Changes In Socioeconomic Position Research Articles

Can Social Mobility Impact Frailty Trajectories of Chinese Adults in Later Life? A Nationwide Longitudinal Study.

Evidence remains unclear on the impact of life-course socioeconomic position (SEP) mobility on frailty trajectories in later life. We aim to examine the longitudinal effects of social mobility on frailty trajectories among Chinese middle-aged and older populations. A total of 13239 participants aged 45 and older from the 2011-2018 China Health and Retirement Longitudinal Study were analyzed. Based on changes in SEP from childhood to adulthood, 5 patterns of social mobility were established. A 32-item deficit cumulative frailty index (FI) was developed to evaluate frailty trajectories at each follow-up. Linear mixed-effects models were used to examine the longitudinal association of the 5 social mobility patterns with the frailty trajectory. The trajectory of late-life FI increased across all 5 social mobility groups during the follow-up. The FI trajectory had the largest disparity between stable high SEP and stable low SEP, with a faster increase in FI of 0.489 (95% confidence interval [CI]: 0.327-0.650, p < .001) in the stable low versus stable high SEP group. The FI trajectories of individuals in the upward and downward mobility groups fall between those in the stable high SEP and low SEP groups. Specifically, compared to the stable high SEP group, the increase in FI was 0.229 (95% CI: 0.098-0.360, p = .001) faster in the downward mobility group, and 0.145 (95% CI: 0.017-0.273, p = .03) faster in the upward mobility group. The impact of social mobility on frailty trajectories was more pronounced among middle-aged adults and women. These findings emphasize that policies to identify vulnerable populations and reduce frailty inequalities should focus on the socioeconomic environment across the life course, with particular attention paid to those with consistently low SEP and downward mobility.

Intergenerational social mobility and health in Russia: Mind over matter?

The consequences of changing one's socio-economic status over the life course-i.e. social mobility-for individual health are not well understood. Theories of the health implications of social mobility draw on the human perception of one's changing conditions, but empirical studies mostly examine the health implications of moving from objectively defined indicators of parental socio-economic position such as education, occupation, or income, to own socio-economic position in adult life. Little is known about the consequences of individuals' own assessment of changes in socio-economic position for health outcomes. In this study, we examine the association of social mobility and health in a unique sample of the Russian population after the transition to a market society. We take a broad perspective on social mobility, putting emphasis on subjectively perceived social mobility. Results show that individuals' objective characteristics only partially explain the variation in their subjective perceptions of intergenerational mobility. Net of social origin and destination variables, subjective social mobility is associated with individuals' health outcomes, as measured by the 12-Item Short Form Health Survey. Those who perceive being upwardly mobile report better health, and downward mobility is associated with poorer health. The association holds for mental and physical health, for perceived downward and upward social mobility, and for a general subjective measure of mobility and a subjective measure prompting respondents to only think of mobility in terms of occupation. These findings are robust to controlling for a rich set of socio-demographic predictors on childhood adversity, contemporaneous material wellbeing, and family-related circumstances. We conclude that a conventional focus on single socio-economic status dimensions such as occupation might be too narrow to capture the health consequences of social mobility.

Parental socioeconomic position and risk of ADHD in offspring: a cohort study of 9648 individuals in Denmark 1976-2013.

The strength of the association between parental socioeconomic position (SEP) and risk of attention-deficit/hyperactivity disorder (ADHD) in offspring is found to vary substantially, perhaps due to the negligence of possible changes in parental life course SEP. The present study investigated the association between parental SEP in adulthood and risk of ADHD diagnosis in offspring and whether parental childhood SEP modified this association. The study population included 9648 live-born singletons followed in the Psychiatric Central Register from birth in 1976-1996 until 2013. Cox regression was used to estimate hazard ratios for ADHD diagnosis according to parental SEP in adulthood. The results showed that low parental SEP in adulthood was associated with higher risk of ADHD diagnosis in offspring, also after adjustment for possible confounders. Thus, offspring of parents with low SEP in adulthood had 4.52 (95% CI 2.81-7.26) times higher hazard of ADHD diagnosis compared with offspring of parents with high SEP in adulthood. Further, parental childhood SEP was found to modify the observed association. Thus, offspring of parents with downward social mobility from childhood to adulthood and offspring of parents with stable low SEP experienced the highest risk of ADHD diagnosis, followed by offspring of parents with upward social mobility, compared with offspring of parents with stable high SEP. The results suggest that it is important to take into account the possibility of social mobility as changes in parental life course SEP from childhood to adulthood seem to influence the risk of ADHD diagnosis in offspring.

Stability and change in leisure-time physical inactivity and its predictors in mid-adulthood: findings from a prospective British birth cohort study

BackgroundChanges in inactivity occur within individuals as they age, but knowledge of influences on these variations, is lacking. Most studies ignore changes in potential influences, instead focusing on one timepoint. We aimed to identify whether changes in health and social factors are associated with concurrent changes in inactivity. MethodsHealth, social factors, and leisure-time inactivity (activity frequency less than once a week) were self-reported at 33 (baseline) and 50 years in the 1958 British birth cohort (n=12 271). Using multinomial logistic regression, we assessed the association of baseline health and social factors, and stability and change in these factors from age 33 to 50 years, with inactivity patterns from ages 33 to 50 years (never inactive, persistently inactive, deteriorating, or improving). Missing values were imputed via multiple imputation; results were broadly similar to those using observed values. FindingsApproximately 3804 individuals (31%) were inactive at both ages; 4295 (35%) had changed inactivity from age 33 to 50 (2086 [17%] deteriorating, 2209 [18%] improving). Baseline poor-rated health and obesity were associated with subsequent (33–50 years) inactivity; for example, for poor-rated health, relative risk ratios (RRRs) for persistent inactivity and deterioration versus never inactive were 2·01 (95% CI 1·70–2·38) and 1·38 (1·16–1·64), respectively; and for improvement versus persistently inactive was 0·77 (0·63–0·94). Stability and change in health factors were associated with concurrent inactivity patterns; for example, compared with always good or excellent health, worsening and always poor health were associated with lower RRRs for inactivity improvement (0·64 [0·50–0·80] and 0·58 [0·44–0·76], respectively). Low self-efficacy at baseline was associated with persistent inactivity and deterioration; worsening and always low self-efficacy from 33 to 50 years were associated with detrimental inactivity patterns. Although manual socioeconomic position at baseline was associated with persistent inactivity and deterioration, associations for changes in socioeconomic position were less consistent. Baseline depression was associated with persistent inactivity; depression at 33–50 years was not associated with inactivity patterns. No associations were observed for employment, marital or cohabitation status, or parenthood status. InterpretationSelf-reported data could potentially bias results because of misclassification, whereas the prospective repeated data spanning decades is a study strength. Associated changes in mid-life health factors with deleterious changes in inactivity shown in our study, highlight the maintenance of health, weight, and self-efficacy across adulthood to deter inactivity. Several of these factors are relatively common, underscoring their potential importance for population levels of inactivity in mid-adulthood. FundingThis work was supported by the Department of Health Policy Research Programme through the Public Health Research Consortium. The views expressed in this abstract are those of the authors and not necessarily those of the Department of Health.

Socioeconomic position in young adulthood is associated with BMI in Australian families.

Low socioeconomic position (SEP) is associated with increased cardiovascular (CV) disease risk, but the relative importance of SEP in childhood and adulthood, and of changes in SEP between these two life stages, remains unclear. Studies of families may help clarify these issues. We aimed to assess whether SEP in young adulthood, or change in SEP from childhood to young adulthood, was associated with five continuously measured CV risk factors. We used data from 286 adult Australian families from the Victorian Family Heart Study (VFHS), in which some offspring have left home (n = 364) and some remained at home (n = 199). SEP (defined as the Index of Relative Socioeconomic Disadvantage) was matched to addresses. We fitted variance components models to test whether young adult SEP and/or change in SEP was associated with systolic blood pressure, diastolic blood pressure, body mass index (BMI), total cholesterol or high-density lipoprotein cholesterol, after adjustment for parental SEP and within-family correlation. An increase in SEP of 100 SEIFA units from childhood to adulthood was associated with a lower BMI (β = -0.49 kg/m(2), P < 0.01) only. These results suggest that a change in SEP in young adulthood is an important predictor of BMI, independent of childhood SEP.

Alcohol use in adolescence and risk of disability pension 20-40 years later in Sweden: What role does socioeconomic position play?

Background Risk use of alcohol consumption in adolescence is associated with future disability pension (DP). We investigated if this association was affected by adult socioeconomic position (SEP), and/or changes in SEP from childhood to middle-age. Since risk use of alcohol in adolescence is important for future reduced work capacity, it is crucial to identify if some groups are more vulnerable than other in order to target prevention. Methods This is a population-based follow-up study including 49.321 Swedish men born 1949-1951 conscripted for mandatory military …

Lifecourse SEP and tobacco and cannabis use

Background: Social inequalities in substance use have been well-documented; however, the impact of changes in socio-economic position from childhood to adulthood is unclear. We examined the relationship between intergenerational trajectories of social position and tobacco and cannabis use among young adults. Methods: Data come from 1103 participants (mean age: 28.9 years) of the Trajectoires Epidémiologiques en Population (TEMPO) study and their parents, participants of the GAZEL study, France. Multinomial regression analyses were used to examine associations between lifecourse socio-economic position (SEP) assessed using the parent’s reports of family income (1989 and 2002) and the participant’s educational attainment, occupational grade and job stability in 2009, with self-reported tobacco and cannabis use in 2009. Results: Compared with participants with stable intermediate/high SEP, those with stable low SEP and those with declining SEP were more likely to use tobacco (age- and sex-adjusted ORs = 2.03 and 2.26). Participants who experienced declining SEP were also disproportionately likely to use and abuse cannabis (adjusted ORs = 2.22 and 2.73). Associations remained significant after adjusting for family (parental smoking, alcohol use, ill health, unemployment, depression and divorce) and individual (early tobacco and cannabis use, academic difficulties, juvenile internalizing and externalizing problems) risk factors. Conclusions: Cross-sectional studies indicate social inequalities in substance use. Our longitudinal findings suggest that individuals who experienced declining SEP from childhood to adulthood may be twice as likely to use tobacco and cannabis compared with individuals with a stable/high trajectory. Interventions targeting substance abuse should take into account lifecourse determinants including the interplay between individuals’ socio-economic origins and later attainment.

Trends and inequalities in late-life health and functioning in England

BackgroundRecently, late-life disability rates have declined in several countries of the Organisation for Economic Co-operation, but no national-level trend analysis for England has been available. The authors provide such analysis,...

Migration, social mobility and common mental disorders: critical review of the literature and meta-analysis

Objective. Changes in socio-economic position in people who migrate may have adverse associations with mental health. The main objective of this review was to assess the association of social mobility with common mental disorders in migrant and second-generation groups, to inform future research. Design. Systematic review and meta-analysis of English-language studies assessing the association of social mobility in migrant or second-generation groups with common mental disorders. Approaches to operationalise ‘social mobility’ were reviewed. Results. Twelve studies (n=18,548) met criteria for retrieval. Very few included second-generation groups, and most studies were cross-sectional in design. Approaches to operationalise ‘social mobility’ varied between studies. Downward intragenerational social mobility was associated with migration in the majority of studies. Random effects meta-analysis (n=5179) suggested that migrants to higher income countries who experienced downward mobility or underemployment were more likely to screen positive for common mental disorders, relative to migrants who were upwardly mobile or experienced no changes to socio-economic position. Conclusions on second-generation groups were limited by the lack of research highlighted for these groups. Downward intragenerational mobility associated with migration may be associated with vulnerability to common mental disorders in some migrant groups. Conclusion. Given the increasing scale of global migration, further research is needed to clarify how changes to socio-economic position associated with international migration may impact on the mental health of migrants, and in their children.

Life-Course Socioeconomic Position and Incidence of Dementia and Cognitive Impairment Without Dementia in Older Mexican Americans: Results From the Sacramento Area Latino Study on Aging

There have been few investigations of the link between changes in life-course socioeconomic position (SEP) and cognitive decline or incidence of dementia. The authors examined the impact of changes in life-course SEP on incidence of dementia and cognitive impairment but not dementia (CIND) over a decade of follow-up. Participants of Mexican origin (n = 1,789) were members of the Sacramento Area Latino Study on Aging cohort. Incidence of dementia/CIND was ascertained by using standard diagnostic criteria. SEP indicators at 3 life stages (childhood, adulthood, and midlife) were used to derive a measure of cumulative SEP (range, 0 to 8) and SEP mobility. Nearly 24% of the sample maintained a low SEP throughout life. Hazard ratios and 95% confidence intervals were computed from Cox proportional hazards regression models. In fully adjusted models, participants with a continuously high SEP had lower hazard ratios for dementia/CIND compared with those with a continuously low SEP at all 3 life stages (hazard ratio = 0.49, 95% confidence interval: 0.24, 0.98; P = 0.04). In age-adjusted models, participants experienced a 16% greater hazard of dementia/CIND with every 1-unit increase in cumulative SEP disadvantage across the life course (hazard ratio = 1.16, 95% confidence interval: 1.01, 1.33; P = 0.04). Early exposures to social disadvantage may increase the risk of late-life dementia.

Health selection operating between classes and across employment statuses

BackgroundsThe debate on health selection which describes the influence of health on subsequent social mobility is highly contested. The authors set out to examine the effect of health selection by...

The impact of sociodemographic conditions on quality of life among adolescents in a Brazilian birth cohort: a longitudinal study

To examine associations between certain aspects of self-reported Quality of Life (QoL) in early adolescence, and gender, skin color, maternal education at birth, and changes in socioeconomic position (SEP) occurring from 0-11 years of age. A longitudinal study of a birth cohort composed of 5 249 individuals born in 1993 in Pelotas, Brazil, who were followed periodically from birth to age 11. Socioeconomic variables were collected at birth in 1993, and again, in 2004. The following eight variables were analyzed: relationship with mother, relationship with father, family conflicts, physical punishment by parents, family relationship problems, discrimination, academic failure, and fear of neighborhood of residence. Adjustments were made using a hierarchical model. Skin color was related to all the variables (more so for nonwhites than for whites), except in family conflicts. Physical punishment and academic failure were more frequent in males. Discrimination and fear of neighborhood were more prevalent in females. Maternal education at birth was inversely associated, especially with failing/repeating a grade in school(19.5 times more frequent in the lower maternal education group than in the highest). A similar pattern was found with the SEP change: worse QoL in the group that was always poor (at birth and at 11 years of age) than in the group that was never poor. Fear of neighborhood was not related to maternal education or SEP change. Gender, skin color, maternal education, and SEP change were related to various measured aspects of QoL. These results should be considered in policymaking that seeks to minimize inequities at birth, across the life-course, and for future generations.

Differences between women’s and men’s socioeconomic inequalities in health: longitudinal analysis of the Canadian population, 1994–2003

Background:Socioeconomic inequalities in health are ubiquitous in developed countries; however, whether these inequalities differ between women and men over time is less clear.Objective:To estimate the potentially different health effects of...

Census-based and personally reported income measures as long-term risk-adjusted mortality predictors

Census-based and personally reported income measures as long-term risk-adjusted mortality predictors

Survival strategies of Serbian households

Concept of household strategies was firstly used in poverty surveys in Africa and Latin America, and lately developed in economic changes surveys in Western developed societies. Connecting the structure and action, macro and micro level of analysis and focusing on households, rather than individual as basic unit of analysis, the concept opened possibilities for better understanding of household economic behavior during social and economic changes. New developments concept experienced in numerous surveys in post-socialist as well as 'post-fordists' societies. The economic household strategies surveys were conducted in Serbia in two waves - in summer of 2000. and autumn of 2002. Comparative analysis of results has not show significant changes in socio-economic position of households. However, changes were evident in the field of action (economic strategies of households and individuals). Decreasing of passive and defensive strategies and increasing of pro-active, particularly working strategies were significant trends from survey.