Life Disparity Research Articles

Socioeconomic disparities in life and health expectancy among the household population in Canada.

Life expectancy (LE) and health expectancy have increased throughout much of the world. However, these gains have not been shared equally across all population groups. Socioeconomic disparities exist, though varied methodologies and data sources have made it difficult to ascertain changes over time in Canada. The 1996 and 2011 Canadian Census Health and Environment Cohorts, with a five-year mortality follow-up, were used to estimate the LE of the household population at ages 25 and 65, according to individual-level education and income. Health status was measured by the Health Utilities Index Mark 3 instrument in two national population health surveys and was used to adjust LE to estimate health-adjusted life expectancy (HALE). Disparities in LE and HALE, and differences between cohorts, were examined. LE, HALE and the ratio of HALE to LE were greater at higher levels of education or income. A stepwise gradient was also observed by level of education within and across income quintiles, with people in the lowest combined education and income categories at the greatest disadvantage. Disparities were wider in the 2011 cohort compared with the 1996 cohort, but not necessarily to the same extent for both sexes or at different ages. In Canada, education-related and income-related disparities in life and health expectancy persist and may be wider than they were in the past. This underscores the importance of ongoing data development for routine monitoring of trends in mortality and morbidity, which can, in turn, inform policy development and planning to advance health equity.

Correlating Effect of Temperature on Cyclic Plastic Deformation Behavior with Substructural Developments for Austenitic Stainless Steel

Low-cycle fatigue experiments have been carried out at elevated and sub-zero temperatures. Corresponding effect on cyclic plasticity characterizing parameters such as cyclic hardening/softening and Masing behavior is compared for different loading conditions. Disparities in the fatigue life as well as the cyclic plastic behavior have been attributed to the phase transformations that largely obstruct the dislocation motion. Further, the changes in strains in the materials matrix have been quantified through misorientation studies, wherein clear demarcation in strain distributions due to fatigue loading at different temperatures was obtained and further correlated with the substructural alterations observed through transmission electron microscopy.

Older adults incarcerated in state prison: health and quality of life disparities between age cohorts

Objectives This research sought to describe the physical and psychological health and quality of life among older adult men incarcerated in a state prison and to examine the role of age and historical time between age cohorts. Methods Survey responses from male respondents incarcerated in a medium-security prison (N = 186) were described using frequencies and descriptive statistics; chi-square and analysis of variance analyses were used to examine differences between age cohorts. Results The average number of chronic health conditions for the sample was higher than those in similar samples; the proportion of older adults with four or more chronic conditions was 10% higher than the national average for adults age 65 or older. Depression and post-traumatic stress (PTS) symptom severity scores were higher than those found in community-based samples. Significant differences were identified between cohorts regarding physical (number of chronic conditions, F = 12.48, p < .01); functional impairment, F = 4.28, p < .05) and psychological health (PTS symptom severity, F = 3.16, p < .05). Conclusion Policy and practice implications are discussed including the expansion of on- and off-site services for older adults in prisons, enhanced accessibility, and the use of grief counseling and stress management strategies.

EARLY-LIFE INFLUENCES ON LATER-LIFE HEALTH

This symposium identifies risk and protective factors in childhood and adolescence that continue to influence the physical and cognitive health of older adults. Dimensions of early life inequality include geographic location, educational opportunities, and total amount of adversity faced. Papers in the symposium use data from three major U.S. longitudinal studies: the Health and Retirement Study (HRS), the MacArthur Study of Midlife in the U.S. (MIDUS), and the Wisconsin Longitudinal Study (WLS). Each paper focuses on the mechanisms (i.e., mediators and moderators) linking well-being in childhood and adolescence to health in older adulthood. Greenfield, Akincigil, and Moorman find that net of IQ, college education boosts later life cognition, especially for men who had a low probability of college attendance. Kemp and Montez further find that state economic policy and adult health behavior explain later life disparities in health by educational attainment. Herd, Sicinski, and Asthana continue the theme of geographic place, finding that rural children who were raised on farms are at a cognitive disadvantage in later life. Both Ferraro and Sauerteig and Homan and Kong generate indices of total childhood misfortune. Ferraro and Sauerteig conclude that childhood misfortune affects obesity by way of adult health behavior, specifically, physical activity. Homan and Kong find that childhood misfortune affects subjective and functional health by way of the psychological mechanism of purpose in life. Together, these five papers begin to identify the ways in which experiences in childhood and adolescence have long-lasting consequences for a variety of health outcomes in later life.

WEALTH PROFILES AND VARIATIONS BY GENDER AND RACE: A GROWTH-MIXTURE MULTIGROUP COMPARISON

Wealth is fundamentally affected by various life course characteristics. However, little is known about the role of life course factors in shaping wealth trajectories in later life. This study explored how the longitudinal profiles of wealth varied by gender and race (white and non-white populations). Data came from the 2004-2014 Health and Retirement Study with 16,189 older adults aged 51 and older. With corrections for clustered effect within household, this study used growth mixture modeling (GMM) to identify the longitudinal patterns of wealth, and how these profiles varied by these two important life course attributes. The model began with a separate GMM model for race and gender to investigate the optimal latent class model. These results were combined using multi-group approach to incrementally examine the gender and race invariance using configural (same form), structural (same trajectory mean), dispersion (same trajectory variance), and distributional (same latent class size) test. Results identified four distinct wealth profiles—Stable high, Low and increasing, Stable low, and High but decline—for each race and gender category. The multigroup GMM analyses revealed that the wealth profiles varied by gender and race, but the degrees of variation differed a great deal, with results supporting a dispersion model for gender but a configural model for race. Results indicate that race has a stronger effect in shaping wealth development compared to gender. The findings suggest that understanding wealth disparities in later life could be facilitated by examining how wealth varies by gender and race.

Contextual and socioeconomic variation in early motor and language development

ObjectiveTo compare early motor and language development of children <3 years of age growing up in high-income and low-income contexts.DesignCross-sectional study.SettingWe analysed differences in motor and language skills across study...

Inequalities in time from stopping paid work to death: findings from the ONS Longitudinal Study, 2001–2011

BackgroundUK state pension eligibility ages are linked to average life expectancy, which ignores wide socioeconomic disparities in both healthy and overall life expectancy.ObjectivesInvestigate whether there are occupational social class differences...

Investigating the Effect of Carbonaceous Host Materials on the Performance of Alkali Metal Composite Anodes

Alkali metals (lithium, sodium, etc.) have been extensively investigated throughout the past several decades as potential anode materials for batteries. Their high theoretical capacities, low redox potentials, and low densities have garnered much attention and effort to yield highly efficient and capable anodes. These metals, through past efforts, have been shown to be highly reactive and unstable, forming layers of “dead” material, thick passivation layers, and producing dendritic structures. Within the past few years, the use of carbon host, support, materials have been employed to control the undesirable growths and reactions, and improve the efficiency and stability of the alkali metal anodes. While past results have shown to improve anode stability and performance, there have not been many studies to understand the fundamental interactions between the alkali metal and the host material. Utilizing a carbon fiber host material, we have observed disparities in the cycle life and performance between lithium and sodium metal. We employ characterization, electrochemical, and computational analysis to determine the differences of the host-metal interactions of lithium and sodium metal. Our results highlight the inherent properties and surface functionalization of the carbon host material that contribute to enhanced stability and performance of the composite anodes.

The threshold age of the lifetable entropy

Background: Indicators of relative variation of lifespans are markers of inequality at the population level and of uncertainty at the time of death at the individual level. In particular, the lifetable entropy H represents the elasticity of life expectancy to a change in mortality. However, it is unknown how this measure changes over time and whether a threshold age exists, as it does for other lifespan variation indicators. Results: The time derivative of H can be decomposed into changes in life disparity e† and life expectancy at birth eo. Likewise, changes over time in H are a weighted average of age-specific rates of mortality improvements. These weights reflect the sensitivity of H and show how mortality improvements can increase (or decrease) the relative inequality of lifespans. Further, we prove that in the assumption that mortality is reduced at all ages, H, as well as e†, has a threshold age below which saving lives reduces entropy, whereas improvements above that age increase entropy. Contribution: We give a formal expression for changes of H over time and provide a formal proof of the existence of a unique threshold age that separates reductions and increases in lifespan variation as a result age-specific mortality improvements.

Lifespan Dispersion in Times of Life Expectancy Fluctuation: The Case of Central and Eastern Europe

Central and Eastern Europe (CEE) have experienced considerable instability in mortality since the 1960s. Long periods of stagnating life expectancy were followed by rapid increases in life expectancy and, in some cases, even more rapid declines, before more recent periods of improvement. These trends have been well documented, but to date, no study has comprehensively explored trends in lifespan variation. We improved such analyses by incorporating life disparity as a health indicator alongside life expectancy, examining trends since the 1960s for 12 countries from the region. Generally, life disparity was high and fluctuated strongly over the period. For nearly 30 of these years, life expectancy and life disparity varied independently of each other, largely because mortality trends ran in opposite directions over different ages. Furthermore, we quantified the impact of large classes of diseases on life disparity trends since 1994 using a newly harmonized cause-of-death time series for eight countries in the region. Mortality patterns in CEE countries were heterogeneous and ran counter to the common patterns observed in most developed countries. They contribute to the discussion about life expectancy disparity by showing that expansion/compression levels do not necessarily mean lower/higher life expectancy or mortality deterioration/improvements.

ACTIVITY PATTERNS AND VARIATIONS BY GENDER AND RACE AND ETHNICITY: A MULTI-GROUP COMPARISON

AbstractResearchers have identified patterns of activity engagement in later life and described the relationship of these patterns to health outcomes. Little is known about how activity patterns vary by important demographics. Further, studies often include middle-aged sample without focusing on older adults. This study aims to identify patterns of activity engagement among 65+ older adults and explore whether these patterns vary by gender and race (white/black). Thirty-three activity measures were selected from the 2015 Consumption and Activity Mail Survey (n=2,794). Latent class analysis (LCA) identified three activity patterns, representing high, medium and low activity groups. The multi-group LCA showed that activity patterns varied across gender and race. Activity engagement varied more between females and males than between blacks and whites. Our findings suggest that understanding about health disparities in later life could be increased by examining how activities vary by gender and by race.

Age×stage-classified demographic analysis: a comprehensive approach.

This paper presents a comprehensive theory for the demographic analysis of populations in which individuals are classified by both age and stage. The earliest demographic models were age classified. Ecologists adopted methods developed by human demographers and used life tables to quantify survivorship and fertility of cohorts and the growth rates and structures of populations. Later, motivated by studies of plants and insects, matrix population models structured by size or stage were developed. The theory of these models has been extended to cover all the aspects of age‐classified demography and more. It is a natural development to consider populations classified by both age and stage. A steady trickle of results has appeared since the 1960s, analyzing one or another aspect of age × stage‐classified populations, in both ecology and human demography. Here, we use the vec‐permutation formulation of multistate matrix population models to incorporate age‐ and stage‐specific vital rates into demographic analysis. We present cohort results for the life table functions (survivorship, mortality, and fertility), the dynamics of intra‐cohort selection, the statistics of longevity, the joint distribution of age and stage at death, and the statistics of life disparity. Combining transitions and fertility yields a complete set of population dynamic results, including population growth rates and structures, net reproductive rate, the statistics of lifetime reproduction, and measures of generation time. We present a complete analysis of a hypothetical model species, inspired by poecilogonous marine invertebrates that produce two kinds of larval offspring. Given the joint effects of age and stage, many familiar demographic results become multidimensional, so calculations of marginal and mixture distributions are an important tool. From an age‐classified point of view, stage structure is a form of unobserved heterogeneity. From a stage‐classified point of view, age structure is unobserved heterogeneity. In an age × stage‐classified model, variance in demographic outcomes can be partitioned into contributions from both sources. Because these models are formulated as matrices, they are amenable to a complete sensitivity analysis. As more detailed and longer longitudinal studies are developed, age × stage‐classified demography will become more common and more important.

Adequate life-expectancy reconstruction for adult human mortality data.

Mortality information of populations is aggregated in life tables that serve as a basis for calculation of life expectancy and various life disparity measures. Conventional life-table methods address right-censoring inadequately by assuming a constant hazard in the last open-ended age group. As a result, life expectancy can be substantially distorted, especially in the case when the last age group in a life table contains a large proportion of the population. Previous research suggests addressing censoring in a gamma-Gompertz-Makeham model setting as this framework incorporates all major features of adult mortality. In this article, we quantify the difference between gamma-Gompertz-Makeham life expectancy values and those published in the largest publicly available high-quality life-table databases for human populations, drawing attention to populations for which life expectancy values should be reconsidered. We also advocate the use of gamma-Gompertz-Makeham life expectancy for three reasons. First, model-based life-expectancy calculation successfully handles the problem of data quality or availability, resulting in severe censoring due to the unification of a substantial number of deaths in the last open-end age group. Second, model-based life expectancies are preferable in the case of data scarcity, i.e. when data contain numerous age groups with zero death counts: here, we provide an example of hunter-gatherer populations. Third, gamma-Gompertz-Makeham-based life expectancy values are almost identical to the ones provided by the major high-quality human mortality databases that use more complicated procedures. Applying a gamma-Gompertz-Makeham model to adult mortality data can be used to revise life-expectancy trends for historical populations that usually serve as input for mortality forecasts.

Quality of life disparities between persons with schizophrenia and their professional caregivers: Network analysis in a National Cohort

BackgroundDisparities between mental health patients and their professional caregivers in quality of life appraisals have been identified, however, the structure that such disparities assume is unknown. AimsTo examine the network structure of quality of life appraisals and disparities using network analysis. MethodsParticipants were 1639 persons with schizophrenia using psychiatric rehabilitation services and their primary professional caregivers (N=582). Quality of life for persons with schizophrenia was measured based on an abbreviated version of the Manchester Short Assessment of Quality of Life. Appraisals were made self-reported and by professional caregivers. Disparities scores between the aforementioned were computed. Network analysis was performed on all quality of life appraisals. Sensitivity analyses were conducted. ResultsThe self-appraised network significantly (p<0.05) differed by network strength compared to the caregiver-appraised network. Self-appraised network communities (clusters of quality of life items) were health conditions and socioeconomic system, whereas caregiver-appraised network communities were social activities, and combined socioeconomic and health conditions. Strength centrality was highest for self-appraised social status and for caregiver-appraised residential status (Z=1.63, Z=1.12, respectively). The disparity scores network clustered into two communities: social relations and combined financial and health conditions. The most central appraisal disparities were in social status. ConclusionsQuality of life differed when self-appraised by persons with schizophrenia compared to when appraised by their professional caregivers, yet the salient role of social relations was shared. The latter may be an initial focus of discussion by persons with schizophrenia and their caregivers.

Socially disparate trends in lifespan variation: a trend study on income and mortality based on nationwide Danish register data

BackgroundSocial inequality trends in life expectancy are not informative as to changes in social disparity in the age-at-death distribution. The purpose of the study was to investigate social differentials in...

Race, Marital History, and Risks for Stroke in US Older Adults.

Stroke is among the leading causes of disability and death in the United States, and racial differences are greater for stroke than for all other major chronic diseases. Considering the equally sizeable racial disparities in marital life and associated risks across adulthood, the current study hypothesizes that black-white differences in marital history play an important role in the large racial inequalities in the incidence of stroke. The major objective are to (i) demonstrate how marital history is associated with the incidence of stroke, (ii) examine how marital factors mediate and/or moderate racial disparities in stroke, and (iii) examine the factors that may explain the associations. Using retrospective and prospective data from the Health and Retirement Study (n = 23,289), the results show that non-Hispanic (NH) blacks have significantly higher rates of marital instability, greater numbers of health-risk factors, and substantially higher rates of stroke compared with NH whites. Contrary to the cumulative disadvantage hypothesis, findings from discrete-time-hazard models show that the effects of marital history are more pronounced for NH whites than for NH blacks. Risks for stroke were significantly higher in NH whites who were currently divorced, remarried, and widowed, as well as in those with a history of divorce or widowhood, compared with NH whites who were continuously married. In NH blacks, risks for stroke were elevated only in those who had either never married or had been widowed-with no significant risks attributable to divorce. The potential mechanisms underlying the associations are assessed, and the implications of the findings are discussed.

Suicide Attempt Status and Quality of Life Disparity Among Individuals with Schizophrenia: A Longitudinal Analysis

AbstractObjective: Survivors of a suicide attempt are at greater risk for future suicide than those who have no history of such attempts (i.e., non-attempters), particularly in the context of schizophrenia. Although disparity between attempt survivors and non-attempters in quality of life (QoL) can potentially influence suicide risk disparity over time, no known longitudinal work has focused on QoL disparities between these groups. This study examined 2 types of QoL differences between attempt survivors and non-attempters over a 3-year period: (a) differences in levels of QoL (i.e., chronic disparity), and (b) differences in QoL change (i.e., change disparity). Method: In a sample of 166 adults with schizophrenia entering community-based psychosocial rehabilitation, 2-level hierarchical linear models were used to compare attempt survivors and non-attempters on objective and subjective QoL domains over 7 waves. Results: Chronic disparity in subjective QoL between groups was observed in work (b = −0.51; 95%...

Sensitivity of model-based human mortality measures to exclusion of the Makeham or the frailty parameter

Adult human mortality is well captured by a gamma-Gompertz-Makeham model that accounts for the exponential increase in individual hazards, the existence of age-independent mortality component, and unobserved heterogeneity in the study population. The article studies the impact of neglecting statistically significant extrinsic mortality or frailty on human mortality measures: aggregate indicators like life expectancy, life disparity, entropy, and the Gini coefficient are little affected while the rates of individual and population aging, the modal age at death, and temporary life expectancy can be substantially distorted. Trifon I. MISSOV, Assistant Professor, Max Planck Institute for Demographic Research, Rostock, Germany and Institute of Sociology and Demography, University of Rostock, Rostock, Germany. E-mail: missov@demogr.mpg.de . Laszlo NEMETH, Guest Researcher, Max Planck Institute for Demographic Research, Rostock, Germany. E-mail: nemeth@demogr.mpg.de .

How much can we trust life tables? Sensitivity of mortality measures to right-censoring treatment

AbstractInternational organizations, research institutions, insurance companies, pension funds and health policymakers calculate human mortality measures from life tables. Life-table data, though, are usually right-censored; that is, the last open-end age group does not contain information about the exact ages at death of individuals there, and mortality measures are sensitive to the way censoring is addressed. The standard way of “closing” the life table assumes a constant hazard of death for the last age group. This might lead to erroneous conclusions about mortality measures, especially when the open-end age interval contains a large proportion of the study population. In this article, we propose, instead, fitting a parametric model that well describes human mortality patterns, the gamma-Gompertz-Makeham, accounting for censoring, and constructing model-based equivalents of five mortality measures: life expectancy, the modal age at death, life disparity, entropy and the Gini coefficient. We show that, in comparison to conventional life-table measures, model-based measures are less sensitive to the age at censoring or, equivalently, to the proportion of censored individuals, and can be only slightly distorted even if the age at censoring is low. This study also compares life-table and model-based mortality measures for a non-human population with an underlying Gompertz mortality schedule in which a fixed proportion of the population is censored. Using model-based mortality measures is essential when studying the mortality of populations subjected to substantial censoring; for instance, many life tables for developing countries contain an open-end interval that contains more than 10% of the population. In this study, we show that life expectancy at birth for Brazilian females in 2007, calculated by standard life-table algebra, exceeds by almost 3 years the gamma-Gompertz-Makeham model-based life expectancy. This article might serve as a basis for recalculation of mortality measures for all populations subjected to substantial censoring.

PUISI ARAB DAN PROTES SOSIAL : KAJIAN STRUKTUR-MUATAN PUISI SHA'ALIK PRA-ISLAM

This article aims to introduce another trend in pre-Islamic Arabic poetry as opposed to tribalism. This trend is particularly as reflected in brigand poetry (Sha‘âlik). In the content, Sha‘âlik poems are not derived from tribal personality similarly to the poem that’s being used in tribes, however derived from an act of rebelliousness and protest against the dominating social disparities in tribes life. The goal of protest’s Sha‘âlik was against poverty dan social disparities. So, there are two kinds of Sha‘âlik’s poems. First, protest against differenciation of genealogical tribe. This tribe was marginalizied Arab tribe. Second, protest against poverty which caused by social disparity in the tribe life. DOI: 10.15408/a.v2i2.2126