Impact of objective and subjective social status on obesity in a biracial cohort of adolescents

Longitudinal association between perceived economic stress and adolescents' depression in rural China: the mediating roles of hope trajectories

BACKGROUND

Family economic hardship is a risk factor for adolescents' depression. However, research on this topic is limited in its focus on objective economic conditions, and less is known about whether and how perceived economic stress is associated with adolescents' depression. This study explored the longitudinal relationship between perceived economic stress and depression and examined the extent to which heterogeneous developmental trajectories of hope explained the aforementioned relation in Chinese rural adolescents.

METHODS

A total of 2823 Chinese rural adolescents (56.0 % boys; Mage (T1) = 13.48 ± 0.50 years) participated in five assessments conducted at approximately six-month intervals over three years. Perceived economic stress was assessed at Time 1, hope was measured from Time 1 to Time 4, and depression was evaluated at Time 1 and Time 5.

RESULTS

The trajectories of hope were divided into three subgroups: "high-stable" (33.2 %), "moderate-decreasing" (41.9 %), and "low-decreasing" (24.9 %). Perceived economic stress was longitudinally and positively associated with depression, and this association was mediated by heterogeneous developmental trajectories of hope. Specifically, the mediation effect of low-decreasing and moderate-decreasing groups between perceived economic stress and depression was stronger than that of high-stable group, and there was no significant difference in the mediation effect between low-decreasing and moderate-decreasing groups.

LIMITATIONS

This study was limited by the nonrandomized sampling, the self-reporting method, and the relatively short observation period.

CONCLUSION

These findings demonstrate the long-term detrimental impact of perceived economic stress on depression among Chinese rural adolescents and underscore the importance of fostering hope in adolescents' intervention programs.

The Bidirectional Relation Between Bullying/Victimization and Negative Automatic Thoughts among Children

As a common form of negative interpersonal interaction in childhood, school bullying is closely related to individual negative cognition. Few studies have assessed whether there is an interaction between different kinds of school bullying roles and negative cognition. The present study administered four questionnaire follow-up tests among Chinese children over two years to explore the bidirectional relation and underlying mechanisms between bullying/victimization and negative automatic thoughts (about self/others). A total of 993 children with MT1age = 9.66 ± 0.72 participated in the study, including 647(65.16%) boys and 346(34.84%) girls. Results indicated a bidirectional relation between victimization and negative automatic thoughts (about self/others); negative automatic thoughts (about self/others) predicting bullying; negative automatic thoughts (about self/others) form two vicious cycles with victimization separately, in which victimization plays a mediating role. The findings suggest that considering improving children's negative cognition of self and others is an important pathway to reduce the occurrence of bullying and victimization in children and to stop children from falling into the cycle of victimization, which is crucial for children to have healthy relationships later in adolescence.

The Bidirectional Relations Between Parental Autonomy Support, Gratitude and Academic Engagement in Chinese Adolescents

Abundant evidence highlights the benefits of self-determined motivation (e.g., parental autonomy support as internalized extrinsic motivation, gratitude as intrinsic motivation) on academic engagement during adolescence, yet the potential mutual relations remain relatively unexplored. This study investigated the bidirectional relations and potential mechanisms among parental autonomy support, gratitude, and academic engagement using a traditional cross-lag-panel model (CLPM) and a within-person CLPM with random intercept (RI-CLPM) in a sample of Chinese youth (N = 1214; Mage = 15.46, SDage = 0.71; 39.30% girls) across three time points with 6-month intervals. The results indicated that the bidirectional relation between parental autonomy support and academic engagement was present in CLPM but not in RI-CLPM. However, the bidirectional relations between gratitude and academic engagement, and between gratitude and parental autonomy support, existed at both levels. Furthermore, in CLPM, parental autonomy support influenced academic engagement through gratitude, and gratitude, in turn, affected academic engagement through parental autonomy support. Academic engagement impacted gratitude via parental autonomy support, and simultaneously, academic engagement influenced parental autonomy support through gratitude. Academic engagement served as a mediator between parental autonomy support and gratitude, as well as between gratitude and parental autonomy support. Five self-enhancing loops were identified in CLPM. These findings reveal a virtuous cycle of mutual influence between parental autonomy support, gratitude, and adolescent academic engagement, highlighting the important role of academic engagement in strengthening autonomous motivation.

Contributions of subjective status to eating behaviors, obesity, and metabolic health across development

Subjective status is the evaluation of one's social or socioeconomic status relative to others. Lower subjective status has been associated with risk of overweight/obesity, poorer metabolic health, and obesogenic food preferences and eating behaviors. However, these findings are predominantly based on studies of adolescents and young adults. This indicates major gaps in knowledge and application of this social determinant of obesity and metabolic health, given that perceived status develops throughout the life course along with food environments and eating habits. Here, we review the relationships that subjective status shares with the outcomes of eating behaviors, obesity, and metabolic health across milestones and periods of development: during the prenatal period, as caregivers who feed children, during childhood (prior to age 10) and from adolescence into emerging adulthood (until mid-20's). For each developmental period, we explore why the period critically contributes to these outcomes and how subjective status may affect eating behaviors and metabolic health. We propose that subjective status contributes to eating/feeding behaviors and metabolic health both within and across developmental periods, such that the effect of low subjective status at an earlier period may contribute to obesogenic eating behaviors and metabolic health in later developmental periods and intergenerationally. The influence of low subjective status on higher body weight may also threaten subjective status later in development through heightened vulnerability to social stressors, such as weight-based stigma. Overall, subjective status may be a broadly influential factor to consider when examining social determinants of obesity and metabolic health across development.

Perceived Familial Financial Insecurity and Obesity Among Korean Adolescents During the COVID-19 Pandemic

BACKGROUND

In high-income countries, socioeconomically disadvantaged adolescents experience a higher risk of obesity, which may have been further exacerbated during the early phase of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to investigate the association between obesity and familial financial insecurity, utilizing data on subjective household socioeconomic status (SES) and perceived family-level financial deterioration induced by COVID-19.

METHODS

We utilized data from the Korea Youth Risk Behavior Survey, a nationally representative sample of Korean adolescents, in 2020 and 2021. The independent and joint associations of two primary exposures, subjective household SES and perceived family-level financial deterioration, with obesity were assessed using multivariable logistic regression models.

RESULTS

Among 106,979 adolescents aged 12-18 years, 16.9% of boys and 9.0% of girls met the criteria for obesity. Notably, 70.5% reported experiencing COVID-19-related financial deterioration. Both subjective household SES and perceived family-level financial deterioration independently and synergistically increased the odds of obesity. A graded association was observed between obesity and lower SES and more severe financial deterioration, particularly among girls. Younger adolescents were more sensitive to household SES, whereas older adolescents were more sensitive to financial deterioration.

CONCLUSION

While the COVID-19 pandemic presented a unique social context, our findings highlight that financially insecure adolescents were at an increased risk of obesity during the early phase of the pandemic. This underscores the need for obesity-prevention strategies in times of macroeconomic recession to address not only the persistent influence of household SES but also the direct and indirect effects of family-level financial deterioration.

The negative association of low subjective socioeconomic status with future orientation: the protective role of low fatalism

BACKGROUND

Subjective socioeconomic status (SES), an individual's beliefs about his or her social class, is anticipated to be related to future orientation. This study proposed a moderation model to examine the relationship between subjective SES on future orientation and the protective role of low fatalism.

METHODS

Two studies were conducted to test the proposed model. Specifically, in Study 1, the structured questionnaires were administered to a sample comprising 217 Chinese participants (192 females, Mage = 18.24 ± 0.63). In Study 2, the structured questionnaires and an Imaginative Scenario Test were administered to collect data among 244 Chinese participants (167 females, Mage = 18.44 ± 0.73). Regression analyses were used to explore the moderating role of fatalism in the association between subjective SES on future orientation. The Bootstrap methods were used to test the significance of these moderating effects.

RESULTS

The results revealed two primary findings: (1) Fatalism moderated the pathway from subjective SES to future orientation. Specifically, low fatalism served as a protective factor, making low subjective SES less disruptive to their future orientation. (2) The moderating effect was primarily attributed to the "luck dimension", which was the belief that luck plays a pivotal role in determining one's fate.

CONCLUSIONS

The findings contribute to enriching the current understanding of the subjective SES on future orientation and the protective role of low fatalism.

Incidence and influencing factors of kinesiophobia in patients with chronic heart failure: a scoping review

Introduction

Kinesiophobia denotes an excessive and irrational apprehension towards physical activity or exercise among patients, stemming from a perception of susceptibility to painful injury or re-injury. Cardiac rehabilitation stands pivotal in the secondary prevention spectrum for individuals with cardiovascular ailments, with exercise constituting a cornerstone of this regimen. However, the emergence of kinesiophobia poses a formidable challenge, diminishing patient adherence to cardiac rehabilitation protocols, particularly among those grappling with chronic heart failure. To bolster exercise-based rehabilitation initiatives in this cohort, a thorough comprehension of the multifaceted factors precipitating kinesiophobia is imperative. This review endeavors to delineate prevailing evidence and prevalence concerning kinesiophobia triggers in chronic heart failure patients, while pinpointing research lacunae for future exploration.

Methods

Employing a scoping review methodology, our investigation culled data from diverse scholarly databases, including Embase, PubMed, Scopus, CINAHL, Web of Science, Medline, Sinomed, CNKI, Wangfan, and VIP.

Results

After thorough evaluation, 9 studies that met the inclusion criteria were ultimately incorporated.

Discussion

Our findings underscore a notable prevalence of kinesiophobia in chronic heart failure patients, predominantly influenced by socio-demographic factors, psychological and cognitive factors, disease and treatment factors, as well as lifestyle and behavior. Armed with these insights, future interventions can be tailored to mitigate kinesiophobia levels, fostering enhanced engagement in exercise-centric cardiac rehabilitation endeavors among patients grappling with chronic heart failure.

Lower subjective social status is associated with increased adiposity and self-reported eating in the absence of hunger due to negative affect among children reporting teasing distress

OBJECTIVES

Low social standing and teasing are independently associated with increased body mass index (BMI) and overeating in children. However, children with low social status may be vulnerable to teasing.

METHODS

We tested the statistical interaction of subjective social status (SSS) and subjective socioeconomic status (SSES) and teasing distress on BMI, fat mass index (FMI), and eating in the absence of hunger (EAH) in children (Mage = 13.09 years, SD = 2.50 years; 27.8% overweight/obese). Multiple linear regressions identified the main effects of self-reported SSS (compared to peers in school), distress due to teasing, and their interaction on BMI (n = 115), FMI (n = 114), and child- (n = 100) and parent-reported (n = 97) EAH.

RESULTS

Teasing distress was associated with greater BMI, FMI, and child-reported EAH due to negative affect (a subscale of EAH) and total EAH scores. There were no associations of SSS with these outcomes. However, there was an interaction between SSS and teasing distress for BMI, FMI, and EAH from negative affect such that lower SSS was associated with higher BMI, FMI, and EAH from negative affect in the presence of teasing distress. However, there were no main effects or interactions (with teasing distress) of SSES on the outcomes.

CONCLUSIONS

These findings suggest that the relationship between lower SSS and increased adiposity and overeating behaviors may be exacerbated by other threats to social standing, such as teasing. Children exposed to multiple social threats may be more susceptible to eating beyond physiological need and obesity than those who experience a single form of perceived social disadvantage.

Associations Between Subjective Social Status and Health Behaviors Among College Students

OBJECTIVE

Examine the associations between subjective social status (SSS), diet, and health outcomes in college students.

METHODS

Cross-sectional study of 841 students enrolled at a large Midwestern university. Subjective social status within the US, as well as within the university, was measured using the MacArthur Scale of SSS. Outcomes included dietary intake (assessed using the Dietary Screening Questionnaire), body mass index, sleep, physical activity, alcohol use, and vaping behavior. Generalized linear models adjusting for students' sociodemographic characteristics were used to assess associations between SSS and outcomes of interest.

RESULTS

Higher SSS-US was associated with 4%, 3%, and 1% higher intake of fruits, whole grains, and fiber, respectively (P < 0.05). Higher SSS-US and SSS-university rankings were both significantly associated with lower body mass index and better sleep duration (P < 0.05). Higher SSS-university rankings were also associated with more days of physical activity and alcohol consumption (P < 0.05).

CONCLUSIONS AND IMPLICATIONS

In this exploratory study, higher SSS, apart from alcohol intake, was associated with more favorable health outcomes. More research is needed to consider additional psychological and biological mediators and dynamic aspects of SSS, examine potential interactions between SSS and racial and ethnic identities, and explore potential mechanisms underlying the observed associations.

Association between depression and stroke and the role of sociodemographic factors: A study among hypertensive populations

OBJECTIVES

Studies have shown that depression increases the risk of stroke, and that this relationship can be modified by sex. However, few studies have explored this relationship in a hypertensive population, and an examination of sociodemographic factors may be useful in determining whether depression and stroke are related.

MATERIALS AND METHODS

We used data from the National Health and Nutrition Examination Survey conducted between 2005-2018. The relationship between depression and stroke was investigated using a multivariate logistic regression. Effect modification by sex was examined using an interaction analysis model.

RESULTS

Participants with mild or moderate depression had a 53 % (odds ratio, [OR] 1.53; 95 % confidence interval [CI], 1.15-2.04) higher risk of stroke than those without depression, with 1.76 times (95 % CI, 1.14-2.72) greater risk for major depression. Interaction analysis indicated that sex had no effect on this relationship (OR, 1.30; 95 % CI, 0.85-1.47, P=0.430). In comparison with Hispanics, non-Hispanic blacks and others/mixed-race individuals with depression had a greater risk of stroke (OR, 2.26; 95 % CI, 1.5-3.14; OR, 2.67, 95 % CI, 1.29-5.55).

CONCLUSIONS

Our study found that the degree of depression was positively correlated with stroke in a hypertensive population, and that this relationship was not affected by sex.

Subjective socioeconomic status and self-rated health in the English Longitudinal Study of Aging: A fixed-effects analysis

Higher subjective socio-economic status (SES) goes along with better self-rated health: This finding is well-established in the literature, yet the majority of studies it is based on only rely on cross-sectional analyses and only account for few potential confounders of the association. Particularly wealth, which is increasingly thought of as an important dimension of accumulated advantage, is only rarely examined as a confounder. Using eight waves of panel data from the English Longitudinal Study of Aging (ELSA, 2002-19), we investigate the association between subjective SES and self-rated health. We use random effects models that account for theoretically important time-constant (such as education and social class) and time-varying confounders (such as income and wealth) as well as fixed-effects models, that in addition control for all time-constant confounders, whether observed or unobserved. The fully adjusted fixed-effects model reveals a statistically significant association between subjective SES and self-rated health. Yet, a one-point increase on the subjective SES ladder goes along with a two per cent of a standard deviation increase in self-rated health, only around a quarter of the size of the random-effects estimate. The role of wealth for the subjective SES-self-rated health association is negligible in the fixed-effects specifications. Smoking, drinking, and physical activity do not appear to mediate the association. A substantial part, though not all, of the observed association between subjective SES and self-rated health is due to unobserved confounding rather than a causal effect. Reducing health inequalities based on objective SES is likely more effective than based on subjective SES.

Subjective Social Status and Longitudinal Changes in Systemic Inflammation

BACKGROUND

Subjective social status (SSS) refers to a person's perception of their social rank relative to others and is cross-sectionally linked to systemic inflammation independently of objective socioeconomic status.

PURPOSE

We test the extent to which SSS relates to multiyear changes in inflammation, or if associations differ by race or sex.

METHODS

Healthy adults (N = 331; 30-51 years) completed a baseline visit and 278 participants returned for a second visit 2.85 years later. At both visits, participants underwent a fasting blood draw and completed community (SSSC) and US (SSSUS) versions of the MacArthur Scale. Multiple linear regression analyses examined change in interleukin-6 (IL-6) and C-reactive protein (CRP) predicted by each type of SSS, adjusting for time between visits, sex, race, age, body mass index, smoking, baseline inflammation, and objective socioeconomic status. Additional analyses further adjusted for hopelessness and depressive symptoms. Interactions examined moderations by sex and race.

RESULTS

Lower SSSC was longitudinally associated with greater IL-6 independently of all covariates, including education and income (β = -0.06), hopelessness (β = -0.06), and depressive symptoms (β = -0.06). Lower SSSUS was longitudinally associated with greater IL-6 independently of demographic covariates including education and income (β = -0.06), but was slightly attenuated after adjusting for hopelessness (β = -0.06) and depressive symptoms (β = -0.06). There were no associations for CRP or moderation by race or sex.

CONCLUSIONS

Lower SSS may be associated with greater circulating markers of inflammation over time as suggested by increases in IL-6.

Relationships examined: Parent and child readiness to change and sociodemographic characteristics in family based weight loss treatment

BACKGROUND

Family based treatment is an effective, multipronged approach to address obesity as it plagues families.

OBJECTIVE

To investigate the relationships among sociodemographic characteristics (e.g., education and income), body mass index (BMI) and race/ethnicity with readiness to change for parents enrolled in the Primary care pediatrics, Learning, Activity and Nutrition (PLAN) study.

METHODS

Multivariate linear regressions tested two hypotheses: (1) White parents will have higher levels of baseline readiness to change, when compared to Black parents; (2) parents with higher income and education will have higher levels of readiness to change at baseline.

RESULTS

A positive relationship exists between baseline parent BMI and readiness to change (Pearson correlation, 0.09, p < 0.05); statistically significant relationships exist between parent education level (-0.14, p < 0.05), income (0.04, p < 0.05) and readiness to change. Additionally, a statistically significant relationship exists, with both White (β, -0.10, p < 0.05), and Other, non-Hispanic (-0.10, p < 0.05) parents exhibiting lower readiness to change than Black, non-Hispanic parents. Child data did not indicate significant relationships between race/ethnicity and readiness to change.

CONCLUSIONS

Results demonstrate that investigators should consider sociodemographic characteristic factors and different levels of readiness to change in participants enrolling in obesity interventions.

Racial and ethnic differences in the relationship between financial worry and white matter hyperintensities in Latinx, non-Latinx Black, and non-Latinx White older adults

Socioeconomic status (SES) is associated with white matter hyperintensities (WMHs) and contributes to racial and ethnic health disparities. However, traditional measures of SES may not accurately represent individual financial circumstances among non-Latinx Black and Latinx older adults due to longstanding structural inequities. This study examined associations between multiple SES indicators (education, income, subjective financial worry) and WMHs across non-Latinx Black, Latinx, and non-Latinx White older adults in the Washington Heights-Inwood Columbia Aging Project (N = 662). Latinx participants reported the lowest SES and greatest financial worry, while Black participants evidenced the most WMHs. Greater financial worry was associated with higher WMHs volume above and beyond education and income, which were not associated with WMHs. However, this association was only evident among Latinx older adults. These results provide evidence for the minority poverty hypothesis and highlight the need for systemic socioeconomic interventions to alleviate brain health disparities in older adulthood.

The Effect of Social Appearance Anxiety on the Online Impulse Purchases of Fashionable Outfits Among Female College Students During Pandemic Periods: The Mediating Role of Self-Control and the Moderating Role of Subjective Socioeconomic Status

Purpose

With the rise of social media, an increasing number of young females have focused more attention on their body image, leading to social appearance anxiety. Thus, the current study aimed to investigate a moderated mediation model of social appearance anxiety and online impulse purchases of fashionable outfits through self-control moderated by subjective socioeconomic status during the pandemic.

Methods

A total of 1651 female college students (Age = 17-24, Mage = 19.30, SD = 1.14) with more than one month of closed-off management experience completed self-report questionnaires concerning social appearance anxiety, self-control, online impulse purchases of fashionable outfits, and subjective socioeconomic status.

Results

After controlling for the potential influence of coronavirus stress, the results indicated that social appearance anxiety was positively related to online impulse purchases of fashionable outfits among female college students during the pandemic, mediated by self-control. Furthermore, subjective socioeconomic status moderated the indirect link between social appearance anxiety and the online impulse purchase of fashionable outfits. Specifically, subjective socioeconomic status buffers the negative effect of social appearance anxiety on self-control and the risk effect of low self-control on the online impulse purchases of fashionable outfits.

Implications

The current study deepens the research on the relationship between social appearance anxiety and online impulse purchases during pandemic periods; meanwhile, it provides evidence for preventing excessive online impulse purchases of fashionable outfits among young females.

Low subjective social status is associated with daily selection of fewer healthy foods and more high-fat/high sugar foods

Socioeconomic status has been related to poorer eating behaviors, potentially due to feeling of lower status relative to peers. Despite experimental evidence that temporarily feeling of lower status can contribute to greater caloric intake, it remains unclear how feeling of lower social status relate to eating behavior in daily life. This study aimed to test whether lower subjective social status (SSS)-the feeling of having relatively lower social status-in American society and relative to college peers were related to daily food selection. A sample of 131 young adults (Mage = 20.3, SD = 0.8; 60% female; 46% Latinos; 34% European American; 15% Asian American; 5% of other ethnicities) reported their SSS in society and in college and completed 15 daily reports regarding the number of daily servings they had of fruits, vegetables, fried foods, fast foods, desserts, and sugary drinks. Multilevel models with days nested within individuals were used to test whether low SSS in society or college related to daily food intake. Next, we examined whether associations were driven by young adults' perceived stress and daily stressors. Analyses controlled for age, gender, ethnicity, family and personal income, and parents' education to test the unique associations between subjective status and food intake. Whereas SSS in society was not related to food intake, young adults with lower SSS in their college consumed fewer daily servings of healthy foods and more daily servings of high-fat/high-sugar foods. Although lower college SSS was related to greater perceived stress, perceived stress and daily stressors were consistently unrelated to daily food intake. Findings suggested that lower SSS in local environments (e.g., college) may impact young adults' daily food choices through processes beyond heightened stress.

The relationship between Chinese adults' self-assessments of family social status in childhood and depression: A moderated mediation model

BACKGROUND

Using the data from a large-scale Chinese national survey, this study aimed to explore the underlying mechanisms between Chinese adults' self-assessments of family social status in childhood and depression.

METHODS

The research data was from the China Family Panel Studies (CFPS) in 2020. We selected 13,430 Chinese adults aged 16-60 as participants, and used the PROCESS macro program to conduct moderated mediation analysis.

RESULTS

Chinese adults' self-assessments of family social status in childhood had a statistically significant negative predictive effect on depression. The sharing frequency of WeChat Moments played a partial mediating role in the relationship between self-assessment of family social status in childhood and depression. Furthermore, social trust moderated the direct effect of mediation model. Age moderated the second half of the mediation model, and the effect was statistically significant in the younger population (young people), but not in the older population (middle-aged people).

LIMITATIONS

This was a cross-sectional study and no causal conclusions could be drawn.

CONCLUSIONS

Chinese adults' self-assessment of family social status in childhood could affect depression in adulthood through sharing frequency of WeChat Moments. People with higher social trust can effectively buffer the adverse effect of self-assessed low family social status in childhood on depression. Age moderated the relationship between sharing frequency of WeChat Moments and depression, but this moderating effect was only significant in the younger population.

The Influence of Subjective Socioeconomic Status on Life Satisfaction: The Chain Mediating Role of Social Equity and Social Trust

Life satisfaction is significantly influenced by social capital, a key sociological term that links people to their social surroundings. Through a survey of 17,217 Chinese residents, this study investigated the probable processes of how subjective socioeconomic status affects life satisfaction within the framework of social capital. The results indicate that there is a positive correlation between subjective socioeconomic status and life satisfaction. Subjective socioeconomic status influences citizens' life satisfaction not only through the independent mediating effects of perceived social equity and social trust, but also through the chain mediation of perceived social equity and social trust. This research advances our knowledge of the mechanisms behind the association between subjective socioeconomic status and life satisfaction. In improving citizens' life satisfaction, we should not only provide sufficient subjective socioeconomic status to improve it, but also focus on the improvement of their social equity perceptions and social trust.

A moderated mediation mechanism underlying the impact of website telepresence on purchase intention - Evidence from Chinese female college student customers

Telepresence in e-commerce, the feeling of resembling shopping in a physical store, plays a critical role in determining online purchase intention. However, the cognitive mechanism and boundary conditions about its effect still need further investigation. The current study construed flow experience and socioeconomic status as important variables and developed a moderated mediation model for their roles in the effect of telepresence. The model was supported by our study where a group of Chinese female college students participated in simulated online apparel shopping and completes relevant questionnaire surveys. The results show that: (1) website telepresence predicts positively the purchase intention of females, (2) flow experience mediates the impact of website telepresence on purchase intention, and (3) the relationship between website telepresence and flow experience could be moderated by socioeconomic status, namely, females with higher socioeconomic status demonstrate stronger mediation of flow experience. These findings can help researchers and online retailers understand the flow concept in e-commerce and formulate marketing strategies to retain consumers with different socioeconomic statuses.

The effects of experimentally manipulated social status and subjective social status on physical activity among Hispanic adolescents: An RCT

BACKGROUND

Low objective socioeconomic status (SES) and subjective social status (SSS), one's perceived social rank, are associated with obesity. This association may be due, in part, to social status-related differences in energy expenditure. Experimental studies are needed to assess the extent to which SES and SSS relate to energy expenditure.

OBJECTIVE

Assess the effects of experimentally manipulated social status and SSS on moderate-to-vigorous physical activity (MVPA) and sedentary behaviour.

METHODS

One hundred thirty-three Hispanic adolescents aged 15-21 were randomized to a high or low social status position, facilitated through a rigged game of Monopoly™. SSS was assessed with MacArthur Scales. Post-manipulation 24-h MVPA and sedentary behaviour were assessed via accelerometry. Analyses were conducted with general linear regression models.

RESULTS

Experimentally manipulated social status did not significantly affect the total time spent in MVPA or sedentary behaviour; however, identifying as low SSS was significantly associated with less MVPA (p = 0.0060; 18.76 min less).

CONCLUSIONS

Tewnty-four-hour MVPA and sedentary behaviour are not affected by an acute experimental manipulation of social status. However, low SSS, independent of SES, was associated with clinically significant differences in MVPA. SSS may be a better predictor of MVPA than SES among Hispanic adolescents, potentially influencing obesity, and other health-related outcomes.

Trajectories of health-related quality of life by change pattern of objective and subjective social status

Long-term and cumulative social experiences influence an individual's objective and subjective social status. Social determinants of health are more effectively investigated by longitudinal rather than cross-sectional studies. The primary focus of this study was the prospective effect of socioeconomic transition on health-related quality of life trajectories. The study population were adults over 18 years of age who responded in all nine waves of the Korea Health Panel (2009-2017). Data were analyzed by group-based trajectory modeling to identify health trajectories, and group-based multi-trajectory modeling to investigate combined change patterns of objective and subjective social status (i.e., multi-SES trajectories). To predict the effects of underlying socioeconomic measures on health trajectory group membership, we included these time-stable covariates in trajectory modeling and estimated the risk of belonging to each trajectory based on the measures. The health-related quality of life trajectories showed three patterns during the period 2013 to 2017; 13.7% of individuals had a low and declining health trajectory and the others had a higher stable health trajectory. Four types of multi-SES trajectory were derived during the period 2009 to 2013; the richer had a steeper income slope while there were slight changes in subjective social status among all groups. These combined longitudinal SES patterns in 2009-2013 were strong predictors of subsequent health trajectory group membership in 2013-2017. These findings indicate that rich countries, such as South Korea, may encounter growing income inequality, where individuals become entrenched in income disparity that pins down their perceptions of social position. Over time this rigid social structure will widen the gap in health-related quality of life.

Cues of Social Status: Associations Between Attractiveness, Dominance, and Status

Hierarchies naturally emerge in social species, and judgments of status in these hierarchies have consequences for social relationships and health. Although judgments of social status are shaped by appearance, the physical cues that inform judgments of status remain unclear. The transition to college presents an opportunity to examine judgments of social status in a newly developing social hierarchy. We examined whether appearances—as measured by raters’ judgments of photographs and videos—provide information about undergraduate students’ social status at their university and in society in Study 1. Exploratory analyses investigated whether associations differed by participants’ sex. Eighty-one first-year undergraduate students (M_age = 18.20, SD = 0.50; 64.2% female) provided photographs and videos and reported their social status relative to university peers and relative to other people in society. As hypothesized, when participants were judged to be more attractive and dominant they were also judged to have higher status. These associations were replicated in two additional samples of raters who evaluated smiling and neutral photographs from the Chicago Faces Database in Study 2. Multilevel models also revealed that college students with higher self-reported university social status were judged to have higher status, attractiveness, and dominance, although judgments were not related to self-reported society social status. Findings highlight that there is agreement between self-reports of university status and observer-perceptions of status based solely on photographs and videos, and suggest that appearance may shape newly developing social hierarchies, such as those that emerge during the transition to college.

Inequality in Place: Effects of Exposure to Neighborhood-Level Economic Inequality on Mortality

This study contributes to the debate on whether income inequality is harmful for health by addressing several analytical weaknesses of previous studies. Using the Panel Study of Income Dynamics in combination with tract-level measures of income inequality in the United States, we estimate the effects of differential exposure to income inequality during three decades of the life course on mortality. Our study is among the first to consider the implications of income inequality within U.S. tracts for mortality using longitudinal and individual-level data. In addition, we improve upon prior work by accounting for the dynamic relationship between local areas and individuals' health, using marginal structural models to account for changes in exposure to local income inequality. In contrast to other studies that found no significant relation between income inequality and mortality, we find that recent exposure to higher local inequality predicts higher relative risk of mortality among individuals at ages 45 or older.

Subjective Social Status Is Associated with Dysregulated Eating Behaviors and Greater Body Mass Index in an Urban Predominantly Black and Low-Income Sample

Background: Higher subjective social status (SSS) or a person’s perception of their social standing is related to better health outcomes, but few studies examined SSS in relation to obesity. Emotional eating and food addiction have been linked to obesity. Some studies indicated that manipulating SSS may lead to altered food intake, but the relationship between SSS and dysregulated eating, such as emotional eating and food addiction (FA), has not been examined. The goal of this study was to examine the associations between SSS in the community and the larger society, dysregulated eating (emotional eating and FA), and body mass index (BMI) in a majority racial minority sample. Methods: The participants (N = 89; 93% Black, 86% women, and 56% with obesity; 72% income lower than USD 2000), recruited from a publicly funded hospital in Atlanta, GA, completed the MacArthur Scale, Dutch Eating Behaviors Questionnaire, Yale Food Addiction Scale, Beck Depression Inventory, PTSD Symptom Checklist, and demographics questionnaire. Results: Twenty-two percent of the sample met the criteria for FA; those with FA had significantly higher BMI than those without (p = 0.018). In the hierarchical linear regression, the SSS community (but not in society) predicted higher severity of emotional eating (β = 0.26, p = 0.029) and FA (β = 0.30, p = 0.029), and higher BMI (β = 0.28, p = 0.046), independent from depression and PTSD symptoms. Conclusions: The findings indicate that, among Black individuals with predominantly low income in the U.S., perceived role in their community is associated with eating patterns and body mass. Given the small sample size, the results should be interpreted with caution.

Dietary Intake of Folate and Assessment of the Folate Deficiency Prevalence in Slovenia Using Serum Biomarkers

Folate deficiency is associated with various health issues, including anemia, cardiovascular disease, and birth defects. Low folate intake and suboptimal folate status were found in several countries; however, this topic has not yet been investigated in Slovenia. Dietary folate intake and serum folate status were investigated through the nationally representative food consumption study SI.Menu/Nutrihealth. Folate intake was estimated using a sample of N = 1248 subjects aged 10-74 years, stratified in three age groups (adolescents, adults, elderly population), through two 24 h-dietary recalls and food propensity questionnaire. Data on serum folate and homocysteine was available for 280 participants. Very low folate intake (<300 µg/day) was observed in 59% of adolescents, 58% of adults and 68% of elderlies, and only about 12% achieved the WHO recommended level of 400 µg/day. Major dietary contributors were vegetables and fruit, and cereal products. Living environment, education, employment status and BMI were linked with low folate intake in adults; BMI, and sex in adolescents; and sex in elderlies. Considering low serum folate (<7 nmol/L) and high serum homocysteine (>15 nmol/L), folate deficiency was found in 7.6 and 10.5% in adults and elderlies, respectively. Additional public health strategies should be employed to promote the consumption of folate-rich foods. With current folate intakes, supplementation with folic acid is relevant especially in specific vulnerable populations, particularly in women planning and during pregnancy.

Marginal Food Security Predicts Earlier Age at Menarche Among Girls From the 2009-2014 National Health and Nutrition Examination Surveys

STUDY OBJECTIVE

This study analyzed the relationship between household food security and variation in age at menarche, as well as the connections between food insecurity, nutritional status, and allostatic load, among girls aged 12-15 years from the 2009-2014 United States National Health and Nutrition Examination Survey (NHANES).

METHODS

Data analysis included mean comparisons of age at menarche among household food security groups (high, marginal, low, and very low) as well as categorical variables known to associate with age at menarche (ethnicity, poverty status, body mass index [BMI], allostatic load, and milk consumption). χ² Analyses were used to test the associations between household food security and additional categorical variables. Univariate and multivariate regression models were used to test the relationship between variation in age at menarche and household food security, ethnicity, BMI, and allostatic load categories while controlling for age.

RESULTS

Non-Hispanic Black and Hispanic/Mexican American girls had earlier mean ages at menarche, higher mean BMIs, and disproportionately experienced household food insecurity when compared to non-Hispanic White-identifying girls. In the univariate analyses, marginal household food security, Hispanic/Mexican American and Black ethnicities, overweight and obese BMI categories, and marginal-high allostatic load were each associated with lower age at menarche compared to reference categories. These associations were maintained in the multivariate analysis, although only Hispanic/Mexican American ethnicity predicted earlier menarche when compared to that of non-Hispanic White girls.

CONCLUSIONS

Marginal household food security, particularly for girls who identified as non-White, predicted earlier age at menarche independent of nutritional status and allostatic load. At the same time, having more energetic resources (ie, higher BMI) also significantly predicted earlier menarche.

Explaining subjective social status in two countries: The relative importance of education, occupation, income and childhood circumstances

In the literature on social inequalities in health, subjective socioeconomic position (SEP) is increasingly applied as a determinant of health, motivated by the hypothesis that having a high subjective SEP is health-enhancing. However, the relative importance of determinants of subjective SEP is not well understood. Objective SEP indicators, such as education, occupation and income, are assumed to determine individuals' position in the status hierarchy. Furthermore, an extensive literature has shown that past childhood SEP affects adult health. Does it also affect subjective SEP? In this paper, we estimate the relative importance of i) the common objective SEP indicators (education, occupation and income) in explaining subjective SEP, and ii) childhood SEP (childhood financial circumstances and parents' education) in determining subjective SEP, after controlling for objective SEP. Given that the relative importance of these factors is expected to differ across institutional settings, we compare data from two countries: Australia and Norway. We use data from an online survey based on adult samples, with N ≈ 1400 from each country. Ordinary least squares regression is conducted to assess how objective and childhood SEP indicators predict subjective SEP. We use Shapley value decomposition to estimate the relative importance of these factors in explaining subjective SEP. Income was the strongest predictor of subjective SEP in Australia; in Norway, it was occupation. Of the childhood SEP variables, childhood financial circumstances were significantly associated with subjective SEP, even after controlling for objective SEP. This association was the strongest in the Norwegian sample. Only the mother's education had a significant impact on subjective SEP. Our findings highlight the need to understand the specific mechanisms between objective and subjective SEP as determinants of inequalities in health, and to assess the role of institutional factors in influencing these complex relationships.

The Status Dynamics of Role Blurring in the Time of COVID-19

Has the coronavirus disease 2019 pandemic altered the status dynamics of role blurring? Although researchers typically investigate its conflictual aspects, the authors assess if the work-home interface might also be a source of status—and the relevance of schedule control in these processes. Analyzing data from nationally representative samples of workers in September 2019 and March 2020, the authors find that role blurring is associated with elevated status, but the onset of coronavirus disease 2019 weakens that effect. Likewise, schedule control enhances the status of role blurring, but its potency is also weakened during the pandemic. These findings align with the suggestion that role blurring signals a commitment to work and adherence to ideal worker norms. However, the pandemic changed that by intensifying role integration and possibly by reducing the degree of agency once associated with role blurring. The loss of choice around role blurring might have also diluted the distinctive status that it once carried.

Sociodemographic Predictors of Adherence to National Diet and Physical Activity Guidelines at Age 5 Years: The Healthy Start Study

PURPOSE

To assess adherence to the 2015-2020 Dietary Guidelines for Americans and 2018 Physical Activity Guidelines, and identify sociodemographic predictors of adherence among children.

DESIGN

Cross sectional.

SETTING

Colorado, United States.

PARTICIPANTS

Children aged 5 (n = 482).

MEASURES

Sex, race/ethnicity, maternal education, maternal employment, maternal subjective social status and household income were assessed via questionnaires. Diet was assessed via 2 interviewer-administered 24-hour dietary recalls. Physical activity was objectively-measured with accelerometry for 7 days. Adherence was defined as a Healthy Eating Index-2015 score of ≥70 and/or ≥6 hours/day of light, moderate and vigorous activity.

ANALYSIS

For each predictor, logistic regression was used to estimate odds ratios for adherence to the diet guidelines only, the activity guidelines only or both guidelines.

RESULTS

In the full sample, 29% of children were non-adherent to both guidelines, 6% adhered to the dietary guidelines only, 50% adhered to the activity guidelines only and 14% adhered to both. Girls had a 41% lower odds of adhering to the physical activity guidelines than boys (p = 0.01), after adjustment for race/ethnicity, household income and maternal education level, perceived social status and employment status.

CONCLUSION

Efforts to improve the health of young children should promote adherence to the Dietary Guidelines for Americans among all children. Targeted interventions that increase physical activity among girls may help to mitigate health disparities.

Psychological Resilience, Experimentally Manipulated Social Status, and Dietary Intake among Adolescents

Relative to other racial/ethnic groups in the United States, Hispanic American (HA) youth have higher rates of overweight and obesity. Previous work suggests that low perceived social status (SS) promotes excess caloric intake and, thereby, development of obesity. Psychological resilience may play a role in reducing adverse eating behaviors and risk for obesity. The objective of this study was to investigate whether resilience (as measured by the Connor Davidson Resilience Scale) interacts with experimentally manipulated SS to affect dietary intake among HA adolescents (n = 132). Using a rigged game of Monopoly (Hasbro, Inc.), participants were randomized to a high or low SS condition. Following the Monopoly game, participants consumed an ad libitum lunch and their dietary intake was assessed. There was a significant interaction between resilience and experimentally manipulated SS for total energy intake (p = 0.006), percent energy needs consumed (p = 0.005), and sugar intake (p = 0.004). For the high SS condition, for each increase in resilience score, total energy intake decreased by 7.165 ± 2.866 kcal (p = 0.014) and percent energy needs consumed decreased by 0.394 ± 0.153 (p = 0.011). In the low SS condition, sugar intake increased by 0.621 ± 0.240 g for each increase in resilience score (p = 0.011). After correction for multiple comparisons, the aforementioned interactions, but not simple slopes, were statistically significant.

What is the causal effect of income gains on youth obesity? Leveraging the economic boom created by the Marcellus Shale development

Low family income is frequently assumed to be a primary social determinant of youth obesity in the U.S. But while the observed correlation between family income and youth obesity is consistently negative, the true causal relationship is unclear. I take advantage of a natural experiment - the boom economy created by development of the Marcellus Shale geological formation for natural gas extraction - to study whether income gains affect youth obesity rates among Pennsylvania students. To test this relationship, I compile data from geological, administrative, Census and other governmental sources and estimate cross-sectional OLS regression models, longitudinal fixed effects models, and two-stage instrumental variable models within a difference-in-differences framework. Falsification tests indicate that children's location relative to the Marcellus Shale's geological boundaries is a valid instrument for income gains. Yet plausibly exogenous income gains do not alter youth obesity rates, regardless of the community's initial level of poverty or affluence and regardless of the child's grade level. Thus, the observed disparities in youth obesity by area income in Pennsylvania do not result from simple differences in disposable income and the relative cost of "healthy" versus "unhealthy" goods and services.

Relations between cannabis use, socioeconomic status, and risk perceptions in a Hispanic/Latinx population

Socioeconomic status (SES) and risk perceptions are indicative of cannabis use and subjective social status (SSS) may have utility in predicting cannabis use. This work examined relations between these indicators of cannabis use and use in a Hispanic/Latinx sample. Results found negative relations between risk perceptions and cannabis use. SES was unrelated to cannabis outcomes and risk perceptions but SSS had a negative relation with lifetime use. SSS positively related to risk assimilation in the full sample. Findings demonstrate how risk perceptions relate to cannabis use and suggest SES and SSS may not be indicative of use among Hispanic/Latinx populations.

Health-Related Behaviors in Adolescents Mediate the Association between Subjective Social Status and Body Mass Index

The aim of this study was to explore the association between adolescent subjective social status (SSS) and body mass index (BMI) at two different time points and to determine whether this association was mediated by health-related behaviors. In 2002 (n = 1596) and 2017 (n = 1534), tenth-grade students (15-16 years old) in schools in the District of Oppland, Norway, completed a survey. Four categories of perceived family economy were measured as SSS, and structural equation modeling was performed, including a latent variable for unhealthy behavior derived from cigarette smoking, snuff-use, and alcohol-drinking as well as dietary and exercise as mediators. No linear association was found between SSS and BMI in 2002 (standardized ß -0.02, (95% confidence interval (CI) -0.07, 0.03)). However, an association was present in 2017 (standardized ß -0.05 (95% CI -0.10, -0.001)), indicating that BMI decreased by 0.05 standard deviations (0.05 × 3.1 = 0.16 BMI unit) for every one-category increase in SSS. This association was mediated by exercise (standardized ß -0.013 (95% CI -0.02, -0.004) and unhealthy behavior (standardized ß -0.009 (95% CI -0.002, -0.04)). In conclusion, a direct association between SSS and BMI was found in 2017 in this repeated cross-sectional survey of 15-16-year-old Norwegian adolescents. This association was mediated through health-related behavior.

Race Differences in the Effect of Subjective Social Status on Hostility and Depressive Symptoms Among 9- to 11-Year-Old Children

PURPOSE

Research shows that subjective social status (SSS) is a salient determinant of health. However, there is little research on SSS-related group differences on psychosocial outcomes among children. The purpose of the current study was to determine if associations between psychosocial functioning and SSS in children varied as a function of racial groups.

METHODS

We used a series of regression models to examine associations between SSS and measures of hostility and depressive symptom severity in groups of Black and White children. All analyses controlled for objective markers of family- and neighborhood-level socioeconomic status. Participants included 291 school-age children in Syracuse, NY.

RESULTS

Among Black children, SSS was negatively associated with hostility scores, R2 = 0.10, F(6, 160) = 3.34, p = 0.006, but not depressive symptom severity. Conversely, among White children, SSS was negatively associated with depressive symptom severity, R2 = 0.18, F(6, 117) = 4.37, p = 0.001, but not hostility.

CONCLUSION

These racial differences in SSS-associated psychosocial functioning could be explained by race-based differences in attributions of social mobility and socioeconomic inequalities. Findings provide support for investigating possible tailoring of behavioral interventions to assist children in developing high SSS or coping with low SSS.

A Cross-Sectional Study of the Relationship Between Mental Health Problems and Overweight and Obesity in Adolescents

Background: There is a suggested coexistence between obesity and mental health discomfort in adolescence. The objective of this study was to explore if mental health indices covaried with body mass index (BMI) in adolescence and if there were gender-related disparities. Methods: Data were collected in two cross-sectional surveys of 10th-grade students (15 to 16 years old) carried out in 2002 and 2017. The questionnaires included self-reported height and weight, questions covering mental health using the Strengths and Difficulties Questionnaire (SDQ), lifestyle, and sociodemographic variables. We estimated the associations between SDQ subscale scores and BMI and the prevalence of overweight and obesity in linear and logistic multivariable models. We also estimated the extent to which gender modified these associations. Results: BMI was positively associated with peer problems [beta (β): 0.08, (95% confidence interval 0.01, 0.14)], indicating that for every point increase in peer problems subscore, BMI increased by 0.08 kg/m². The association between internalizing (i.e., peer and emotional) problems and BMI and conduct problems and BMI was different for boys and girls (p < 0.05 for all effect modifications). Conclusion: In this repeated cross-sectional study across 15 years, we found that peer problems were associated with BMI in Norwegian adolescents. We also found that there is a possibility that adolescent boys and girls report different mental health symptoms related to increased BMI. This finding implicates a need for gender-specific attention when assessing risk factors for increased BMI in adolescents.

Subjective status and perceived legitimacy across countries

The relationships between subjective status and perceived legitimacy are important for understanding the extent to which people with low status are complicit in their oppression. We use novel data from 66 samples and 30 countries (N = 12,788) and find that people with higher status see the social system as more legitimate than those with lower status, but there is variation across people and countries. The association between subjective status and perceived legitimacy was never negative at any levels of eight moderator variables, although the positive association was sometimes reduced. Although not always consistent with hypotheses, group identification, self-esteem, and beliefs in social mobility were all associated with perceived legitimacy among people who have low subjective status. These findings enrich our understanding of the relationship between social status and legitimacy.

Objective and subjective socioeconomic status associated with metabolic syndrome severity among African American adults in Jackson Heart Study

PURPOSE

To assess independent associations between objective socioeconomic status (OSS) and subjective social status (SSS) with metabolic syndrome (MetS) severity and indicators among African American (AA) adults in the Jackson Heart Study (JHS) at baseline (2000-2004) and eight-year follow-up (2009-2013).

METHODS

Participants included 1724 AA adults from the JHS cohort (64.4 % women; mean age 53.4 ± 11.8). Associations of OSS (annual household income and school years completed) and SSS (measured with MacArthur Scales) with sex- and race/ethnic-specific MetS severity Z-score were examined after adjustment for demographics and MetS risk factors (i.e., nutrition, physical activity, smoking status, alcohol consumption, and depressive symptoms) at baseline and eight-year follow-up.

PRINCIPAL RESULTS

Independent of OSS, demographic, psychosocial, and lifestyle factors, individuals with lower US-society SSS had more severe MetS at baseline. A significant interaction existed between sex and US-society SSS such that women with lower perceived social status had more severe MetS severity at baseline, and for every one unit increase in US-society SSS, MetS severity Z-score is estimated to decrease by 0.04. Components of MetS driving the relationship between US-society SSS and MetS severity at baseline were the inverse associations of SSS with glucose levels and the positive associations of SSS with HDL-C. Physical activity was independently associated with MetS severity at baseline, but not at eight-year follow-up.

MAJOR CONCLUSIONS

Though subjective and objective measures of social status are independently associated with cardiometabolic risk factors and MetS severity among AA adults, SSS may be a stronger predictor of MetS severity than OSS, particularly among women. SSS should be considered in conjunction with OSS when exploring social determinants of cardiometabolic health.

Socioeconomic Status and Psychological Well-Being: Revisiting the Role of Subjective Socioeconomic Status

Socioeconomic status (SES) is a complex and multidimensional construct, encompassing both independent objective characteristics (e.g., income or education) and subjective people's ratings of their placement in the socioeconomic spectrum. Within the growing literature on subjective SES belongingness and psychological well-being, subjective indices of SES have tended to center on the use of pictorial rank-related social ladders where individuals place themselves relative to others by simultaneously considering their income, educational level, and occupation. This approach, albeit consistent with the idea of these social ladders as summative or cognitive SES markers, might potentially constrain individuals' conceptions of their SES. This research (N = 368; M age = 39.67, SD = 13.40) is intended to expand prior investigations on SES and psychological well-being by revisiting the role of subjective SES. In particular, it (a) proposes an innovative adaptation of the traditional MacArthur Scale of subjective SES to income, education, and occupation, thus resulting in three separate social ladders; and (b) tests the empirical contribution of such three social ladders to psychological well-being. Overall, our findings showed that the novel education and occupation ladders (excluding the income ladder) are predictive of a significant part of the variance levels of psychological well-being that is not due to canonical objective metrics of SES (i.e., income, education, and occupation), or to the conventional MacArthur Scale of subjective SES. Although preliminary, these results underscore the need to further reconsider (subjective) SES-related conceptualization and measurement strategies to gather a more comprehensive understanding of the SES-psychological well-being link.

Compared with whom? Reference groups in socio-economic comparisons and self-reported health in 34 countries

BACKGROUND

The association between socio-economic position and health is believed to be mediated, in part, by psycho-social comparison of one's situation with that of others. But with whom? Possibilities include family, friends, elites, or even those in other countries or in previous times. So far, there has been almost no research on whether the reference point matters.

METHODS

We take advantage of a comparative data set that, uniquely, allows us to ask this question. The Life in Transition Survey was conducted in four Southern European and 30 Central and Eastern European and Eurasian countries. We sought differences in the probability of good self-reported health among those using different reference groups, including own family, friends and neighbours, domestic elites, people living in other countries and those living prior to a major politico-economic transition. We used multivariable and multilevel mixed-effects Poisson regressions and estimated treatment effects via the regression adjustment of Poisson models.

RESULTS

In most cases the choice of reference group did not matter but in some it did. Among men in Eastern European and Eurasian societies, those who compared themselves with their parents and their own families before the start of transition were less likely to report good health compared with those who did not compare their own economic situation with any specific reference group.

CONCLUSIONS

For some individuals, the choice of who to compare one's situation with does seem to matter, pointing to an area for future investigation in research on psycho-social determinants of health.

Income dividends and subjective survival in a Cherokee Indian cohort: a quasi-experiment

Persons with high temporal discounting tend to value immediate gratification over future gains. Low self-reported lifespan (SRL)-an individual's assessment of a relatively short future lifespan-concentrates in low-income populations and may reflect high temporal discounting. We use casino-based cash dividends among the Eastern Band of Cherokee Indians (EBCI) as a quasi-experiment to test whether large income gains among EBCI members translate into increased SRL. We used SRL data for EBCI and White youth, aged 19 to 28, participating in two waves of the Life Time Trajectory of Youth (LTI-Y) survey from 2000 to 2010. We controlled for unobserved confounding across individuals, time, and region through a longitudinal design using a difference-in-difference analytic approach (N = 294). We conducted all analyses separately by gender and by quartile of socioeconomic status. Cash dividends correspond with a 15.23 year increase in SRL among EBCI men below the lowest socio-economic quartile at baseline relative to Whites (standard error = 5.39, p < .01). Results using other socio-economic cut-points support improved SRL among EBCI men (but not women). The large magnitude of this result among EBCI men indicates that a non-trivial cash dividend to a low-income population may confer long-term benefits on perceptions of future lifespan and, in turn, reduce temporal discounting.Abbreviations: EBCI: Eastern Band of Cherokee Indians; SES: Socioeconomic Status; LTI-Y: Life Trajectory Interview for Youth; GSMS: Great Smoky Mountains Study; SRL: Self-Reported Lifespan; SSS: Subjective Social Status.

Subjective social status and health during high school and young adulthood

Although many facets of social status (i.e., socioeconomic status, gender, race) are fairly stable, limited work has assessed how youths' identification with their status changes over time. Subjective social status (SSS) refers to one's perception of standing or rank relative to others, and for youth status is generally in the context of society or school. The current study assessed how adolescents' SSS in American society and in their school changes and predicts health and well-being during and after high school. A total of 336 adolescents (M_age = 16.40 at Wave 1) reported their SSS at up to three time points, each 2 years apart, such that youth provided data between the 10th grade and 3 years following the transition from high school. Piecewise multilevel modeling was used, including discontinuities to assess the importance of the transition from high school. Society SSS decreased across the period, especially among youth with lower family income, youth whose parents reported lower SSS, and youth who did not attend college. School SSS was stable during high school, declined after 12th grade, and remained stable thereafter. Moderation analyses revealed that school SSS declines more consistently among female adolescents than male adolescents and Latinos relative to other ethnic groups. Lower society and school SSS were associated with more depressive symptoms and greater likelihood of obesity, highlighting the relevance of SSS for health during this important developmental transition. Results suggest declines in SSS are especially common among disadvantaged groups as they age, and that lower SSS may indicate risk for poorer health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Poverty and other correlates of obesity and underweight among 7-year-olds from Croatia and Montenegro

OBJECTIVES

This study aimed at investigating poverty and other correlates of childhood underweight and obesity in two urban regions with lower (Podgorica, Montenegro) and higher economic development (Osijek, Croatia).

STUDY DESIGN

Comparative study.

METHODS

A comparative study was conducted on 693 children (52% boys), aged 7 years old (224 from Podgorica and 469 from Osijek). Parents completed the study-specific questionnaire on relevant factors for children's nutritional status. We measured children's height and weight and calculated their body mass index (BMI). International Obesity Task Force cut-off values of BMI were used to assess children's nutritional status. Subjective social position was assessed by the Mac Arthur scale.

RESULTS

There were more underweight children in Osijek compared with Podgorica, both among boys (5.5% vs. 1.6%) and girls (6.9% vs. 1.0%). Obesity was more frequent in Podgorica than Osijek, both among boys (11.3% vs. 5.9%) and girls (10.0% vs. 4.3%). However, poverty in two cities diminished observed differences in children's nutritional status. The odds for child underweight decreased by 12.2%, while the odds for obesity increased by 3.6% per each paternal BMI unit. The frequency of child obesity was lowered per each step higher on the Mac Arthur scale and with breastfeeding by 23.2% and 68.0%, respectively.

CONCLUSIONS

We show that a higher economic development is related to less obese children but more underweight children. However, poverty seems to impact nutritionally all children equally, regardless of the regional economic development. Paternal and not maternal BMI is relevant for both extremes in children's nutritional status. Breastfeeding and higher social position independently protect from child obesity.

The economic gradient of obesity in Mexico: Independent predictive roles of absolute and relative wealth by gender

Despite the vast literature on the economic gradient of obesity, no study investigates the independent predictive roles of absolute and relative standards of living using a large nationally representative adult sample. This gap limits our ability to discern 'material' and 'psychosocial' pathways to obesity as well as our understanding of the role played by economic inequality in the growing obesity epidemic. Using a large and nationally representative Mexican dataset, we find that absolute wealth and relative deprivation are independently related to obesity, and that such relationships are patterned by sex. Absolute wealth predicts body mass index as well as abdominal obesity according to an inverted-U shape for both sexes, and more markedly so for females. Relative deprivation predicts higher body mass index for females and higher waist circumference for both sexes, with highly relatively deprived females being 24.29% (95% CI [24.26, 24.31]) more likely to be obese and 34.46% (95% CI [34.40,34.53]) more likely to be abdominal obese, and highly relatively deprived males being 14.91% (95% CI [14.88,14.93] more likely to be abdominal obese. Our results offer a new perspective on the economic gradient of obesity and highlight the potential impact of economic inequality, especially for women. Greater awareness of the independent and sex-specific roles of the absolute and relative facets of economic status is needed to better understand and address the obesity epidemic.

Interplay of subjective and objective economic well-being on the mental health of Norwegian adolescents

Objective and subjective socioeconomic status (SES) are important determinants of adolescent mental health problems, but we know less about how they interact. Research has demonstrated independent associations of both variables to mental health problems, but less is known about their relationship and role in adolescent mental health problems. Data from the youth@hordaland study, a survey of 9079 Norwegian adolescents aged 16 to 19 were linked to official tax register information about household income, and was used to examine the relationship between perceived economic well-being and household income. We also investigated how perceptions of economic well-being interacted with household income in relation to adolescent mental health problems. The overall relationship between perceived and actual household income was relatively low (r = .33 [95% CI = 0.32–0.35], p < .001, although this relationship was somewhat higher in adolescents with either low or high household incomes. Low income and unfavorable perceptions of economic well-being were associated with most mental health problems. Importantly, the mental health benefits associated with higher income appeared to depend on the adolescents' perceptions of their family's relative economic position. The results show moderate associations between perceived economic well-being and household income and that the influence of perceived economic well-being on conduct- and peer problems depended on the level of household income. Symptoms of depression explained some of this association. Knowledge about how the adolescents feel about their relative economic standing may be potentially important information for adolescents with mental health problems, and additional work is needed to understand how adolescents establish perceptions of economic rank.

Food Insecurity Moderates the Acute Effect of Subjective Socioeconomic Status on Food Consumption

Experimentally inducing low subjective socioeconomic status (SSES) increases food consumption in standardized eating opportunities. Separately, food insecurity (FI) has also been shown to be associated with increased food consumption when a free eating opportunity is provided. Here, we assigned 123 adult volunteers to a low-SSES manipulation or a control condition, followed by an opportunity to consume snack foods. We measured FI prior to the experiment. Thus, our experiment served to replicate the effects of SSES and of FI on consumption, and also to establish whether these effects combine additively or interactively. The low-SSES manipulation increased food consumption, but only among participants who were food secure at baseline. Among food-insecure participants, the effect was reversed. This interaction was not predicted a priori and is presented as an exploratory finding. We also found evidence that both SSES and FI affected the hedonic evaluation of the snack foods, though the changes in evaluation did not mediate the changes in consumption. Our findings suggest that both FI and low SSES affect the consumption and evaluation of food. Their combined effects on consumption may be complex.

Peer Status Position within School-Based Hierarchies and Excessive Fat Accumulation in Adulthood-A 30 Year Follow up of a Stockholm Cohort

Disadvantaged socioeconomic status is arguably the one exposure that has most consistently been linked to obesity, even more strongly so than diet and physical inactivity, which are the two main perceived root causes of weight gain. However, we still know very little about the relationship between having a disadvantaged social position and excessive fat accumulation, particularly when it comes to whether the relationship in question can also be seen as a long-term one, i.e., spanning from childhood to adulthood. By making use of the unique Stockholm Birth Cohort Multigenerational Study, the present study uses generalized ordered logistic regressions to examine the association between sociometrically assessed peer status position in school at age 13 and excessive fat accumulation at age 32. The results suggest that the odds of having excessive fat accumulation are about 0.5 times lower among popular and accepted children (ORs = 0.52 and 0.56, respectively), compared to those with a marginalized peer status position, independent of other obesogenic risk factors measured both prior and subsequent to peer status position. Our results give support to the notion that improved weight status may be another positive consequence of policies aiming to increase social inclusion within schools.

Protecting children's health in a calorie-surplus context: Household structure and child growth in the United States

Studies from the social and health sciences have tended to view the household as the locus of access to and distribution of care, resources, monitoring and modeling for children's wellbeing. Obesity may present a special case for the study of investments in children, being a component of health for which more of certain inputs may not lead to better outcomes. We expanded on common measures of household structure in the child health literature by considering co-residence and relatedness of parents, grandparents, other relatives, and other children. Data were from a longitudinal sample of 6,700 children participating in the Early Childhood Longitudinal Study Kindergarten Class of 1998-99 (ECLS-K), the largest U.S. national dataset with measures of child anthropometrics and household structure at seven time-points over nine years. We used lagged survey-adjusted regressions to estimate associations between household structure and subsequent changes in children's weight between ages 5 and 14 years in terms of BMI gain and incident obesity. Adjusting for household structure more thoroughly, children living in households with two parents rather than one parent did not experience advantages in terms of less excess weight gain or lower incidence of obesity during elementary and middle school. Children living with a grandmother gained more weight than children not living with a grandmother. Living with siblings and with non-related adults was associated with less weight gain. These findings corroborate a scenario in which, for health problems associated with caloric surplus, classic household factors have more complex associations with child wellbeing.

Self-rated health, subjective social status in school and socioeconomic status in adolescents: a cross-sectional study

BACKGROUND

Social position, traditionally measured by objective data on socioeconomic status (SES), is linked to health status in adults. In adolescents, the association is more uncertain and there are some studies suggesting that subjective social status (SSS) might be more adequate in relation to health. This study aimed to examine associations between SSS in school, SES and self-rated health (SRH) in adolescent boys and girls.

METHODS

A descriptive cross-sectional research design with quantitative survey data was used. The study involved 705 Swedish adolescents in upper secondary school (17-18-year-olds). SRH was measured with a single-item question and SSS by a question where adolescents were asked to assess their social position within their school. Formal education level of the parents was used as a proxy for objective SES. Univariable and multivariable ordinal regression analyses were conducted to assess the associations between SRH and SSS in school and SES.

RESULTS

In the multivariable analysis, SSS in school was positively associated with SRH, whereas no significant association between SES and SRH was found. The proportion of adolescents with high SRH increased with higher steps on the SSS ladder. Significant gender differences were found in that boys rated their SRH and SSS in school higher than girls did.

CONCLUSIONS

The study shows that self-rated health in adolescents is related to perceived social position in school. Subjective social status in school seems to be a useful health-related measure of social position in adolescents.

Psychosocial distress among unpaid community health workers in rural Ethiopia: Comparing leaders in Ethiopia's Women's Development Army to their peers

There is a growing critical social science literature on volunteering in health programs in non-western, low-income countries, yet few have mixed quantitative and qualitative methods to examine the psychological and social wellbeing of unpaid community health workers in such contexts. We address this issue with data from unpaid community health workers (CHWs) and other women who comprise Ethiopia's state-organized Women's Development Army. We draw on qualitative and cross-sectional survey data collected between 2013 and 2016 to test links between various aspects of psychosocial and economic wellbeing and volunteer status in a rural context. We surveyed 422 adult women in Amhara state, 73 of whom were unpaid CHWs in the "Army". We also conducted interviews and focus group discussions with health officials, salaried Health Extension Workers, volunteer CHWs, and other adult women. Analyses of our qualitative and quantitative datasets show that volunteer CHWs are actually worse off than their peers in various psychosocial and economic respects, and that CHW recruitment processes are the most likely explanation for this difference. Additionally, the unpaid CHW position adds work to already burdened shoulders, and makes women-especially unmarried women-vulnerable to negative gossip and high levels of psychological distress. To a limited extent, the volunteer CHW position also bolsters married women's subjective socioeconomic status and confidence in achieving future gains in status. By showing that unpaid CHWs do not necessarily enjoy psychosocial benefits, and may experience harm as a result of their work, these findings reinforce the recommendation that CHWs in contexts of poverty be paid and better supported.