Childhood migration experience and adult health: evidence from China's rural migrants

BACKGROUND

Place of residence plays an influential role in shaping individual development, and studies have established links between Childhood migration experience (CME) and health outcomes through maturity. Over the past three decades, China has undergone one of the largest rural-to-urban migrations, however, little is known about the effect of CME on rural migrants' adult health in China.

METHODS

Data from 7035 members of the 2016 and 2018 China Labor-force Dynamics Survey were analyzed. CME was measured by whether the place of residence and place of birth changed at the age of 14 years. Three measures of health (self-assessed health, BMI, and mental health scale) were obtained. Causal inferential analysis was performed, using the Probit model, the OLS model and the Propensity Score Matching (PSM) method, to explore the impact of CME on the adult health of rural migrants.

RESULTS

Overall, compared to individuals who did not migrate in childhood, the probability of reporting "very unhealthy", "rather unhealthy", and "fair" in the self-assessed health of the rural migrants with CME decreased by 0.23%, 1.55%, and 5.53%, the probability of reporting "healthy" and "very healthy" increased by 1.94% and 5.38%, the probability of BMI within the normal range was higher by 7.32%, and the mental health test scores were 0.2591 points higher significantly. Furthermore, in comparison with childhood non-migration, both cross-county and cross-city migration promoted the health status of rural migrants, but the positive effect of cross-province migration was not significant; from the gender perspective, CME could more dramatically improve rural women's adult health than men, especially in mental health.

CONCLUSION

CME can significantly improve adult health, including physical and mental health, and the positive effect is more obvious among women, helping to reduce gender differences in health. For the migration distance, attention can be focused on the long-distance migrating individuals, who should get more support.

Adverse childhood experiences and trajectories of multimorbidity in individuals aged over 50: Evidence from the English Longitudinal Study of Ageing

BACKGROUND

Adverse childhood experiences (ACE) are important for chronic diseases yet their association with multimorbidity remains understudied. Few studies consider the complexity of multimorbidity or observe multimorbidity development over time.

OBJECTIVE

We investigated whether ACE were associated with multimorbidity at baseline and over a 12-year follow-up period.

PARTICIPANTS AND SETTING

5326 participants aged over 50 were obtained from the English Longitudinal Study of Ageing (ELSA).

METHODS

An ACE summary score was derived using eight ACE items measuring abuse, social care, and household dysfunction. From repeated measurements of 29 chronic conditions over a 12-year period (2008-2019) we derived two multimorbidity measures: number of chronic diseases and number of chronic disease categories. We used multinomial logistic regression to assess associations between ACE and both measures. Mixed effects models were estimated to examine trajectories of multimorbidity by ACE over time.

RESULTS

Graded associations between ACE and multimorbidity were observed. Compared to those without ACE, participants with ≥3 ACE had three times the risk of having ≥3 chronic diseases (RRR 3.06, 95 % CI 1.85-5.05) and falling into ≥3 chronic disease categories (RRR 2·93 95 % CI 1·74-4·95). Graded associations persisted during 12-year follow-up, though differences in multimorbidity between those with ≥3 ACE and those without ACE remained constant (B 0.02, 95 % CI 0·01-0·03, and B -0·01, 95 % CI -0·02-0·00, number of chronic conditions and chronic condition categories respectively).

CONCLUSION

ACE are associated with multimorbidity risk and complexity, associations arising before the age of 50. Early intervention amongst those with ACE could attenuate this association.

Trends in food consumption by adults in a Brazilian northeastern state

Objective

The economic and political crisis experienced by Brazil, together with the COVID-19 pandemic, may have negatively impacted the food consumption of Brazilian families over recent years. This study aimed to analyze trends in food consumption among adults in a Brazilian northeastern state.

Methods

This was an epidemiological study which involved the analysis of data from the Food and Nutrition Surveillance System (SISVAN) relating to the food consumption of adults (20-59 years-of-age) in the state of Ceará in 2015 and 2020. Data are presented by frequency distribution.

Results

In the year 2015-2020, the food consumption of 14,840 adults were registered in SISVAN. There was evidence of a decline in the habit of having three main meals a day (-63.5%), mainly among women (-67.9%). Between 2015 and 2020, there was a decline in the consumption of beans (-7.4%) and an increase in the consumption of fruits (68.2%) and vegetables (82.9%). When considering ultra-processed foods, there was a significant increase in the consumption of hamburgers and sausages (83.3%), cookies (39.1%) and sweetened beverages (25.5%).

Conclusions

Our findings indicate that the habit of having three main meals a day decreased between 2015 and 2020 in the adult population of Ceará, as determined by public data available in SISVAN, especially among women. In addition, there was an increase in the consumption of ultra-processed foods. Therefore, health interventions aimed at nutritional education and the fight against hunger are essential to face these challenges that affect society.

Associations between childhood maltreatment and physiological dysregulation in adulthood: Methodological decisions and implications

BACKGROUND

Childhood maltreatment is linked with health problems in adulthood. Theoretical models suggest that maltreatment leads to dysregulation in several bodily systems, and this has been corroborated using measures of physiological function (i.e., biomarkers). Methodological decisions involving the measurement of maltreatment and dimension reduction with respect to biomarkers (i.e., combining information across multiple measures) may influence research findings.

OBJECTIVE

The present study compares associations between childhood maltreatment and adult physiological dysregulation using multiple dimension reduction approaches and measures of maltreatment.

PARTICIPANTS AND SETTING

Participants were recruited, as children, to a prospective study of the correlates and consequences of childhood maltreatment. 253 participants were retained and provided biomarker data at midlife. Physiological dysregulation was operationalized with a conventional allostatic load approach and a novel statistical distance approach.

METHODS

Regression models were employed with allostatic load or statistical distance as the outcome and prospectively or retrospectively measured child maltreatment as the primary predictor.

RESULTS

When using allostatic load as the outcome, prospectively measured childhood maltreatment was positively associated with physiological dysregulation (b = 0.70, SE = 0.31, p = 0.02). When using statistical distance as the outcome, retrospectively measured childhood maltreatment was positively associated with physiological dysregulation (b = 0.69, SE = 0.19 p < 0.001).

CONCLUSIONS

We report a positive association between childhood maltreatment and physiological dysregulation at midlife. However, the significance and magnitude of effects varied with different maltreatment and physiological dysregulation measures. Further review of the methods used to study adult health conditions and their relation to childhood maltreatment is needed.

Explaining adult obesity, severe obesity, and BMI: Five decades of change

Obesity rates have increased across all segments of society since the late 1970s, but the reason behind population-level increases in body weight remains unclear. We used the 1971-2020 NHANES data to examine whether the observed trend in obesity prevalence is attributable to changing public health behaviors (i.e., intracohort change) or changing publics (i.e., cohort replacement). We partitioned total change in mean BMI, and rates of obesity and severe obesity, into its IC and CR components using linear and algebraic decomposition methods. We found that the IC mechanism (i.e., broad sectors of individuals changing) plays a dominant role in the overall increase in mean BMI, and obesity and severe obesity prevalence. Birth cohort membership (i.e., the CR mechanism) is also influencing mean BMI, and rates of obesity and severe obesity, but in differing ways. Specifically, the large positive IC and the small positive CR effects are amplifying one another, thus creating a steep increase in the observed rates of severe obesity. Conversely, the large positive IC effect is offset by a small negative CR effect, which created a more gradual rise in mean BMI and rates of obesity. Furthermore, we computed total change for models that entered separately sociodemographic, lifestyle, nutritional, and physical activity measures to estimate differences in mean BMI, and rates of obesity and severe obesity, among cohorts and time periods. Adjustment for all the compositional differences among the cohorts during the study period indicate that a combination of a more pronounced IC and a less pronounced CR drove the observed increase in mean BMI, and rates of obesity and severe obesity. Thus, "universal prevention" (i.e., entire community) strategies for healthy weight promotion may need to be combined with "selective prevention" (i.e., at-risk groups) and/or "targeted prevention" (i.e., at-risk individuals) approaches in order to reverse the obesity epidemic.

Long-term health effects of childhood parental income

While research on the link between socio-economic status and health spans several decades, our understanding of this relationship is still severely constrained. We estimate the long-term effects of parental income from birth to age 18 on health and risky health behaviors in adulthood. We use over 4 decades of data from the Panel Study of Income Dynamics, from 1968 to 2017, to construct a unique data set that links 49,459 person-year outcomes in adulthood, to several parental and family level variables when they were born and throughout their childhood. To mitigate concerns that parental income is likely correlated with unobserved factors that determine children's outcomes in adulthood, we estimate an instrumental variables model. We construct a simulated income variable that is used to instrument for parental income. This approach breaks the link between an individual's own parental income and unobserved characteristics that are possibly correlated with their health in the long run. We find that a $10,000 increase in annual parental income increases the likelihood of very good or excellent health in adulthood by 3.7%, reduces the likelihood of physical limitation by 10.3%, and reduces the likelihood of smoking and the number of cigarettes smoked per day by 12.7% and 16.7%, respectively. We also find that the pathways by which income improves health are increased education, employment, annual hours worked, pre-tax hourly earnings and pre-tax annual earnings. Our results highlight the lasting impact of economic resources in childhood and the importance of growing up in a financially stable environment.

Rising childhood income inequality and declining Americans' health

Morbidity and mortality are on the rise among Baby Boomers and younger cohorts. This study investigates whether this unfavorable health trend across birth cohorts 1925-1999 is related to rising income inequality Americans face during childhood. We use two nationally representative datasets: National Health and Nutrition Examination Surveys (NHANES) 1988-2018 and Panel Studies of Income Dynamics (PSID) 1968-2013, and two health outcomes: biomarkers of physiological dysregulation, and a chronic disease index. Childhood income inequality is measured by the average of the Gini index at the national level each birth cohort is exposed to between birth and age 18, where the Gini index from 1925 to 2016 is computed based on Internal Revenue Service income data. By merging childhood income inequality to individual level data from NHANES or PSID based on birth cohort, we find childhood income inequality is positively associated with the risk of physiological dysregulation in adulthood for all gender and racial groups in the NHANES data. It is also significantly related to the risk of chronic disease in the PSID data. This association is robust to controls for individual level childhood health and family background, adulthood socioeconomic and marital status, and contemporary macro socioeconomic factors. More importantly, childhood income inequality exposure explains a substantial amount of variation in these two health outcomes across cohorts, a pattern not observed for other early life exposures that display negative temporal trends similar to those for childhood income inequality. This study provides important evidence that income inequality experienced during childhood may have a long-lasting negative consequence for adult health, which partially explains the adverse health trends experienced by Baby Boomers and younger cohorts in the United States.

Associations between prospective and retrospective measures of child abuse and self-reported adult health at midlife

BACKGROUND

The long-term health effects of physical child abuse are well documented in self-report, retrospective studies. However, there have been few longitudinal, multimethod studies on physiological responses to stress and the onset of chronic disease, thereby slowing the advancement of prevention and intervention programs.

OBJECTIVES

This study used survey data from an extended longitudinal study to examine prospective and retrospective associations between measures of physical child abuse and adult health in the 40s.

PARTICIPANTS AND SETTING

Data are from an ongoing longitudinal study of the correlates and consequences of child maltreatment that began in the 1970s with a sample of 457 children.

METHODS

Bivariate correlations and multiple regression models with covariates were used to assess associations between measures of physical child abuse and outcomes of self-reported health in adulthood.

RESULTS

Physical child abuse, measured retrospectively, was moderately related to reports of overall health, as well as a number of adult health problems and conditions, such as back and chest pain, hypertension, and certain forms of cancer. Associations were also observed for lifetime alcohol problems and past-year doctor and emergency room visits. Fewer associations between prospective parent self-report measures of physical child abuse and adult health were identified, although child welfare (official record) reports performed similarly to retrospective measures.

CONCLUSIONS

This study adds important information on the long-term health effects of child physical abuse, as well as measurement differences in the prediction of adult health outcomes. Conclusions drawn from prospective and retrospective studies of abuse are at best inconsistent, and possibly incompatible.

SNAP participation and the health and health care utilisation of low-income adults and children

OBJECTIVE

This article examined whether participation in the Supplemental Nutrition Assistance Program (SNAP) produced changes to adult and child health and health care utilisation during a period of economic recession.

DESIGN

Instrumental variables analysis relying on variation in state SNAP policies to isolate exogenous variation in household SNAP participation.

SETTING

Nationally representative data on child and adult health from the 2008 to 2013 National Health Interview Survey.

PARTICIPANTS

Participants were 92 237 adults and 45 469 children who were either eligible for SNAP based on household income and state eligibility rules or were low income but not eligible for SNAP benefits.

RESULTS

For adults, SNAP participation increased the probability of reporting very good or excellent health, and for both adults and children, reduced needing but having to go without dental care or eyeglasses. The size of these benefits was especially pronounced for children. However, SNAP participation increased the probability of needing but not being able to afford prescription medicine, and increased psychological distress for adults and behavioural problems for children under age 10.

CONCLUSIONS

SNAP's benefits for adult health and improved access to dental and vision care for adults and children suggest benefits from the program's expansions during the current COVID-induced crisis. Predicted negative effects of SNAP participation suggest the need for attention to program and benefit structure to avoid harm and the need for continued research to explore the causal effects of program participation.

Effects of Social Development Intervention in Childhood on Adult Life at Ages 30 to 39

Elementary schools can be effective sites for universal preventive interventions. Less is known about how long effects of intervention in elementary grades last. Can they improve outcomes in adulthood? To test effects of a social developmental intervention in the elementary grades on adult life through the 30s, the Seattle Social Development Project, a nonrandomized controlled trial, followed all consenting 5th-grade students (N = 808) from 18 Seattle public elementary schools from age 10 (in 1985) to age 39 (in 2014), with 88% retention. The sample was gender balanced and ethnically and economically diverse. The full intervention, called Raising Healthy Children, continued from Grades 1 through 6 and consisted of teacher in-service training in classroom management and instructional methods; cognitive, social, and refusal skills training for children; and parent workshops in child behavior monitoring and management, academic support, and anticipatory guidance. Using structural equation modeling, we examined intervention effects from age 30 to age 39 across 9 constructs indicating 3 domains of adult life: health behavior, positive functioning, and adult health and success. An omnibus test across all 9 constructs indicated a significant positive overall intervention-control difference. Examined individually, significant intervention effects included better health maintenance behavior, mental health, and overall adult health and success. Significant effects were not found on substance use disorder symptoms, sex-risk behaviors, or healthy close relationships in the 30s. Results indicate that sustained, theory-based, multicomponent intervention in the elementary grades can produce lasting changes in health maintenance, mental health, and adult functioning through the 30s.

The impact of financial hardship in childhood on depression and anxiety in adult life: Testing the accumulation, critical period and social mobility hypotheses

This paper examines the association between financial hardship in childhood and adulthood, and depression and anxiety in adulthood with reference to the accumulation, critical period and social mobility hypotheses in lifecourse epidemiology. Using the BBC Stress test, linear regression models were used to investigate the associations for the whole population and stratifying by gender and adjusting for age and highest education attainment. The critical period hypothesis was not confirmed. The accumulation hypothesis was confirmed and stratifying by gender women had a higher estimated mean GAD score if they were poor in both childhood and adulthood compared to men. Our findings do not support the social mobility hypothesis. However, stratifying by gender, a clear difference emerged with upward mobility having a favourable impact (lower) on women's mean GAD scores, while upward social mobility in adulthood did not attenuate the impact of financial hardship in childhood or men. The impact of financial hardship in childhood on later mental health outcomes is particularly concerning for future health outcomes as current levels of child poverty increases in the UK.

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The association between financial hardship in childhood and adulthood, and depression and anxiety in adulthood was tested.

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A lifecourse approach was used.

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Two episodes of financial hardship had a greater impact on women’s Goldberg Anxiety & Depression score compared to men.

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Upward mobility had a favourable impact on women's mean Goldberg Anxiety & Depression scores, but not for men.

The impact of childhood socioeconomic status on depression and anxiety in adult life: Testing the accumulation, critical period and social mobility hypotheses

This paper examines the association between financial hardship in childhood and adulthood, and depression and anxiety in adulthood with reference to the accumulation, critical period and social mobility hypotheses in lifecourse epidemiology. Using the BBC Stress test, linear regression models were used to investigate the associations for the whole population and stratifying by sex and adjusting for age and highest education attainment. The critical period hypothesis was not confirmed. The accumulation hypothesis was confirmed and stratifying by sex women had a higher estimated mean GAD score if they were poor in both childhood and adulthood compared to men. Our findings do not support the social mobility hypothesis. However, stratifying by sex, a clear difference emerged with upward mobility having a favourable impact (lower) on women's mean GAD scores, while upward social mobility in adulthood did not attenuate the impact of financial hardship in childhood or men. The impact of financial hardship in childhood on later mental health outcomes is particularly concerning for future health outcomes as current levels of child poverty increases in the UK.

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The association between socioeconomic status in childhood and adulthood, and depression and anxiety in adulthood was tested.

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A lifecourse approach was used.

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Two episodes of financial hardship had a greater impact on women’s Goldberg Anxiety & Depression score compared to men.

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Upward mobility had a favourable impact on women's mean Goldberg Anxiety & Depression scores, but not for men.

Is it possible to substitute the monofilament test for the Ipswich Touch Test in screening for peripheral diabetic neuropathy?

BACKGROUND

This study aimed to assess the agreement and efficacy of the Ipswich Touch Test compared to the monofilament test in individuals with type 2 diabetes.

MATERIALS AND METHODS

A cross-sectional and analytical study was conducted. The inclusion criteria were patients with type II diabetes (n = 250) who did not present ulcers or amputation in either foot. The exclusion criteria were as follows: patients who presented sequelae of cerebrovascular disease or other neurological pathologies, as well as diagnoses of malignancy, alcohol abuse, liver cirrhosis, hepatitis B, AIDS, hypothyroidism, chronic kidney disease or lupus erythaematosus, as these clinical conditions could influence or bias the results (Won and Park in Endocrinol Metab 31:230-238, 2016). Sensitivity, specificity, predictive values, likelihood ratios, and Kappa index were calculated. Other factors assessed were glycated haemoglobin and body mass index.

RESULTS

Most of the participants were female (71.2%), and glycated haemoglobin (HbA1c) was greater than 7% in 54.4% of the patients. The mean age was 59.43 years, and the mean time since diagnosis was 12.38 years. The Kappa index was 0.819 (p < 0.001), and the Ipswich Touch Test had a sensitivity of 83.33%, a specificity of 97.66%, a positive predictive value of 85.71%, a negative predictive value of 97.21%, a positive likelihood ratio of 30.19%, and a negative likelihood ratio of 0.17%. The level of significance was 5% in this study.

CONCLUSION

The Ipswich Touch Test resented good agreement and efficacy compared to the gold standard-the 10 g monofilament test.

Interdisciplinary Approaches to Assessing the Health of People Living in Environmentally Adverse Conditions

BACKGROUND

The health status of the population of different ages was examined. Since children are very vulnerable to environmental factors, our goal was to examine their health status and compare them with those of the older population. Also one of the important tasks of our study was the installation of carcinogenic and non-carcinogenic risks for children and adults of different sexes.

METHODS

During our research, we calculated the air pollution index, investigated the incidence statistics of the population, and calculated the lifetime average daily dose (LADD). We investigated the content of sulfur dioxide, hydrogen sulfide, nitrogen oxide, ammonium and hydrogen carbonates and compared it with safe level of exposure.

RESULTS

In Aktobe, the Republic of Kazakhstan the external environment is polluted with boron and chromium, and in Aktau - with organic hydrocarbons. High morbidity rates in adolescents were found for endocrine disorders, digestive system diseases, and musculoskeletal system disorders. Estimating the prevalence and incidence of newly diagnosed diseases among women in Aktau showed that the overall incidence rate, as well as the incidence of respiratory and skin diseases, declines with age. The incidence of the genitourinary system and the number of nervous disorders increase, and the number of neoplasms increases in men population. A study of carcinogenic risks showed that children with Aktau, especially boys, have the greatest risk of cancer.

CONCLUSION

The conducted research shows that environmental factors have a big impact on the health of the population.

Quality of life related to oral health and its impact in adults

Oral health is part of general health, and is recognized as an essential component of quality of life (QoL). For years, oral health was determined solely by the clinic, which did not allow an evaluation of the true impact of oral diseases on the patients' daily lives. The development of instruments for assessing QoL related to oral health has occurred due to the urgency of determining the effects of changes in the oral cavity of individuals. This study aims, through a bibliographical survey, to describe issues involving the relationship between QoL and oral health focusing on methodological and conceptual aspects as well as considering how oral health of adult individuals affects their QoL in a general way. Research in this area has developed the concept of "quality of life related to oral health", which comprises four categories: functional factors, psychological factors, social factors and existence of discomfort or pain. The negative impacts that poor oral health of the population have on their QoL makes this issue a relevant problem for public health. Although most oral problems do not represent an immediate risk of death, they are responsible for decreasing the QoL of individuals as they prolong states of pain and suffering, and cause functional, aesthetic, nutritional and psychological problems. Actions focused on health education with emphasis on self-perception, self-protection and self-care should be explored. Programs based on equity seeking to reduce inequalities and their negative effects on people's QoL should also be explored.

The impact of a multilevel childhood obesity prevention intervention on healthful food acquisition, preparation, and fruit and vegetable consumption on African-American adult caregivers

OBJECTIVE

To evaluate the secondary impact of a multilevel, child-focused, obesity intervention on food-related behaviours (acquisition, preparation, fruit and vegetable (FV) consumption) on youths' primary caregivers.

DESIGN

B'More Healthy Communities for Kids (BHCK) group-randomized controlled trial promoted access to healthy foods and food-related behaviours through wholesaler and small store strategies, peer mentor-led nutrition education aimed at youths, and social media and text messaging targeting their adult caregivers. Measures included caregivers' (n 516) self-reported household food acquisition frequency for FV, snacks and grocery items over 30 d, and usual FV consumption in a sub-sample of 226 caregivers via the NCI FV Screener. Hierarchical models assessed average treatment effects (ATE). Treatment-on-the-treated-effect (TTE) analyses evaluated correlation between behavioural change and exposure to BHCK. Exposure scores at post-assessment were based on self-reported viewing of BHCK materials and participating in activities.

SETTING

Thirty Baltimore City low-income neighbourhoods, USA.ParticipantsAdult caregivers of youths aged 9-15 years.

RESULTS

Of caregivers, 90·89 % were female; mean age 39·31 (sd 9·31) years. Baseline mean (sd) intake (servings/d) was 1·30 (1·69) fruits and 1·35 (1·05) vegetables. In ATE, no significant intervention effect was found on caregivers' food-related behaviours. In TTE, each point increase in BHCK exposure score (range: 0-6·9) increased caregivers' daily fruit consumption by 0·2 servings (0·24 (se 0·11); 95 % CI 0·04, 0·47). Caregivers reporting greater social media exposure tripled their daily fruit intake (3·16 (se 0·92); 95 % CI 1·33, 4·99) and increased their frequency of unhealthy food purchasing v. baseline.

CONCLUSIONS

Child-focused community-based nutrition interventions may also benefit family members' fruit intake. Child-focused interventions should involve adult caregivers and intervention effects on family members should be assessed. Future multilevel studies should consider using social media to improve reach and engage caregiver participants.

The effect of school sports facilities on physical activity, health and socioeconomic status in adulthood

This paper focuses on the long-term impacts of attending a high school with inadequate sports facilities. We use prospective data from the British National Child Development Study, a continuing panel of a cohort of 17,634 children born in Great Britain during a single week of March 1958. Our empirical approach exploits the educational system they were exposed to: children were sorted by educational ability at age 11, but conditional on educational ability, attended their closest school. This produces quasi-random variation in the quality of the school sports facilities across respondents. We use this variation between cohort members residing within the same local authority area, and focus on outcome measures of physical activity, health, health-related lifestyle activities, and socioeconomic status, collected at ages between 33 and 50 years. We control for any potential links between the inadequacy of sports facilities and inadequacy of other facility types, and test that allocation to school type is random with respect to pre-high school observables. We find that attending a school with inadequate sports facilities led to a statistically significant, modest decrease in the likelihood of physical activity participation during adulthood. In contrast, we find no evidence that inadequate sports facilities worsened adulthood measures of physical and mental health, lifestyle or socioeconomic status.

Adults born preterm: a review of general health and system-specific outcomes

In this review of 126 publications, we report that an overwhelming majority of adults born at preterm gestations remain healthy and well. However, a small, but a significant fraction of them remain at higher risk for neurological, personality and behavioural abnormalities, cardio-pulmonary functional limitations, systemic hypertension and metabolic syndrome compared to their term-born counterparts. The magnitude of increased risk differed across organ systems and varied across reports. The risks were proportional to the degree of prematurity at birth and seemed to occur more frequently among preterm infants born in the final two decades of the 20th century and later. These findings have considerable public health and clinical practice relevance.

CONCLUSION

Preterm birth needs to be considered a chronic condition, with a slight increase in the risk for long-term morbidities among adults born preterm. Therefore, obtaining a history of gestational age and weight at birth should be a routine part of care for patients of all age groups.

Genetic endowments, parental resources and adult health: Evidence from the Young Finns Study

This paper uses longitudinal survey data linked to administrative registers to examine socioeconomic gradients in health, particularly whether the effects of genetic endowments interact with the socioeconomic resources of the parental household. We find that genetic risk scores contribute to adult health measured by biomarkers. This result is consistent with the findings from genome-wide association studies. Socioeconomic gradients in health differ based on biomarker and resource measures. Family education is negatively related to obesity and the waist-hip ratio, and family income is negatively related to low-density lipoprotein cholesterol and triglyceride levels. Parental resources do not modify the effects of genetic endowment on adult health. However, there is evidence for gene-family income interactions for triglyceride levels, particularly among women.

Adverse Childhood Experiences and Health in Adulthood in a Rural Population-Based Sample

BACKGROUND

Adverse childhood experiences (ACEs), including emotional abuse, substance abuse in the household, separation or divorce, physical abuse, violence between adults, mental illness in the household, sexual abuse, or incarceration of a household member, have the potential to profoundly impact health and well-being in adulthood. To assess whether previously reported relationships between ACEs and health outcomes withstand validation, we conducted a community-based ACE study with the unique capacity to link self-reported ACEs and other survey results to validated health data in an electronic medical record (EMR).

METHODS

Information regarding ACEs and health outcomes was captured from 2013-2014 via a telephone survey of residents of the predominantly rural northern and central regions of Wisconsin and electronic abstraction of EMR data. ACE score was calculated by counting each exposure as one point. We examined the relationship between ACE score, type, and self-reported and validated health outcomes.

RESULTS

A total of 800 participants completed the telephone survey. Overall, 62% reported at least one ACE and 15% reported experiencing four or more. All self-reported measures of poor health were associated with increased ACE score. EMR data were positively correlated with ACE score for increased body mass index and diagnoses of depression, anxiety, and asthma. In contrast, diagnoses of hypertension, hypercholesterolemia, myocardial infarction, and skin and other cancers were inversely related to ACE score. Emotional abuse was the most common ACE reported followed by substance abuse in the household. ACEs tended to cluster so that people who reported at least one ACE were likely to have experienced multiple ACEs. There was no clear correlation between abuse type (e.g., direct abuse vs. household dysfunction) and health outcomes.

CONCLUSIONS

In the first community-based study to link self-reported ACEs to comprehensive health measures documented in the medical record, we observed previously reported associations between childhood adversity and poor outcomes in adulthood, but also noted an inverse relationship between ACE score and certain medical diagnoses. Potential explanations for this finding warrant further investigation.

People with dyslexia and heart, chest, skin, digestive, musculoskeletal, vision, learning, speech and mental disorders were more dissatisfied with neighbourhoods: Scottish Household Survey, 2007-2008

Rarely do we know the perception toward neighbourhoods in people specifically with health conditions. Therefore, the aim of the present study was to understand the perception toward neighbourhoods among adults with a series of the existing health conditions in a country-wide and population-based setting. Data were retrieved from and analysed in Scottish Household Survey, 2007-2008. Information on demographics, self-reported health conditions and perception toward neighbourhoods and the surrounding facilities was obtained by household interview. Analysis including chi-square test, t test and logistic regression modelling were performed. Of 19,150 Scottish adults (aged 16-80) included in the study cohort, 1079 (7.7 %) people were dissatisfied with their living areas; particularly for those who experienced harassment (15.4 %), did not recycle or with dyslexia, chest, digestive, mental and musculoskeletal problems. Twenty to forty per cent reported common neighbourhood problems including noise, rubbish, disputes, graffiti, harassment and drug misuse. People with heart or digestive problems were more dissatisfied with the existing parks and open space. People with arthritis, chest or hearing problems were more dissatisfied with the waste management condition. People with dyslexia were more dissatisfied with the existing public transportation. People with heart problems were more dissatisfied with the current street cleaning condition. People with hearing, vision, speech, learning problems or dyslexia were also more dissatisfied with sports and recreational facilities. People with heart, chest, skin, digestive, musculoskeletal, vision, learning, speech and mental disorders and dyslexia were more dissatisfied with their current neighbourhood environments. Upgrading neighbourhood planning to tackle social environment injustice and put pleasant life experience as priorty would be suggested. Graphical abstract interrelations of individual health and neighbourhood health.

Cold homes are associated with poor biomarkers and less blood pressure check-up: English Longitudinal Study of Ageing, 2012-2013

It has been known that outdoor temperature influences seasonal fluctuation of blood pressure and cholesterol levels, but the role of indoor temperature has been less studied. Therefore, the aim of the present study was to examine the associations between indoor temperature and biomarkers in a countrywide and population-based setting. Data was retrieved from the English Longitudinal Study of Ageing, 2012-2013. Information on demographics, room temperature and a series of biomarkers measured in the blood and lung was obtained at household interviews. t test, chi-square test and a generalized linear model were performed cross-sectionally. Of 7997 older adults with the valid indoor temperature measurements, there were 1301 (16.3%) people who resided in cold homes (<18 °C). Age was inversely associated with people who resided in cold homes or who tended not to have blood pressure check-up. Those who resided in cold homes had higher blood pressure readings, worse handgrip, lower vitamin D levels, higher cholesterol levels, higher insulin-like growth factor levels, higher haemoglobin levels, lower level of white blood cell count and worse lung conditions. One in six older adults aged 50 and above in England resided in cold homes and had poor biomarker values. For the future research direction, studies with a longitudinal approach to systematically monitor indoor temperature, biomarkers and health and wellbeing would be suggested. From the practice and policy perspectives, increasing health knowledge on the adverse effect of low indoor temperature on risks of cardiac and respiratory conditions, affording to the heating and re-designing of residential buildings to keep warm by using efficient energy, should be kept as priority.

People with diabetes, respiratory, liver or mental disorders, higher urinary antimony, bisphenol A, or pesticides had higher food insecurity: USA NHANES, 2005-2006

This study was aimed to examine the prevalence of food insecurity and what social, health, and environmental characteristics could constitute such situation in a national and population-based setting. Data was retrieved from the National Health and Nutrition Examination Survey, 2005-2006. Information on demographics, lifestyle factors, self-reported ever medical conditions in the past and self-reported food security conditions in the last 12 months calculated on the household level was obtained by household interview. Bloods and urines (subsample) were collected at the interview as well. Only adults aged 20 years and above (n = 4979) were included for statistical analysis in the present study. Chi-square test, t test, and survey-weighted logistic regression modeling were performed. Three thousand eight hundred thirty-four (77.9%) people were with full food security, 466 (9.5%) people were with marginal food security and 624 (12.7%) people were with low or very low food security. Being younger, having higher ratios of family income to poverty thresholds (due to low level of education or lack of financial support), having prior asthma, arthritis, chronic bronchitis, depression, diabetes, eczema, emphysema or liver problems, having higher levels of serum cotinine, urinary antimony, bisphenol A, pesticides, or having lower levels of urinary Benzophenone-3 were associated with food insecurity. In addition to socioeconomic and smoking conditions, evidence on people with several prior health conditions and being exposed to environmental chemicals and food insecurity is further provided. Future social, health and environmental policy, and programs protecting people from food insecurity by considering both health and environmental factors mentioned above would be suggested.

Does early-life income inequality predict self-reported health in later life? Evidence from the United States

We investigate the association between adult health and the income inequality they experienced as children up to 80 years earlier. Our inequality data track shares of national income held by top percentiles from 1913 to 2009. We average those data over the same early-life years and merge them to individual data from the Panel Study of Income Dynamics data for 1984-2009. Controlling for demographic and economic factors, we find both men and women are statistically more likely to report poorer health if income was more unequally distributed during the first years of their lives. The association is robust to alternative specifications of income inequality and time trends and remains significant even when we control for differences in overall childhood health. Our results constitute prima facie evidence that adults' health may be adversely affected by the income inequality they experienced as children.

Are literacy skills associated with young adults' health in Africa? Evidence from Malawi

This study investigates whether literacy skills are a distinct dimension of education that influences young adults' health in the southeast African context of Malawi. It uses new data from Tsogolo la Thanzi, a study of young adults in southern Malawi, to achieve three aims. The first is descriptive: to demonstrate a direct assessment for measuring literacy in a population-based survey, and show that it captures variability in skills among young adults, including those with comparable levels of educational attainment. The second aim is to identify whether literacy influences young adults' health - net of their educational attainment and other confounding factors. Multivariate analyses reveal that literacy is associated with two measures of physical health: self-rated health and prolonged sickness. Because literacy is a key determinant of health, the third aim is to provide insight into how to measure it: can commonly used indirect approaches to estimating literacy (e.g., based on educational attainment or self-reports), accurately capture its prevalence and relationship with health? In a second set of analyses, bivariate results show whether, and the extent to which, indirect measures of literacy overestimate literacy's prevalence, and multivariate models assess whether indirect estimates of literacy capture its relationship with health. The findings support future efforts to incorporate literacy assessments into population surveys to accurately estimate literacy's prevalence and health benefits, particularly in contexts like Malawi where access to high-quality schools remains limited.

Social inequalities in clustering of oral health related behaviors in a national sample of British adults

OBJECTIVES

1. To assess clustering of oral health related behaviors among a sample of British adults. 2. To determine the variation in clustering of oral health related behaviors by socioeconomic position.

METHOD

We used secondary analysis of the Adult Dental Health Survey 2009 data. Health behaviors referred to smoking, tooth brushing frequency, dental visits and sugar consumption. Clustering was assessed by pairwise correlations, counts of clustering of health compromising behaviors and comparison of observed/expected ratios. Logistic regression was used to assess variation in clustering of oral health related behaviors by socioeconomic position crudely and adjusted for age, gender and self-rated oral health.

RESULTS

There were weak correlations between four health behaviors. Very low prevalence of clustering was reported. Higher observed to expected ratio was observed for clustering patterns with lower prevalence. Multivariate logistic regression showed clear, strong and significant educational gradients in associations between different clustering patterns of health compromising behaviors and educational attainment. These educational gradients remained significant after adjusting for age, gender and self-reported oral health.

CONCLUSION

Very clear and strong educational gradients were observed throughout patterns of clustering of oral health compromising behaviors, suggesting chances of having detrimental behavioral clustering are lower in more educated groups in population.