Childlessness trends at different ages by educational attainment for men and women in Finland: A research note

It has long been known that lower socioeconomic status (SES) is a potent risk factor for cardiovascular disease.1 Much effort has been devoted to identifying the mechanisms responsible for this risk, because knowledge of these mechanisms is essential to guide the development of interventions to prevent or ameliorate the health-damaging effects. By showing that increased systolic blood pressure (SBP) levels in persons of lower educational attainment in a large sample drawn from the Paris metropolitan area are mediated to a significant extent by increased body mass index (BMI), waist circumference, and resting heart rate (HR), the report by Chaix et al2 in this issue of Hypertension makes an important contribution toward achieving this goal. Much work remains to be done, however, because the proportion of the association between lower individual education and elevated SBP explained by BMI/waist circumference and resting HR is 28.0% and 14.7%, respectively, meaning that a substantial proportion of the effect of lower education on SBP is mediated by other factors. Moreover, although it is helpful to know that one way lower education gets inside the body to raise blood pressure is via increased BMI, central fat accumulation, and resting HR, it is by no means clear how lower education gets inside the body to influence these mediators of increased blood pressure. Psychosocial risk factors like hostility, depression, and social isolation are increased in lower SES groups3,4 and, therefore, deserve attention …

Introducing an employment variable with five levels of educational attainment per capita and employing inequality decomposition, this study addresses three questions. How does labour force vary by education and provinces? How does labour force utilization vary by education and provinces? What are the potential causes of differences? We find that the no‐primary‐education group is more endowed in less‐developed provinces and allocated most unequally among education groups across provinces, despite past universal primary education policies. The senior‐secondary‐education group with the largest labour share is a growing concern due to the lower employment rate and largest interprovincial inequality.

To examine if reduced financial strain and higher educational attainment would confer less advantage for successful cessation among African Americans than for White individuals. A secondary data analysis of the Quit2Live study, a smoking cessation intervention for individuals who smoke. Recruited participants from a metropolitan city in the Midwest. The sample included 224 African American and 225 White individuals who smoke. Our outcome variable was cotinine-verified smoking abstinence at the end-of-treatment (week 12). Our explanatory variables were a combination of financial strain (high, low) and educational attainment (high, low). We implemented a logistic regression analysis and a two-way interaction of the combined financial strain and educational attainment variable and race on smoking abstinence. About 25% of the study participants were low financial strain and high education, 41% high financial strain and high education, 23% high financial strain and low education, and 11% low financial strain and low education. A greater proportion of African Americans vs Whites were in the high financial strain/low educational attainment category (28% vs 18%, P = .01). Participants with high financial strain and low educational attainment had substantially lower odds of abstinence (OR = .29 [95% CI: .12, .68]) compared to participants with low financial strain and high educational attainment. Contrary to our hypothesis, race did not moderate this association. Findings highlight the constraining role of high financial strain and low educational attainment, irrespective of race, on smoking abstinence among smokers actively engaged in a quit attempt.

Recent research on fertility in industrialized countries focuses primarily on delayed childbearing, despite the facts that large numbers of women continue to enter parenthood at relatively young ages and that early childbearing has been linked to economic disadvantage. This cross-national comparative study describes relationships between women's educational attainment and young age at first birth and evaluates the extent to which these differences have changed over time for women born 1955-1981. Defining 'early' childbearing as the age by which 20% of first births have occurred to women in a given birth cohort and country, we describe differences in early childbearing by educational attainment across three cohorts of women in 20 countries. We find a strong negative educational gradient in early childbearing across all 20 countries and some evidence of an increase in the relative prevalence of early childbearing among the least-educated women. In 10 countries, the relative prevalence of early childbearing among women with low education is significantly higher for one or both of the more recent birth cohorts compared to the earliest cohort. However, many countries show no significant change, and in one country (Poland) there is modest evidence of a decreasing educational gap. Evidence that educational differences in early childbearing have grown in some countries is generally consistent with the notion of family bifurcation and 'diverging destinies' by socioeconomic status. However, the pattern is not universal and future work should examine the various factors that shape these patterns, including the role of public policies.

BackgroundCross-sectional studies on educational levels have shown that inflammatory arthritis (IA) and rheumatoid arthritis (RA) are more prevalent among people with a lower educational attainment. Studies on educational attainment in...

Several cross-sectional studies have found an association between Alzheimer's disease (AD) and limited educational experience. It has been difficult to establish whether educational experience is a risk factor for AD because educational attainment can influence performance on diagnostic tests. This study was designed to determine whether limited educational level and occupational attainment are risk factors for incident dementia. Cohort incidence study. General community. A total of 593 nondemented individuals aged 60 years or older who were listed in a registry of individuals at risk for dementia in North Manhattan, NY, were identified and followed up. We reexamined subjects 1 to 4 years later with the identical standardized neurological and neuropsychological measures. Incident dementia. We used Cox proportional hazards models, adjusting for age and gender, to estimate the relative risk (RR) of incident dementia associated with low educational and occupational attainment. Of the 593 subjects, 106 became demented; all but five of these met research criteria for AD. The risk of dementia was increased in subjects with either low education (RR, 2.02; 95% confidence interval [Cl], 1.33 to 3.06) or low lifetime occupational attainment (RR, 2.25; 95% Cl, 1.32 to 3.84). Risk was greatest for subjects with both low education and low life-time occupational attainment (RR, 2.87; 95% Cl, 1.32 to 3.84). The data suggest that increased educational and occupational attainment may reduce the risk of incident AD, either by decreasing ease of clinical detection of AD or by imparting a reserve that delays the onset of clinical manifestations.

ObjectivesSociodemographic and mental health characteristics are associated with contraceptive choices. We aimed to describe the sociodemographic, reproductive and mental health characteristics of all fertile-aged women in Finland who used hormonal...

The role of socioeconomic indicators on non-alcohol and alcohol-associated suicide mortality among women in Finland. A register-based follow-up study of 12 million person-years

Obesity and education: Recent trends and disparities among 65- to 84-year-old men and women in Finland

BackgroundIn the United States (US), premature cardiovascular disease (CVD) mortality rates (35–74 years) have exhibited increases in recent years, particularly in younger adults, and large differentials by educational attainment. This trend has occurred concurrently with high and increasing obesity prevalence, which also show significant differences by education. This study aims to jointly model premature CVD mortality trends in the US according to obesity status and educational attainment.MethodsWe used multiple cause of death data from the National Center for Health Statistics, obesity prevalence data from the National Health and Nutrition Examination Survey (NHANES), and educational attainment data from the American Community Survey and NHANES. We applied Bayes’ theorem to these data to calculate the conditional probability of premature CVD mortality given obesity status and educational attainment for 2003–2019. We then projected this conditional probability for 2020–2029 using the Lee-Carter model.ResultsThe probability of premature CVD mortality was greatest for obesity and low education (not graduated high school) and was substantially higher (females 6.7 times higher, males 5.9) compared with non-obesity and high education (Bachelor’s degree or higher) in 2019. There was a widening of the gap in premature CVD mortality from 2003 to 2019 between the obese and non-obese populations, which occurred at each education level and was projected to continue in 2020–2029, especially for males. The conditional probability of premature CVD death for obesity and middle education (finished high school but no Bachelor’s degree) increased substantially and was projected to surpass the level for non-obesity and low education in coming years for males and in younger age groups. At high education, the conditional probability of premature CVD death for the obese population was projected to increase to 2029, while for non-obesity it was projected to remain steady for females and fall for males; this projected widening is greatest at older age groups.ConclusionsThe findings demonstrate the public health challenge to reduce premature US CVD mortality posed by continued high obesity prevalence, especially for younger ages, lower education groups and males. The relative importance of obesity in influencing premature CVD mortality trends has risen partly due to the decline in CVD mortality attributable to other risk factors.

BackgroundEducation, as a proxy for cognitive reserves, has been linked to dementia; however, the association between education attainment and brain health remains unclear. We aim to investigate the association between education attainment and neuroimaging based brain‐predicted age difference (BPAD, the difference between brain age and chronological age).MethodThe study included 32,322 chronic neurological disease‐free participants (mean age 54.74 ± 7.49 years, 46.58% female) who underwent brain MRI scans 9+ years after baseline. Years of education were self‐reported and categorized as low (7 and 10 years), medium (13, 15, and 19 years), and high (20 years) according to the International Standard Classification of Education. BPAD was predicted based on 1,079 multimodal imaging‐derived phenotypes (including structural and functional MRI) by a LASSO machine learning model. Alzheimer's disease‐related polygenic risk score (PRSAD) was tertiled as low, moderate and high. Data were analyzed using linear regressions.ResultAt baseline, 6,332 (19.59%), 10,872 (33.64%), and 15,118 (46.77%) participants had low, medium, and high education, separately. Compared to low education, high education (β [95% CI]: ‐0.230 [‐0.392, ‐0.067]) was related to more negative BPAD. In joint‐effect analysis, the β (95% CI) of BPAD was ‐0.542 (‐0.796, ‐0.289) among participants with high education and low‐to‐moderate PRSAD, compared to those with low education and high PRSAD.ConclusionHigh education attainment was associated with more negative BPAD, particularly among people with a low‐to‐moderate genetic susceptibility for dementia.

The clustering of social disadvantage with attention‐deficit/hyperactivity disorder (ADHD) in young adulthood is not well understood. We examined the clustering of ADHD with low educational attainment and unemployment in young adulthood; whether such clustering is stronger when unemployment is prolonged; and whether further clustering of disability pensioning, low education and unemployment occurs among those with ADHD. Data were obtained from Swedish health, demographic and social security registers from which 8,990 individuals with recorded ADHD diagnoses at the age of 10–35 and their 44,387 matched referents without mental disorders. Social disadvantage was measured using data on educational attainment, unemployment and disability pension from the diagnosis year or age 19 if diagnosed at younger age. Clustering was examined by comparing observed and expected occurrence (O/E ratio) of all possible combinations of ADHD, low education and unemployment, and, among those with ADHD, additional combinations with new‐onset disability pension. The likelihood of having neither ADHD, low education nor unemployment was increased (O/E ratio = 1.20, 95% confidence interval 1.19–1.20 at baseline; 1.18, 1.17–1.18 at follow‐up), as well as having all three characteristics (O/E ratio = 3.99, 3.89–4.10 at baseline; 5.68, 5.47–5.89 at follow‐up). This clustering was stronger among women than men and when unemployment was prolonged. The results suggest that low education and unemployment appear to cluster remarkably with ADHD among young adults, more so among women and when unemployment is prolonged.

Inter-subject variability in age-related brain changes may relate to educational attainment, as suggested by cognitive reserve theories. This voxel-based morphometry study investigated the impact of very low educational level on the relationship between regional gray matter (rGM) volumes and age in healthy elders. Magnetic resonance imaging data were acquired in elders with low educational attainment (less than 4 years) (n = 122) and high educational level (n = 66), pulling together individuals examined using either of three MRI scanners/acquisition protocols. Voxelwise group comparisons showed no rGM differences (p<0.05, family-wise error corrected for multiple comparisons). When within-group voxelwise patterns of linear correlation were compared between high and low education groups, there was one cluster of greater rGM loss with aging in low versus high education elders in the left anterior cingulate cortex (p<0.05, FWE-corrected), as well as a trend in the left dorsomedial prefrontal cortex (p<0.10). These results provide preliminary indication that education might exert subtle protective effects against age-related brain changes in healthy subjects. The anterior cingulate cortex, critical to inhibitory control processes, may be particularly sensitive to such effects, possibly given its involvement in cognitive stimulating activities at school or later throughout life.

Education, urbanicity of residence, and cardiometabolic biomarkers among middle-aged and older populations in the US, Mexico, China, and India

Atopic dermatitis (AD) may affect academic performance through multiple pathways, including poor concentration associated with itching, sleep deprivation, or adverse effects of medications. Because educational attainment is associated with health and well-being, any association with a prevalent condition such as AD is of major importance. To examine whether a childhood diagnosis of AD is associated with lower educational attainment. This population-based cohort study used linked routine health care data from January 1, 1977, to June 30, 2017 (end of registry follow-up), in Denmark. The study population included all children born in Denmark on June 30, 1987, or earlier with an inpatient or outpatient hospital clinic diagnosis of AD recorded before their 13th birthday (baseline) and a comparison cohort of children from the general population matched by birth year and sex. A secondary analysis included exposure-discordant full siblings as a comparison cohort to account for familial factors. Data were analyzed from September 11, 2019, to January 21, 2021. Hospital-diagnosed AD. Estimated probability or risk of not attaining specific educational levels (lower secondary, upper secondary, and higher) by 30 years of age among children with AD compared with children in the matched general population cohort. Corresponding risk ratios (RRs) were computed using Poisson regression that was conditioned on matched sets and adjusted for age. The sibling analysis was conditioned on family and adjusted for sex and age. The study included a total of 61 153 children, 5927 in the AD cohort (3341 male [56.4%]) and 55 226 from the general population (31 182 male [56.5%]). Compared with matched children from the general population, children with AD were at increased risk of not attaining lower secondary education (150 of 5927 [2.5%] vs 924 of 55 226 [1.7%]; adjusted RR, 1.50; 95% CI, 1.26-1.78) and upper secondary education (1141 of 5777 [19.8%] vs 8690 of 52 899 [16.4%]; RR, 1.16; 95% CI, 1.09-1.24), but not higher education (2406 of 4636 [51.9%] vs 18 785 of 35 408 [53.1%]; RR, 0.95; 95% CI, 0.91-1.00). The absolute differences in probability were less than 3.5%. The comparison of 3259 children with AD and 4046 of their full siblings yielded estimates that were less pronounced than those in the main analysis (adjusted RR for lower secondary education, 1.29 [95% CI, 0.92-1.82]; adjusted RR for upper secondary education, 1.05 [95% CI, 0.93-1.18]; adjusted RR for higher education, 0.94 [95% CI, 0.87-1.02]). This population-based cohort study found that hospital-diagnosed AD was associated with reduced educational attainment, but the clinical importance was uncertain owing to small absolute differences and possible confounding by familial factors in this study. Future studies should examine for replicability in other populations and variation by AD phenotype.