Individual Life Course Research Articles

Beyond nature, nurture, and chance: Individual agency shapes divergent learning biographies and brain connectome.

Individual choices shape life course trajectories of brain structure and function beyond genes and environment. We hypothesized that individual task engagement in response to a learning program results in individualized learning biographies and connectomics. Genetically identical female mice living in one large shared enclosure freely engaged in self-paced, automatically administered and monitored learning tasks. We discovered growing and increasingly stable interindividual differences in learning trajectories. Adult hippocampal neurogenesis and connectivity as assessed by a high-density multielectrode array positively correlated with the variation in exploration and learning efficiency. During some tasks, divergence transiently collapsed, highlighting the sustained significance of context for individualization. Thus, equal environments and equal genes do not result in equal learning biographies because life confronts individuals with choices that lead to divergent paths.

A Life Course Approach to Cardiovascular Disease Prevention

Abstract During the past 3 decades, life course socio-ecological frameworks have received considerable attention from clinical and public health professionals; developmental, social, and behavioral scientists; and scholars. Substantial evidence underscores the importance of a life course approach to prevention of cardiovascular (CV) disease and the promotion of optimal CV health. This article provides an overview of evidence on early origins and progression of CV disease (CVD) processes across the life course of individuals from diverse populations. Emphasis is placed on the evidence-based guidelines designed to prevent CVD and promote CV health with recommendations for implementation by CV health professionals and directions for future research in global CVD prevention.

Childhood adversities and gender inequality in mental health: Do gendered institutions matter?

Rich sociological literature invokes both individual life course and macro-institutional perspectives to explain gender disparities in depression. While life course theories suggest that women’s mental health is more vulnerable to adverse childhood socioeconomic status (SES), institutional theories highlight macro-level drivers of gender disparities. Integrating these perspectives, I argue that female-friendly macro-institutional contexts ameliorate gendered health disparities by reducing the gendered effects of childhood SES on adult depression. Empirically, I employ data from the European Social Survey, which is the largest cross-nationally comparable dataset containing rich information on childhood experience and health. These data thus allow me to decompose the two-way association between gender, childhood SES, and depression across countries with varying gender regimes. The empirical evidence is largely consistent with my intervention. Women experience more pernicious mental health effects from adverse childhood SES than men, but this gender inequality, and the overall harmfulness of childhood adversity among women, is smaller in countries with more female-friendly gender regimes. I conclude by implicating these findings in broader debates about the interplay between childhood SES, gender, institutional contexts, and mental health.

Becoming “Platform Workers”: A Biographical Exploration of Temporary Visa and Worker Subjectivities in the Gig Economy

As studies worldwide have highlighted, place-based platform work is predominantly carried out by migrant and/or racialized workers. By tracing the migration trajectories of Chilean and Argentinian gig workers on Working Holiday Visas (WHV) in Germany, we shed light on how platform-mediated work fits into the larger life trajectories of these migrant workers. Applying a lens of time and temporalities, we conceptualize migration as a process of becoming that involves the temporalities of particular visa regimes, wider scales of institutional and social temporal ordering, and progression through an individual's life course. We find that the temporal horizons of the visa and the transient nature of platform work foster distinct worker subjectivities that make platform work acceptable despite its precarity. We therefore argue that the temporariness of the WHV is a crucial factor in explaining why highly educated young people engage in low-status and low-waged platform work.

The socioecology of sexual minority stigma: Advancing theory on stigma-based mechanisms underlying sexual orientation-based disparities in health

Research in public health and psychology has identified sexual minority stigma-related risk factors that contribute to sexual orientation-based health disparities across settings and societies worldwide. Existing scholarship, however, has predominantly focused on these factors as independent, stand-alone risk factors, neglecting their interconnected nature across different levels. This article theoretically explores how sexual minority stigma may function as a multilevel socioecological system, by building on prevailing theories and emphasizing the interplay between structural, interpersonal, and intrapersonal stigma-related factors. Drawing on the minority stress and socioecological theories, three central tenets are proposed, namely 1) chronosystem with immediate, accumulating, or lasting effects across spatiotemporal contexts, 2) nested multilevel system with cross-level effects, and 3) mechanistic pathways linking stigma exposure to health. By providing a nuanced and comprehensive understanding of how sexual minority stigma may operate as a multilevel socioecological system, this article reflects on the novel implications of this interpretation for future research and aims to guide future conceptualizations and studies, acknowledging the complexity of sexual minority stigma exposure across historical contexts, societies, and the individual life course in shaping physical and mental health of sexual minorities. Limitations of current research and recommendations for future research are being discussed.

Internal mobility of international migrants in Europe: A critical literature review and research agenda

AbstractThis paper reviews the literature on the internal mobility of international migrants and their descendants in Europe from an interdisciplinary perspective. Europe is becoming increasingly diverse. Where international migrants live and move to after arriving in their destination country influences both individual life courses and macro‐level population compositions. So far, a comprehensive overview of internal mobility patterns and drivers among migrants is missing. The aim of this paper is threefold: first, to discuss the development of the field across disciplines; second, to present and reflect on the current state of knowledge of internal mobility of migrants in Europe, and third, to conclude by setting an agenda for future research. This paper stresses the importance of studying the internal mobility of migrant populations over their life courses, testing theories across migrant generations, doing more justice to population diversity, strengthening the link between the literature on internal and international migration, and finally, emphasises the need for comparative research.

Early-Life Exposures and Social Stratification

Adverse environmental exposures—war and violence, natural disasters, escalating heat, worsening air quality—experienced in pregnancy are consequential for multiple domains of well-being over the life course, including health, cognitive development, schooling, and earnings. Though these environmental exposures become embodied via biological processes, they are fundamentally sociological phenomena: Their emergence, allocation, and impact are structured by institutions and power. As a result, consequential early-life environmental exposures are a critical part of the sociological understanding of social stratification, intergenerational mobility, and individual and cohort life course trajectories. We review theory and evidence on prenatal exposures, describe enduring methodological issues and potential solutions for elucidating these effects, and discuss the importance of this evidence for the stratification of opportunity and outcomes in contemporary societies.

General and Specific Quality of Life Course of Individuals with Different Levels of Stroke Severity: A One-Year Prospective Longitudinal Study

ABSTRACT Objectives To compare the course of generic and specific health-related quality of life (HRQOL) of individuals with stroke, and its physical, mental, and social domains, at three, six, and 12 months after hospital discharge, considering the levels of stroke severity. Methods This is a longitudinal study, in stroke individuals, assessed during hospital admission by the National Institutes of Health Stroke Scale (NIHSS), and divided into mild (NIHSS ≤3) or moderate/severe (NIHSS ≥4) disease. At three, six, and 12 months after hospital discharge, the individuals were assessed for generic (Short Form Health Survey–36: total score and physical and mental domains) and specific (Stroke Specific Quality of Life Scale: total score and social domain) HRQOL. A 2 × 2 repeated measures analysis of variance (ANOVA) with post-hoc was applied. Results 146, 122, and 103 individuals were assessed at three, six and 12 months, respectively HRQOL courses showed different behaviors according to stroke severity (3.37≤F ≤ 4.62; 0.010≤p ≤ .036). Individuals with mild stroke showed significant changes in the physical domain, with a reduction between three and six months, and an increase between six and 12. Moderate/severe individuals showed a significant increase in all HRQOL variables between three and six months, and a maintenance of values for almost all variables, except for physical domain, which improved significantly between three and six months, and got significantly worse between six and 12. Conclusions HRQOL during the first year after stroke showed distinct trajectories, being stroke severity an important factor in identifying stroke subjects at risk of HRQOL decline. Clinical Implications These results demonstrate the importance of considering not only the phase of the stroke, the severity, and the general and specific HRQOL, but also the physical, social, and mainly the mental domain, which has long been neglected, when assessing this population.

Attributions of Loneliness-Life Story Interviews with Older Mental Health Service Users.

There is growing evidence on the prevalence and impact of loneliness, particularly among older people. However, much less is known about the personal origins of loneliness and how it persists, or not, over an individual's life course. This study aimed to increase understanding of the personal experiences of loneliness among older adults across the life course. Central to this study was giving voice to the participants and allowing them to define loneliness, what it meant to them, and how it affected them throughout their lives. This qualitative study employed 18 life story interviews with older adults attending a mental health service. We explored their personal experiences of loneliness and the situations and factors associated with loneliness across the life course. We identified three distinct typologies of loneliness: those who experienced (1) chronic loneliness since childhood, (2) chronic loneliness after a life-changing event in midlife, and (3) loneliness which remained situational/transitional, never becoming chronic. This study found the seeds of chronic life course loneliness are often determined in childhood. Early detection and intervention may prevent situational loneliness from becoming chronic. More research is needed from a life course approach to help understand and address the causes and consequences of loneliness.

Implementation of a countywide adult suicide review commission: Development, lessons learned, and recommendations.

Fatality review is a public health approach designed to inform efforts to prevent fatalities of a certain kind (e.g., suicide, homicide) or in a specific setting or population (e.g., hospitals, youth). Despite extensive literature on fatality review generally, the literature on suicide review teams specifically is scant. The aim of this paper is to: describe the implementation of a local adult suicide review commission, detail examples of initial outcomes and recommendations developed by the commission, and provide recommendations and/or best practices for how to develop and implement an adult suicide review team. We utilize framing questions from the American Association of Suicidology's psychological autopsy framework. By using these guiding questions in the discussion, members are invited to explore not only the stressors that may have more immediately preceded the suicide event itself, but to situate those stressors in the context of the individual's life course. Several recommendations proposed by our commission have resulted in tangible outcomes and are detailed using Haddon's Matrix as a guiding prevention planning tool. We have highlighted the need to move beyond looking at individual-level help-seeking to focus on structural/systemic issues that result in stress or create unsafe environments for at-risk individuals.

Characterizing the "HIV Care Adherence Journey" for Persons With HIV in the Philippines: Conceptual Foundation for Person-Centered Intervention.

Promoting adherence to HIV care among persons with HIV (PWH) is a key component to addressing the rising HIV epidemic in the Philippines. HIV care adherence is a complex process that may change throughout an individual's life course or "journey" living with HIV. This qualitative study aimed to explore the HIV care adherence journey of PWH. Maximum variation sampling was used to select 12 PWH and 3 health care providers for in-depth online interviews, which were analyzed using thematic analysis. The four themes that emerged to describe the HIV care adherence journey are integration, relation, navigation, and manifestation. Each theme corresponds to a unique set of activities and goals related to PWH's lived experiences as they initiate, practice, and maintain care adherence. This study provides a preliminary framework to characterize the HIV care adherence journey as a dynamic, complex, and multifaceted phenomenon, which can help to inform holistic interventions to support PWH.

Social policies and the life course – a complex relationship re-visited

Abstract Social policies structure individual life courses, cushion individual life course risks, and provide normative orientation. The paper brings together literature from life course sociology and welfare state research in order to provide an updated systematisation of the relationship between individual life courses and social policies. The modern life course regime and its welfare regulation are described as centred around individual actors, and as part and parcel of modernisation processes and the institutional arrangement mediating between the modern (democratic) state and the capitalist economy. Furthermore, the paper discusses these structural roots of life course policies, their resulting characteristics and their normativity. Key aspects in this are individualisation and its limits, the multilevel implementation of social policies and their life course effects with regard to inequalities.

‘Untiring’ in her efforts on behalf of the team and discharging her duties ‘in the most capable manner’; female coaches in Edwardian Britain

ABSTRACT The compliments paid to Clara Jarvis by the Amateur Swimming Association in recognition of her contribution as trainer to the women’s swimming team at the 1912 Olympics marked a unique public recognition of the role of the woman as coach in the Edwardian era (1901–1914). The absence of similar references to women as coaches or trainers in the archives could easily persuade the observer that Clara was an isolated example, but the reality was very different in that women were actively coaching in several sports and activities, if coaching is interpreted in the sense of helping others to improve their physical performance. The key to researching these women is to look beyond the terminology ‘coach’ or ‘trainer’. This paper uses a range of search terms to uncover women involved in skating and riding, and as physical culturalists and games mistresses, from the 1911 census and explores the characteristics of each group as well as uncovering some individual life courses. The paper concludes that these women were not unique, in that similar communities can also be identified in activities such as swimming and dance, and that the notion that few women coached in this period needs to be revised.

Life-Course Perspective on Immigrant Loneliness: A Conceptual Framework for Intergenerational Loneliness Trajectories

Feelings of loneliness can impact the relationships between the generations and family members. Loneliness among immigrant family members and its generational transmission are attracting more and more attention from academics. Nonetheless, existing research is frequently lacking theoretical foundations. I provide the life-course approach as a framework for enhancing future studies and theories of intergenerational loneliness in members of immigrant families. Particularly, the life-course perspective emphasizes the significance of considering the influence of both an individual's life course, societal factors, linked lives across generations, and the historical context. I review key dimensions of the life-course perspective and make recommendations for future directions in immigrant research on loneliness, generational loneliness disparities, and the transmission of loneliness across generations.

The Role of Nursing in Pediatric Lifestyle Medicine.

Lifestyle medicine is a critically important part of optimizing holistic health across the life course of individuals. For children and adolescents, lifestyle medicine with the focus on developing healthy lifestyle behaviors, is initiated early in life and emphasizes multidisciplinary, multisectoral efforts. Central to these efforts is primordial prevention, with an emphasis on developing and maintaining healthy patterns of lifestyle behaviors. Viewed within a socio-ecological model of health and behavior, contexts including families, schools, and communities interact to influence and impact the health of children and adolescents. Nurses and nursing organizations and societies promote pediatric lifestyle medicine with the aim of promoting optimal health and development for all children.

The association between age and telomere length is age-dependent: Evidence for a threshold model of telomere length maintenance.

Telomere length and dynamics are commonly used biomarkers of somatic state, yet the role of telomeres underlying the aging process is still debated. Indeed, to date, empirical evidence for an association between age and telomere length is mixed. Here, we test if the age-dependency of the association between age and telomere length can provide a potential explanation for the reported inconsistencies across studies. To this end, we quantified telomere length by telomere restriction fragment analysis in two groups of Japanese quail (Coturnix japonica) that differed in their age distribution. One group consisted of young adults only, whereas the second group consisted of adults across a wide range of ages. In the young adults group, there was a highly significant negative association between telomere length and age, whereas no association between age and telomere length was found in the all-ages adults group. This difference between groups was not due to telomere length-dependent selective disappearance. Our results shows that the association between telomere length and age is age-dependent and suggest that the costs and benefits associated with telomere maintenance are dynamic across an individual's life course.

Knowledge, attitude, and practices of adolescents and peer educators in relation to the components of the National Adolescent Health Program in India: findings from a cross-sectional survey.

Adolescence is a critical period of growth and development. Many adverse health outcomes in adulthood begin during adolescence, often due to insufficient knowledge and attitudes resulting from a lack of education. Therefore, appropriate knowledge, attitudes, and practices (KAP) regarding various aspects of health are essential for holistic adolescent and lifelong health. In India, the Rashtriya Kishore Swasthya Karyakram (RKSK or National Adolescent Health Strategy) has utilized an innovative peer-education approach to engage with adolescents and improve their KAPs. Amid limited evidence, we aimed to assess the KAP of adolescents regarding the six themes of the RKSK, with a particular focus on the status of peer educators (PEs). Our objective was to evaluate these aspects disaggregated by sex and to examine how engagement with the RKSK peer-education program influenced their KAP. A cross-sectional survey of 238 peer educators and 2885 adolescents enrolled under peer educators was conducted in two localities; Madhya Pradesh and Maharashtra states. KAPs were estimated using descriptive statistics then disaggregated by gender. Practice scores of nutrition and non-communicable disease (NCD) were modelled upon engagement with RKSK (graded as 0, 1, 2, 3). Knowledge was highest regarding substance misuse and lowest in the domains of sexual and reproductive health, and violence and injury. PEs possessed greater knowledge in most domains as compared to adolescents enrolled under them. Attitudes toward abstention from substance misuse were positive, whereas attitudes toward injury and violence, and sexual health, were suboptimal. Boys exhibited better practices related to NCDs, while their nutritional practices were comparatively worse than girls. The RKSK engagement was associated with better nutritional practices: adjusted relative risks (RRs) being 1.04 (95% confidence interval [CI]: 0.94-1.15), 1.12 (1.04-1.21), and 1.21 (1.13-1.31), respectively, for engagement scores 1, 2, and 3 with reference to score 0. The relationship between RKSK engagement and NCD-related practices was restricted to the top engagement group. The knowledge regarding sexual health, and injury and violence, was grossly deficient in adolescents. These components must be prioritized in the program because they are critical for health not only across the life course of individuals but also across generations. However, the RKSK engagement was associated with better practices in a variety of domains, which should be leveraged in the future.

Transitions from Long-Term Unemployment to Employment

As labour market research has shown, social networks heavily impact the likelihood of gaining employment. In Germany, factors such as low qualifications, illness, age over 50, immigrant background, language deficits, and care obligations, particularly when combined, hinder job transitions and induce long-term unemployment. Nevertheless, some long-term unemployed individuals can secure jobs and forgo social benefits, seemingly against all odds. To investigate the transition-to-work process and its relationship with information, network compositions, and individual agency, we conducted a qualitative survey supplemented by problem-centred biographical interviews, employing software-based network tools. The results revealed that adopting a process-oriented approach was crucial for understanding the utilization of networks to address long-term unemployment. To encourage future network approaches in investigating labour market transitions, three key aspects appear valuable. First, the development of individual agency within stable living conditions, the contribution of alteri within the network, and information transfer for labour market orientation, including factors contributing to translating information, motivation, and orientation into employment activities. This three-step analysis moves beyond traditional approaches examining factors such as network density and the frequency of interactions or simply distinguishing strong from weak ties, by emphasising relational diachronic perspectives and respecting individual life course trajectories.

High Amino Acid Intake in Early Life Is Associated With Systolic but Not Diastolic Arterial Hypertension at 5 Years of Age in Children Born Very Preterm.

The life course of individuals born very premature is a topic of increasing concern. The association between high early amino acid intake and later high blood pressure (HBP) in preterm neonates is debated. In a national, prospective, population-based birth cohort, EPIPAGE-2 (Etude Epidémiologique sur Petits Ages Gestationnels), we assessed blood pressure at 5 years. Eligible infants were those born between 24 and 29 weeks of gestation. Infants were distributed in 2 groups of 717 infants matched on propensity score on whether or not they were exposed to high amino acid intake (>3.5 g/kg per day at day 7); 455 control term infants were also enrolled. A value ≥95th percentile of reference values for age and height defined systolic or diastolic HBP. Blood pressure at 5 years of age was assessed for 389 and 385 children in the exposed and nonexposed groups, respectively. Rates (in percent) of systolic and diastolic HBP were 18.0% (95% CI, 14.5%-22.2%), 13.3% (95% CI, 10.3%-17.0%), 8.5% (95% CI, 6.5%-11.1%), and 9.0% (95% CI, 6.6%-12.3%), 10.2% (95% CI, 7.5%-13.6%), and 5.4% (95% CI, 3.8%-7.6%) in exposed, nonexposed, and term-born groups, respectively. Exposure to high early amino acid intake and maximal serum creatinine (by 50 μmol/L) between day 3 and day 7 were 2 independent risk factors for systolic HBP (adjusted odds ratio [aOR], 1.60 [95% CI, 1.05-2.43] and aOR, 1.59 [95% CI, 1.12-2.26], respectively) but not for diastolic HBP (aOR, 0.84 [95% CI, 0.50-1.39] and aOR, 1.09 [95% CI, 0.71-1.67], respectively). After adjustment for 5-year weight Z score, the aOR between high early amino acid intake and systolic HBP was 1.50 [95% CI, 0.98-2.30]. These results suggest that mechanisms of childhood systolic HBP involve neonatal renal challenge by high amino acid intake or dysfunction.

Integrating health promotion and palliative care: improving determinants of health and well-being in the context of serious illness and the end of life

Background: Growing evidence shows that using a health promotion approach in palliative care can have a positive impact on health outcomes in patients, their families and communities, yet, the relevance and importance of stimulating health and well-being in the context of serious illness and the end of life is often still not understood or recognized.
 Objectives: With this workshop we aim to 1) provide more knowledge on the integrated approach of health promotion and palliative care, focusing on its practical applications and the partnerships it entails, 2) reflect with the participants about the added value of this integration throughout individual life courses, within communities and society as a whole, 3) discuss if and how this approach could be applied in the work or organization of the participants.
 Format: The speakers will first give a brief overview of the conceptual overlap between health promotion and palliative care, their integration and the professional developments that have resulted from this. After, three short presentations on concrete examples of this integration in practice will be given with an emphasis on the different types of partnerships involved. To stimulate the group discussion on the added value of integrating health promotion and palliative care, we follow with a fictional life story of a person who at different times of her life is confronted with serious illness, loss and the end of life. Afterwards, participants are invited to reflect and debate on the relevance and potential of this approach in their own line of work. We end with a short summary of key messages and offering participants the chance to give final reflections and feedback on the subject as well as structure of the workshop.
 For whom?: Anyone active in the policy, practice, advocacy or research surrounding palliative and end-of-life care and/or health promotion.
 Time schedule (90’ duration):
 - part 1 (5'): 'Introduction' by Anne-Lore Scherrens
 - part 2 (5'): 'Integrating health promotion and palliative care: from conceptual overlap towards new partnerships and promising applications in practice' by Marjolein Matthys
 - part 3 (15'): 'Three short (3x5’) presentations offering concrete examples (the Belgian ‘My Care My Voice’ intervention, the Swedish DöBra cards and the development of a public awareness campaign on palliative care in Flanders, Belgium)' by Anne-Lore Scherrens, Marjolein Matthys and Leen Van Brussel
 - part 4 (25'): Departing from a fictional life story and applying a socio-ecological lens, group discussion on the added value of the integrated approach of health promotion and palliative care
 - part 5 (25'): Group discussion on the relevance and potential of the integrated approach in the context of the participants’ work
 - part 6 (10’): Closing reflections (participants and speakers)
 (5' extra)