VAS were 0.88 (SD = 0.20) and 81.8% (SD = 15.27%), respectively. Only 8.7% utilized inpatient services, and 14.9% used outpatient services. Being more highly educated, suffering acute diseases, and using health service within the last 12 months were associated with a decreased EQ-5D index. Individuals who were multiple substance abusers and those who recently had inpatient care were more likely to have a lower VAS. Older respondents, those taking their medications at the more impoverished clinic, substance abusers, and individuals who were struggling with anxiety/depression or their usual daily activities were more likely to use both inpatient and outpatient care. Conclusions In summary, we observed good HRQOL, but high prevalence of anxiety/depression and low rates of service utilization among MMT patients in Tuyen Quang province. To improve the outcomes of MMT services in mountainous areas, it is necessary to introduce personalized and integrative services models with counseling and interventions on multiple substance use.
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Kruithof N, de Jongh MAC, de Munter L, Lansink KWW, Polinder S. The effect of socio-economic status on non-fatal outcome after injury: A systematic review. Injury 2017; 48:578-590. [PMID: 28077211 DOI: 10.1016/j.injury.2017.01.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/04/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Over the past decades, the number of survivors of injuries has rapidly grown. It has become important to focus more on the determinants of non-fatal outcome. Although socio-economic status (SES) is considered to be a fundamental determinant of health in general, the role of SES as a determinant of non-fatal outcome after injury is largely unknown. METHODS An online search was conducted in November 2015 using Embase, Medline, Web of Science, Cinahl, Cochrane, Google scholar and PubMed. Studies examining the relation between SES and a physical or psychological outcome measure, or using SES as a confounder in a general trauma population were included. There were no restrictions regarding study design. The 'Quality in Prognostic Studies tool' was used to assess the methodological quality of the included studies. RESULTS The 24 included studies showed large variations in methodological quality. The number of participants ranged from 56 to 4639, and assessments of the measures ranged from immediately to 6year post-injury. Studies used a large number of variables as indicators of SES. Participant's educational level was used most frequently. The majority of the studies used a multivariable technique to analyse the relation between SES and non-fatal outcome after injury. All studies found a positive association (80% of studies significant, n=19) between increased SES and better non-fatal outcome after injury. CONCLUSION Although an adequate and valid measure of SES is lacking, the results of this review showed that SES is an important determinant of non-fatal outcome after injury. Future research should focus on the definition and measurement of SES and should further underpin the effect of SES on non-fatal outcome after injury.
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Affiliation(s)
- N Kruithof
- Elisabeth-TweeSteden Hospital, Department Trauma TopCare, Tilburg, the Netherlands.
| | - M A C de Jongh
- Elisabeth-TweeSteden Hospital, Department Trauma TopCare, Tilburg, the Netherlands; Brabant Trauma Registry, Network Emergency Care Brabant, the Netherlands
| | - L de Munter
- Elisabeth-TweeSteden Hospital, Department Trauma TopCare, Tilburg, the Netherlands
| | - K W W Lansink
- Elisabeth-TweeSteden Hospital, Department Trauma TopCare, Tilburg, the Netherlands; Brabant Trauma Registry, Network Emergency Care Brabant, the Netherlands; Elisabeth-TweeSteden Hospital, Department of Surgery, Tilburg, the Netherlands
| | - S Polinder
- Erasmus MC, Department of Public Health, Rotterdam, the Netherlands
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Johnson WC, LaForest M, Lissenden B, Stern S. Variation in mental illness and provision of public mental health services. HEALTH SERVICES AND OUTCOMES RESEARCH METHODOLOGY 2016. [DOI: 10.1007/s10742-016-0167-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fuller-Thomson E, Jayanthikumar J, Agbeyaka SK. Untangling the Association Between Migraine, Pain, and Anxiety: Examining Migraine and Generalized Anxiety Disorders in a Canadian Population Based Study. Headache 2016; 57:375-390. [PMID: 27991658 DOI: 10.1111/head.13010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 10/29/2016] [Accepted: 10/30/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aims of this study were to investigate: (1) the prevalence and unadjusted and adjusted odds of 12-month generalized anxiety disorder (GAD) among adults with migraine in comparison to those without migraine; (2) If debilitating pain and/or limitations in instrumental activities of daily living (IADLs) are mediators of the migraine-GAD association; and (3) Factors associated with past year GAD among adults with migraine. METHODS Secondary data analysis of the nationally representative 2012 Canadian Community Health Survey-Mental Health (CCHS-MS), a population-based survey of community dwellers with a response rate of 68.9%. The first subsample included those with (n = 2232) and without migraine (n = 19,270), and the second subsample was restricted to those with migraine (n = 2232). GAD was based on the WHO-CIDI scale. RESULTS Fully, 6% of those with migraines had past year GAD in comparison of 2.1% of those without migraine (P < .001). The socio-demographically adjusted odds of past year GAD were two and a half times higher among those with migraine than those without (OR= 2.46; 95% CI = 2.00, 3.02). A path analysis indicated that debilitating pain and limitations in IADLs were mediators in the relationship between migraine and GAD. In the sample restricted to migraineurs, the factors associated with higher odds of 12-month GAD included having a university degree, having low income, being without a confidant, and being male. CONCLUSIONS Generalized anxiety disorder is robustly associated with migraine and targeted outreach and interventions are warranted.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Janany Jayanthikumar
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Senyo K Agbeyaka
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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Rasul F, Stansfeld SA, Davey-Smith G, Hart CL, Gillis C. Sociodemographic Factors, Smoking and Common Mental Disorder in the Renfrew and Paisley (MIDSPAN) Study. J Health Psychol 2016; 6:149-58. [DOI: 10.1177/135910530100600205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The relationships between common mental disorder measured by the General Health Questionnaire and sociodemographic variables and cigarette smoking were examined from baseline data in a community study of 15,406 men and women, aged between 45 and 64 years from two towns close to Glasgow. Between 1972 and 1976 all those respondents from Renfrew and Paisley between the ages of 45 and 64 years who met the residency criteria were invited to attend community clinics, where a clinical examination was carried out and the General Health Questionnaire was completed by 3783 (53.6 percent) men, and 4683 (56.1 percent) women. Women had a higher risk of disorder than men did. More women (20.3 percent) than men (15.4 percent) were possible cases of common mental disorder. Women showed a decrease in disorder with age but no apparent trend in men was observed. Marital status was significantly associated with disorder, with the widowed and separated showing especially high rates of psychiatric disorder. Married men, in contrast to married women, had relatively low levels of psychiatric disorder. Both social class and level of deprivation of the area were associated with psychiatric disorder. For both men and women there was a trend in disorder associated with social class; men in social class V had twice the level of psychiatric disorder compared to those in social class II. For women there was a shallow gradient showing higher levels of disorder with lower social class. Smoking habits were also related to psychiatric disorder; never- and exsmokers had relatively low rates of psychiatric disorder whereas, among current smokers, risk of psychiatric disorder, increased with the number of cigarettes smoked, though only for women.
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Affiliation(s)
| | - S. A. Stansfeld
- Department of Psychiatry, St Bartholomews and Royal London School of Medicine and Dentistry, Queen Mary & Westfield College, London, UK
| | - G. Davey-Smith
- Department of Social Medicine, University of Bristol, UK
| | | | - C. Gillis
- Department of Public Health, University of Glasgow, UK
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Abstract
Using data from a random sample of women from the welfare caseload in an urban Michigan county, the authors investigate the prevalence of domestic violence and its association with mental health, health, and economic well-being. Nearly a quarter of the women experienced physical partner violence in the past 12 months, and almost two thirds in their lifetimes. Recent victims had significantly higher rates of five psychiatric disorders (depression, generalized anxiety disorder, post-traumatic stress disorder, drug dependence, and alcohol dependence) and health problems than women who never experienced domestic violence. Recent partner violence was also associated with greater material hardship. Analyses did not indicate any significant association between domestic violence, past or present, and employment.
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Oliver MN, Muntaner C. Researching Health Inequities among African Americans: The Imperative to Understand Social Class. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2016; 35:485-98. [PMID: 16119572 DOI: 10.2190/ppqx-47dy-kw0x-78y8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Racial and ethnic inequities in health abound in many disease categories. African-American communities suffer from an increased burden of illness, with higher incidence and mortality rates and more severe morbidity in cerebrovascular disease, heart disease, several cancers, diabetes, and many other ailments. Healthy People 2010, the federal government's health plan, calls for eliminating health disparities by race, ethnicity, gender, education, income, disability, geographic location, or sexual orientation. Research aimed at increasing our understanding of these health disparities and designing and evaluating interventions to improve African-American health is hampered by a liberal, classless approach. The authors argue for a theoretical framework in this research that recognizes that class exploitation sets the stage for and interacts with racial discrimination to determine racial inequities in health.
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Affiliation(s)
- M Norman Oliver
- Department of Family Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA.
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Pierse N, Carter K, Bierre S, Law D, Howden-Chapman P. Examining the role of tenure, household crowding and housing affordability on psychological distress, using longitudinal data. J Epidemiol Community Health 2016; 70:961-6. [DOI: 10.1136/jech-2015-206716] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 04/15/2016] [Indexed: 11/04/2022]
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Cohen GH, Sampson LA, Fink DS, Wang J, Russell D, Gifford R, Fullerton C, Ursano R, Galea S. Gender, Position of Authority, and the Risk of Depression and Posttraumatic Stress Disorder among a National Sample of U.S. Reserve Component Personnel. Womens Health Issues 2016; 26:268-77. [PMID: 26899583 PMCID: PMC5008021 DOI: 10.1016/j.whi.2016.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 12/24/2015] [Accepted: 01/05/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recent U.S. military operations in Iraq and Afghanistan have seen dramatic increases in the proportion of women serving and the breadth of their occupational roles. General population studies suggest that women, compared with men, and persons with lower, as compared with higher, social position may be at greater risk of posttraumatic stress disorder (PTSD) and depression. However, these relations remain unclear in military populations. Accordingly, we aimed to estimate the effects of 1) gender, 2) military authority (i.e., rank), and 3) the interaction of gender and military authority on a) risk of most recent deployment-related PTSD and b) risk of depression since most recent deployment. METHODS Using a nationally representative sample of 1,024 previously deployed Reserve Component personnel surveyed in 2010, we constructed multivariable logistic regression models to estimate effects of interest. RESULTS Weighted multivariable logistic regression models demonstrated no statistically significant associations between gender or authority, and either PTSD or depression. Interaction models demonstrated multiplicative statistical interaction between gender and authority for PTSD (beta = -2.37; p = .01), and depression (beta = -1.21; p = .057). Predicted probabilities of PTSD and depression, respectively, were lowest in male officers (0.06, 0.09), followed by male enlisted (0.07, 0.14), female enlisted (0.07, 0.15), and female officers (0.30, 0.25). CONCLUSIONS Female officers in the Reserve Component may be at greatest risk for PTSD and depression after deployment, relative to their male and enlisted counterparts, and this relation is not explained by deployment trauma exposure. Future studies may fruitfully examine whether social support, family responsibilities peri-deployment, or contradictory class status may explain these findings.
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Affiliation(s)
- Gregory H Cohen
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.
| | - Laura A Sampson
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - David S Fink
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York
| | - Jing Wang
- Center for the Study of Traumatic Stress, Hebert School of Medicine, Uniformed Services University of the Health Sciences, Department of Psychiatry Bethesda, MD
| | - Dale Russell
- Center for the Study of Traumatic Stress, Hebert School of Medicine, Uniformed Services University of the Health Sciences, Department of Psychiatry Bethesda, MD
| | - Robert Gifford
- Center for the Study of Traumatic Stress, Hebert School of Medicine, Uniformed Services University of the Health Sciences, Department of Psychiatry Bethesda, MD
| | - Carol Fullerton
- Center for the Study of Traumatic Stress, Hebert School of Medicine, Uniformed Services University of the Health Sciences, Department of Psychiatry Bethesda, MD
| | - Robert Ursano
- Center for the Study of Traumatic Stress, Hebert School of Medicine, Uniformed Services University of the Health Sciences, Department of Psychiatry Bethesda, MD
| | - Sandro Galea
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, New York; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
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Fink DS, Cohen GH, Sampson LA, Gifford RK, Fullerton CS, Ursano RJ, Galea S. Incidence of and risk for post-traumatic stress disorder and depression in a representative sample of US Reserve and National Guard. Ann Epidemiol 2016; 26:189-97. [PMID: 26907538 DOI: 10.1016/j.annepidem.2016.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 01/04/2016] [Accepted: 01/11/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE We aim to determine the incidence rates (IR) of first-ever post-traumatic stress disorder (PTSD) and depression in a population-based cohort of US Reserve and National Guard service members. METHODS We used data from the US Reserve and National Guard Study (n = 2003) to annually investigate incident and recurrent PTSD and depression symptoms from 2010 to 2013. We estimated the IR and recurrence rate over 4 years and according to several sociodemographic and military characteristics. RESULTS From 2010 to 2013, IRs were 4.7 per 100 person-years for both PTSD and depression symptoms using the sensitive criteria, 2.9 per 100 person-years using the more specific criteria, recurrence rates for both PTSD and depression were more than 4 times as high as IRs, and IRs were higher among those with past-year civilian trauma, but not past-year deployment. CONCLUSIONS The finding that civilian trauma, but not past-year military deployment, is associated with an increased risk of PTSD and depression incidence suggest that Reserve National Guard psychopathology could be driven by other, nonmilitary, traumatic experiences.
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Affiliation(s)
- David S Fink
- Department of Epidemiology, Columbia University, New York, NY.
| | - Gregory H Cohen
- Department of Epidemiology, Columbia University, New York, NY
| | | | - Robert K Gifford
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Carol S Fullerton
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Robert J Ursano
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Sandro Galea
- Dean of School of Public Health, Boston University, Boston, MA
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Brisson C, Gilbert-Ouimet M, Duchaine C, Trudel X, Vézina M. Workplace Interventions Aiming to Improve Psychosocial Work Factors and Related Health. ALIGNING PERSPECTIVES ON HEALTH, SAFETY AND WELL-BEING 2016. [DOI: 10.1007/978-3-319-32937-6_15] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Prins SJ, Bates LM, Keyes KM, Muntaner C. Anxious? Depressed? You might be suffering from capitalism: contradictory class locations and the prevalence of depression and anxiety in the USA. SOCIOLOGY OF HEALTH & ILLNESS 2015; 37:1352-1372. [PMID: 26385581 PMCID: PMC4609238 DOI: 10.1111/1467-9566.12315] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Despite a well-established social gradient for many mental disorders, there is evidence that individuals near the middle of the social hierarchy suffer higher rates of depression and anxiety than those at the top or bottom. Although prevailing indicators of socioeconomic status (SES) cannot detect or easily explain such patterns, relational theories of social class, which emphasise political-economic processes and dimensions of power, might. We test whether the relational construct of contradictory class location, which embodies aspects of both ownership and labour, can explain this nonlinear pattern. Data on full-time workers from the National Epidemiologic Survey on Alcohol and Related Conditions (n = 21859) show that occupants of contradictory class locations have higher prevalence and odds of depression and anxiety than occupants of non-contradictory class locations. These findings suggest that the effects of class relations on depression and anxiety extend beyond those of SES, pointing to under-studied mechanisms in social epidemiology, for example, domination and exploitation.
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Affiliation(s)
- Seth J. Prins
- Department of Epidemiology, Columbia University, USA
| | - Lisa M. Bates
- Department of Epidemiology, Columbia University, USA
| | | | - Carles Muntaner
- Bloomberg Faculty of Nursing and Dalla Lana School of Public Health, and Department of Psychiatry, Center for Research in Inner City Health, St Michael’s Hospital, Toronto, Canada
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Kendler KS, Ohlsson H, Sundquist K, Sundquist J. Environmental clustering of drug abuse in households and communities: multi-level modeling of a national Swedish sample. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1277-84. [PMID: 25708193 PMCID: PMC4521979 DOI: 10.1007/s00127-015-1030-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 02/09/2015] [Indexed: 10/24/2022]
Abstract
PURPOSE Both epidemiological and genetically informative studies indicate that shared environmental influences contribute to resemblance in siblings for drug abuse (DA). To what degree do these influences arise from living in the same household versus residing in the same community? METHODS We performed a cross-classified multi-level logistic regression on all individuals born in Sweden 1975-1990 (N = 1558,654). We assessed the proportion of the total population variation in DA that was due to household versus community effects controlling for genetic resemblance. DA was assessed from medical, criminal and pharmacy records. RESULTS Expressed as an intraclass correlation (ICC), the combined household/community effects accounted for ~8 % of the total population variation in DA. The variance attributed to the community was greater than that seen for household (4.5 versus 3.4 %). In males, the variance components were slightly larger and nearly equal at the community (5.3 %) and household level (5.1 %). In females, household effects (4.8 %) were stronger than those arising from the community (3.2 %). CONCLUSION In the total population and among males, community effects on DA were somewhat more potent than household effects. However, in females, household effects on DA were stronger than community effects. In Sweden, shared environmental effects for DA arise both at the household and at the community level. Community effects on DA are more potent in males than in females.
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Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Box 980126, Richmond, VA 23298-0126, USA. Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA. Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden. Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden. Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
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Muntaner C, Ng E, Chung H, Prins SJ. Two decades of Neo-Marxist class analysis and health inequalities: A critical reconstruction. SOCIAL THEORY & HEALTH 2015; 13:267-287. [PMID: 26345311 PMCID: PMC4547054 DOI: 10.1057/sth.2015.17] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Most population health researchers conceptualize social class as a set of attributes and material conditions of life of individuals. The empiricist tradition of 'class as an individual attribute' equates class to an 'observation', precluding the investigation of unobservable social mechanisms. Another consequence of this view of social class is that it cannot be conceptualized, measured, or intervened upon at the meso- or macro levels, being reduced to a personal attribute. Thus, population health disciplines marginalize rich traditions in Marxist theory whereby 'class' is understood as a 'hidden' social mechanism such as exploitation. Yet Neo-Marxist social class has been used over the last two decades in population health research as a way of understanding how health inequalities are produced. The Neo-Marxist approach views social class in terms of class relations that give persons control over productive assets and the labour power of others (property and managerial relations). We critically appraise the contribution of the Neo-Marxist approach during the last two decades and suggest realist amendments to understand class effects on the social determinants of health and health outcomes. We argue that when social class is viewed as a social causal mechanism it can inform social change to reduce health inequalities.
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Affiliation(s)
- Carles Muntaner
- Bloomberg School of Nursing, Dalla Lana School of Public Health, University of Toronto , 155 College Street, Suite 386, Toronto, Ontario, Canada M5T 1P8 ; Department of Public Health Sciences, Korea University , Suite 365, Hana Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, 136-713 Republic of Korea . E-mail:
| | - Edwin Ng
- Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute , 209 Victoria Street, 3rd Floor, Toronto, Ontario, Canada M5B 1C6. E-mail:
| | - Haejoo Chung
- Department of Public Health Sciences, Korea University , Suite 365, Hana Science Building, 145 Anam-Ro, Seongbuk-Gu, Seoul, 136-713 Republic of Korea . E-mail:
| | - Seth J Prins
- Department of Epidemiology, Columbia University, Mailman School of Public Health , 722 West 168th Street, Suite #720C, New York, NY 10032, USA . E-mail:
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Murcia M, Chastang JF, Niedhammer I. Educational inequalities in major depressive and generalized anxiety disorders: results from the French national SIP study. Soc Psychiatry Psychiatr Epidemiol 2015; 50:919-28. [PMID: 25605025 DOI: 10.1007/s00127-015-1010-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 01/08/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Social inequalities in mental disorders have been reported; the lower the social position, the higher the prevalence of mental disorders. However, these inequalities have not always been observed and results may vary according to the indicator of social position, mental health outcome and population studied. The objective of this study was to examine the association between social position (educational level) and two mental disorders (major depressive disorder-MDD and general anxiety disorder-GAD), measured using a structured diagnostic interview (MINI), and to evaluate the contribution of work status in the explanation of this association. METHODS The study was based on a national representative sample of the French general population of 11,777 people including 8,072 workers. All analyses were done using weighted data. Bivariate Rao-Scott Chi-square tests were conducted, and multivariate analysis was performed using weighted logistic regression analysis with adjustment for age. RESULTS The prevalences of MDD/GAD and of less educated people were lower in the working population than in the non-working population. Educational inequalities were observed for MDD and GAD in the general population. Non-working status contributed to explain these inequalities by 23-28 % for MDD and by 23-37 % for GAD when the less educated group was considered. Non-working status was strongly associated with both disorders. CONCLUSION These results may improve our knowledge on educational inequalities in mental health and help to understand the discrepancies in the literature. Effort to preserve jobs and facilitate the return to employment may help to reduce social inequalities in mental health.
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Affiliation(s)
- Marie Murcia
- Department of Social Epidemiology, INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 75013, Paris, France
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