Disparities In Well-being Research Articles

Assessment of Factors Associated With Mental Well-Being Among Chinese Youths at Individual, School, and Province Levels

Although rapid urbanization in China provided improved economic prosperity and educational opportunities, it was associated with increased internalizing and externalizing problems among youths, with negative outcomes for mental well-being. Previous studies suggested that factors in individual, school, and regional levels were associated with mental well-being, and comprehensively examining these factors may provide evidence for policies for improving youth mental health. To investigate factors associated with mental well-being at individual, school, and province levels among Chinese youths. This cross-sectional study analyzed nationally representative data collected December 1, 2021, to January 1, 2022, from schools in China. Among 435 schools, 144 institutions had primary school students, 107 institutions had middle school students, 95 institutions had primary and middle school students, and 89 institutions had high school students. A total of 398 520 students were included. Characteristics at individual, school, and province levels. The main outcome was mental well-being, assessed by the Short Warwick-Edinburgh Mental Well-being Scale. Linear mixed-effects models were used to investigate individual, school, and regional disparities in mental well-being among youths. There were 398 520 participants (194 460 females [48.80%]; mean [SD; range] age, 13.78 [2.40; 9-20] years). At the school level, 352 443 students (88.44%) were in public school and 291 354 students (73.11%) were in urban schools. Drinking (coefficient = -1.08; 95% CI, -1.12 to -1.05; P < .001), smoking (coefficient = -0.89; 95% CI, -0.96 to -0.83; P < .001), and increased age (coefficient per 1-year increase in age = -0.02; 95% CI, -0.03 to -0.01; P < .001) were associated with worse mental well-being. Male sex (coefficient = 1.01; 95% CI, 0.98 to 1.04; P < .001), being in a 1-child family (coefficient = 0.17; 95% CI, 0.13 to 0.20; P < .001), being in the Han group (coefficient vs other ethnic groups = 0.20; 95% CI, 0.14 to 0.26; P < .001), a higher frequency and coverage of psychological courses (eg, ≥2/wk for all students vs none: coefficient = 1.02; 95% CI, 0.36 to 1.69; P = .003), and a higher level of self-rated popularity in school (coefficient per 1-unit increase in score = 0.89; 95% CI, 0.88 to 0.89; P < .001) were associated with improved mental well-being. However, age (eg, age and 1 courses/2 wk for all students: coefficient per 1-year increase in age = -0.047; 95% CI, -0.089 to -0.005; P = .03) and sex (eg, female sex and ≥2 courses/wk for some students: coefficient = -0.184; 95% CI, -0.323 to -0.046; P = .009) had interactions with the association between psychological courses and mental well-being. This study found that social disparities in mental well-being existed and that various factors at different levels were associated with mental well-being among Chinese youths. These findings suggest that public mental health programs may be recommended for associated improvements in regional disparities in mental health resources.

Disparities in Subjective Well-being by Sexual Orientation: Comparing Cohorts from pairfam’s (2008-09) and FReDA’s (2021) Baseline Waves

Significant expansion of legal rights and recognition of sexual minority populations triggered expectations that structural stigma, sexual minority stress and, consequently, previously well-documented disadvantages in health and well-being may decline over time. The empirical evidence on this issue is, however, still sparse and inconclusive. We contribute to this research by comparing baseline data from the German Family Panel (pairfam; 2008-09) and the German Family Demography Panel Study (FReDA; 2021). These data allow us to assess disparities in subjective well-being by sexual orientation and potential changes therein after legalisation of same-sex marriage in Germany in two adult cohorts interviewed more than a decade apart. We focus on two specific outcomes, namely life satisfaction and self-rated health. Two main findings emerged from our analysis: First, minority sexual orientation is associated with significantly lower subjective well-being, specifically lower life satisfaction. Second, there are no statistically significant changes in the sexual orientation-health nexus between cohorts. Our study, thus, neither lends support to “optimistic” expectations regarding the contribution of (further) reductions in institutional discrimination and structural stigma to (further) reductions in remaining disadvantages, nor does it lend support to “pessimistic” expectations suggesting that younger cohorts of sexual minority adults may experience an even larger gap in health and well-being than previous cohorts. We propose that the stability of sexual minorities’ disadvantages in subjective well-being during the first two decades of the 21st century in Germany be interpreted as the result of two opposing forces working in parallel: Reduced institutional discrimination and increased exposure to continued stigma. The legal recognition of same-sex relationships appears to be a necessary but not sufficient condition for the acceptance of sexual minorities. Remaining disparities by sexual orientation will thus not simply disappear when institutional discrimination of sexual minorities is eliminated. Currently, we may therefore find ourselves in a “transitory period” whose further evolution is difficult to predict. FReDA – with its evolving longitudinal dimension and the inclusion of self-reported measures of respondents’ sexual orientation – will constitute a powerful resource for future investigations of inequalities in yet understudied but increasingly visible sexual minority populations. * This article belongs to a special issue on “Family Research and Demographic Analysis – New Insights from the German Family Demography Panel Study (FReDA)”.

Measuring Access to Services of General Interest as a Diagnostic Tool to Identify Well-Being Disparities between Rural Areas in Europe

The gradual reorientation of rural policy paradigms away from competitiveness and economic growth and towards well-being and sustainability creates a need for more appropriate diagnostic tools to assess disparities and policy outcomes. One of the most cited determinants of rural well-being is access to Services of General Interest. Areas with relatively poor access to services can be described as “inner peripheries”, and peripherisation literature provides helpful insights into the challenges faced and policy needs. This paper presents a methodology for modelling and mapping access to a suite of ten key services, covering all of Europe at a 2.5 km grid square level. The approach is intrinsically relative, comparing the travel time to services from each grid square with the average for surrounding regions. Maps are provided for 2017 and 2021, and changes between these dates are described. ‘Inner peripheries’ are found in every country, their configuration being influenced not only by geographical features, but also by service delivery practices. Further analysis explores patterns of risk, identifying areas in which service provision is in a precarious position. The results presented are rich in practical policy implications, not least the suggestion that, in terms of patterns of well-being, local roads are at least as important as trunk infrastructure.

Evidence of validation of the Difficulties in Emotion Regulation Scale-18 in Arab, Middle Eastern, and North African emerging adults living in the United States.

Arab, Middle Eastern, and North African (Arab/MENA) individuals are regularly unaccounted for in research because they are conflated with the racial category "White." The systematic underrepresentation of Arab/MENA individuals in research persists, despite the fact that Arab/MENA individuals experience stigma, discrimination, and structural barriers that separate them from their White peers and contribute to disparities in mental health and well-being (Awad et al., 2021). Further, the lack of widespread inclusion of an Arab/MENA racial category has created assumptions about the generalizability of psychological constructs, measures, and treatments for Arab/MENA people, despite well-known cultural differences. The present study explored the validity of a widely used emotion regulation measure, the Difficulties in Emotion Regulation Scale-18, in an Arab/MENA emerging adult sample (Mage = 21.8, SD = 3.02), invariance across sex assigned at birth, differences in latent scores for religious identity, and associations with mental health and well-being. Results support the original six-factor model and are invariant across males and females. The implications of these findings for supporting assessment and treatment of Arab/MENA individuals, and the importance of including Arab/MENA as a racial category in research, are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Regional Well-Being Disparities in Morocco and its OECD Partners.

This article proposes a multidimensional analysis grid to assess regional disparities, transcending monetary considerations. This grid agrees overall with the common framework that prevails in the literature review that we have carried out. It is built around four dimensions of well-being: economy (development, labor market, human capital and innovation), social (health, living conditions and gender), environment and governance. Our analysis of regional disparities was based on the synthesis of fifteen indicators by constructing a Synthetic Index of Well-being (SIWB) by combining its four dimensions using an aggregative-compensative approach. This analysis covers Morocco, 35 of the OECD member countries and their 389 regions between 2000 and 2019. We have assessed the dynamics of Moroccan regions compared to those of the benchmark. Thus, we have highlighted the gaps to be made up in relation to the different areas of well-being as well as their thematic variations.

Family Formation History and the Psychological Well-Being of Women from Diverse Racial-Ethnic Groups.

Studying disparities in psychological well-being across diverse groups of women can illuminate the racialized health risks of gendered family life. Integrating life course and demand-reward perspectives, this study applied sequencing techniques to the National Longitudinal Study of Youth: 1979 to reveal seven trajectories of partnership and parenthood through women's 20s and 30s, including several in which parenthood followed partnership at different ages and with varying numbers of children and others characterized by nonmarital fertility or eschewing such roles altogether. These sequences differentiated positive and negative dimensions of women's well-being in their 50s. Women who inhabited any family role had greater life satisfaction and fewer depressive symptoms, although these general patterns differed by race-ethnicity. Family roles were more closely related to well-being than ill-being for White women, parenthood had more pronounced importance across outcomes for Black women, and the coupling of partnership and parenthood generally mattered more for Latinas.

Socioeconomic status, positive experiences, and allostatic load.

Socioeconomic disparities in physiological well-being may be a pathway to the poorer health outcomes observed in those of lower socioeconomic status (SES). The present research examined greater frequency of positive life experiences (POS) as a route through which greater cumulative SES (CSES) may be linked to lower allostatic load (AL), a multisystem index of physiological dysregulation, and assessed whether the association between POS and AL varies along the socioeconomic spectrum. These associations were examined using data from the Midlife Development in the United States Biomarker Project (N = 2,096). Analyses included tests of whether positive experiences mediated the CSES-AL association, whether CSES moderated associations of positive experiences and AL, and whether CSES moderated positive experience mediation of the CSES-AL association (moderated mediation). The observed association between CSES and AL was weakly mediated by POS. CSES moderated the POS-AL association, such that POS was associated with AL only at lower levels of CSES. The moderated mediation analysis showed that POS mediated the association between CSES and AL only at lower levels of CSES. The results suggest complexity in associations between cumulative socioeconomic advantage, positive life events, and physiological well-being. Positive life events may play a stronger role in physiological health in those of lower socioeconomic advantage, as one of multiple pathways through which lower SES is linked to poor health. Given the modifiability of access to, and frequency of, positive life events, the potential role of positive experiences in lessening health disparities warrants further study. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Harmonizing the Yin and Yang: Gender Disparities in Subjective Well-Being after Retirement in China

Harmonizing the Yin and Yang: Gender Disparities in Subjective Well-Being after Retirement in China

Intersectional vulnerability in the relationship between discrimination and inflammatory gene expression

Addressing social disparities in health and well-being requires understanding how the effects of discrimination become biologically embedded, and how embedding processes might vary across different demographic contexts. Emerging research suggests that a threat-related gene expression response may contribute to social disparities in health. We tested a contextual vulnerability model of discrimination embedding using an empirical intersectionality (interaction discovery) analysis of pro-inflammatory gene expression in a national sample of non-institutionalized, English-speaking adults with RNA biomarker data (n = 543). At the time of data collection, the average age of participants was 55 years (SD = 13.26) and approximately half identified as female (50.46%). Most participants identified as White (∼73%) and had some college experience (∼60%). Results showed significant variation in the strength of association between daily discrimination and inflammatory gene expression by race and sex (b = −0.022; 95% CI:-0.038,-0.005, p = .009) with the estimated marginal association larger for racially-minoritized males (b = 0.007; 95% CI:-0.003,0.017, p = .163), compared to White males (b = −0.006; 95% CI:-0.013,0.001, p = .076). This study indicates that the link between daily discrimination and inflammatory gene expression may vary by sociodemographic characteristics. To improve initiatives and policies aimed at ameliorating disparities within populations, greater attention is needed to understand how interlocking systems of inequalities contribute to physiological health.

Does Agricultural Intensification Enhance Rural Wellbeing? A Structural Model Assessment at the Sub-Communal Level: A Case Study in Tunisia

We examined the impact of agricultural intensification on the wellbeing of rural communities in a developing country on a sub-communal scale. To measure the interactions within this complex causal relationship, a statistical approach was applied, using partial least squares path modeling (PLS-PM) in its formative structure. Using PLS-PM to simultaneously relate the measured variables (manifest variables) and conceptual variables (latent variables), while incorporating other variables, such as the bioclimate and demography, we characterized the spatial structure of the links between intensive agriculture and wellbeing. The aim was to facilitate government intervention aiming to improve the wellbeing of rural households, while avoiding cumbersome and costly surveys when the scope of public action is extended to a region or a country. Our findings show that the generalization of the productivist system is not always appropriate in developing countries. In our case study, employment in the secondary and tertiary sectors is insufficient to accommodate the rural exodus. In such situations, agricultural intensification leads to poverty and migration to the areas of production and increases disparities in social wellbeing in rural areas.

COVID-19, global health and climate change: Causes and convergences

Despite massive global economic growth and advances in science and medicine with spectacular aggregate and individual improvements in health and life expectancy over the past century, the world has now become severely unstable in multiple domains – biological, sociological, political, ecological, economic, and health care. These pervasive instabilities are organically interactive within a complex world system that has reached crisis status at local, global, and planetary levels. Lying at the heart of this complex crisis are long-neglected disparities in health and well-being within and between countries, the refusal to face how these and climate change have arisen, and how economic considerations have fuelled the trend towards entropy (gradual decline of the planet into disorder). The critical point we have reached, starkly highlighted by the emergence of the COVID-19 pandemic pari passu with ongoing climate change and planetary degradation, reminds us of our global interconnectedness with each other and with nature. Comprehending and acknowledging the myriad, humanly constructed forces in each of these domains influencing all aspects of life, are the first steps towards effectively facing challenges to our health, our humanity (collectivity as humans) and our planet. Overcoming denial, acknowledging the magnitude and complexity of these challenges, prescient vision and dedicated action capable of fostering the cooperation for overcoming obstacles are now vital to seeking peaceful pathways towards more equitable and sustainable lives. South Africa is a microcosm of the world, with its local threats and challenges mirroring the global. Significance: Instabilities that pervade the world, highlighted by the COVID-19 pandemic, are especially significant for South Africa, where they manifest most starkly because of its apartheid legacy, its relative success economically on the African continent, and the implications of ongoing widening disparities and antagonism amongst South Africa’s diverse people. Belief in moving towards narrowing wide disparities through decolonisation and reversion to an ‘idyllic African heritage’ via a transformation that includes widespread corruption, and the ANC government’s perverse erosion of lives today and in the future through ‘state capture’, intensifies rather than ameliorates our predicament in an era when cooperation and a clear vision of current threats and future possibilities are desperately needed. In an accompanying article, potential pathways towards a better future are offered through suggested shifts in paradigms of thought and action.

Adult Children's Education and Mothers' Psychological Well-Being: Do Adult Children's Problems Mediate This Relationship?

A growing body of literature documents a positive association between adult children's education and older parents' health, and existing studies have identified social support, social influence, and material transfers as factors linking adult children's education and various dimensions of older parents' health. The present study joins this literature by assessing adult children's problems as mechanisms that may underlie disparities in psychological well-being between mothers whose adult children have completed higher and lower levels of education. Using 2 waves of longitudinal data collected in 2001-2003 and 2008-2011 from 400 mothers aged 73-85 years at the second wave as part of the Within-Family Differences Study, we examine the role of adult children's problems in mediating the association between adult children's education and mothers' depressive symptoms. Mothers with children who completed post-high school education reported fewer depressive symptoms than mothers whose children all completed high school or less. We found evidence that this relationship was mediated by the proportion of adult children who have experienced physical and emotional problems in the last 5 years. This study underscores the importance of considering how resources and risks that affect well-being accumulate both across the life course and across generations. Providing education opportunities to younger generations and enhancing programs that address challenges that low-attaining children may face have the potential to help minimize socioeconomic disparities in psychological well-being among older adults.

Promoting Gender Balance: An In-depth Analysis of Gender Equity in the Works of Shashi Deshpande

In the twenty-first century, gender discrimination persists, and equality remains elusive in a society deeply rooted in misogyny. Shashi Deshpande's novel, "A Matter of Time," serves as a compelling narrative that sheds light on the struggles women face within the confines of gender inequality. Over generations, we witness how society grants varying degrees of freedom and independence to boys, perpetuating disparities in emotional well-being and adaptability to their environment. The novel's plot delves into the lives of three generations of women, exploring their individuality, values, and attitudes towards their circumstances. As they transition into married life and move into their in-law families, the women find themselves ensnared within a confined space. Shashi Deshpande uses her literary prowess to articulate the personal experiences of women in this marital context, reflecting the coops they often find themselves in. The novel unearths the stark reality of gender inequality entrenched in the stereotypical social roles assigned to women. In a strongly patriarchal Indian society, women of all ages remain shackled to their homes and are subjected to inferior treatment compared to men. Even the slightest deviation from prescribed norms leads to societal rejection, making it evident that the battle for gender equality is far from over.

The General Surgery Residency Experience: A Multicenter Study of Differences in Wellbeing by Race/Ethnicity.

We explored differences by race/ethnicity in regard to several factors that reflect or impact wellbeing. Physician wellbeing has critical ramifications for the US healthcare system, affecting clinical outcomes, patient experience, and healthcare economics. Within surgery, literature examining the association between race/ethnicity and wellbeing has been limited and inconclusive. Residents at 16 academic General Surgery training programs completed an online questionnaire. Racial/ethnic identity, gender identity, post-graduate year (PGY) level, and gap years were self-reported. Differences by race/ethnicity in flourishing (global wellbeing) as well as factors reflecting resilience (mindfulness, personal accomplishment, workplace support, workplace control) and risk (depression, emotional exhaustion, depersonalization, stress, anxiety, workplace demand) were assessed. Of 300 respondents (response rate 34%), 179 (60%) were non-male, 123 (41%) were residents of color (ROC), and 53 (18%) were from racial/ethnic groups that are underrepresented in medicine (UIM). Relative to White residents, ROC have significantly lower flourishing and higher anxiety, and these remain significant when adjusting for gender, PGY level, and gap years. Relative to residents overrepresented in medicine (OIM), UIM residents have significantly lower emotional exhaustion and depersonalization after adjusting for gender, PGY level and gap years. Disparities in resident wellbeing based on race/ethnicity and UIM/OIM status exist. However, the experience of ROC is not homogeneous. As part of the transformative process to address systemic racism, eliminate disparities in surgical training, and reconceptualize wellbeing as a fundamental asset for optimal surgeon performance, further understanding the specific contributors and detractors of wellbeing among different individuals and groups is critical.

Demonstrating Equity Through the Convening of Expert Panels.

Population-specific data gaps for a range of demographic characteristics, including race, ethnicity, sex, sexual orientation, gender identity, and disability status, inhibit efforts to protect and improve public health. To identify system and policy levers for addressing these data inequities, the Robert Wood Johnson Foundation (RWJF) convened five expert panels to inform deliberations of the National Commission to Transform Public Health Data Systems (as well as other articles in this supplement). This article reflects the experiences and observations of the authors, RWJF program officers who worked with the expert panels. It provides a brief overview of the process for selecting and convening the expert panels, how this process demonstrated principles of equity, and key themes that emerged across the panels. The processes RWJF used to develop and support the expert panels reflect the Foundation's effort to challenge orthodoxies in research and philanthropy that perpetuate and exacerbate disparities in health and well-being.

Youth Mental Well-Being Following Witnessed Police Stops.

The purpose of the present study is to investigate mental well-being among youth after witnessing police stops. A national, urban-born sample of youth in the USA from the most recent wave (2014-2017) of the Fragile Families and Child Wellbeing Study (FFCWS) was employed, with a focus on youth who had not been directly stopped by police (N = 2506). We used t-tests and multivariable ordinary least squares (OLS) regression to estimate direct associations, product-term analysis to test for effect modification by gender and race/ethnicity, and the Karlson-Holm-Breen (KHB) method to assess for mediation by experiences of emotional distress during a stop. Findings indicate that youth who have witnessed police stops report significantly higher levels of depression (t = 5.93, p &lt; 0.01) and anxiety (t = 6.57, p &lt; 0.01) and lower levels of happiness (t = - 4.02, p &lt; 0.01) following the stop than those who have not. Among youth witnessing stops (N = 1488), more intrusive witnessed encounters correspond to diminished mental well-being across indicators, in part due to elevated emotional distress during witnessed stops. Findings hold regardless of gender, yet vary somewhat by race and ethnicity, with youth of color reporting less anxiety than their White counterparts after witnessing an intrusive stop, but reporting greater reductions in happiness. Collectively, our findings suggest that witnessing police stops may contribute to inequities in youth mental well-being. A public health approach that combines prevention and treatment strategies may mitigate the harms of police exposure and reduce disparities in youth well-being.

Who prefers to stay? voluntary immobility among youth in Ethiopia, India, and Vietnam

ABSTRACT Far fewer people migrate than global disparities in wealth and well-being would lead us to predict, yet we know relatively little about why those who presumably have much to gain from migration prefer to stay in place. This article examines the motivations of young people who express the preference to stay put, and asks what individual and household characteristics are associated with voluntary immobility. Using survey data collected in Ethiopia, India, and Vietnam for the Young Lives Project, we find that the majority of young people surveyed envision a future within their home country, and between 32 per cent (Ethiopia) and 60 per cent (Vietnam) prefer to stay in their current location. Most youth prefer to stay for family-related reasons. Living in an urban area and engagement in farm work are associated with greater staying aspirations, but only for youth from the most resource-poor or the wealthiest households. Higher levels of schooling, wealth, feelings of self-efficacy and paid employment are consistently associated with diminished desires to stay, with stronger effects for youth from rural settings, resource-poor households, and women. Our results reveal the social patterning of staying aspirations and have important implications for development interventions that seek to enhance aspirations and capabilities of individuals to stay in place.

A Trauma-Informed and Gender-Inclusive Medical Nomenclature.

Transgender individuals face discrimination in several contexts and spaces, which exacerbates dysphoria and disparities in mental and physical well-being. Gender-exclusionary environments in the health care system lead to limitations in access to care and unaddressed health care needs. The full spectrum of gender is often not recognized in the field of medicine, which is predicated on the binary of male and female. Obstetrics and gynecology is societally viewed as a field for cisgender women, but transgender individuals can, and do, benefit from services offered by obstetricians and gynecologists. It is imperative that all specialties consider which aspects of care can be altered to promote the safety and health care of medically marginalized groups, including transgender patients. Alternative vocabulary to gendered language commonly used in medicine is discussed in three contexts: patient counseling, medical records, and institutional language. Understanding and using gender-inclusive language is an important step to create safer, respectful, affirming spaces for transgender people to receive medical care.

The Persistence of Rural Underdevelopment: Evidence from Land Reform in Italy

Patchiness in rural development remains a salient feature of many developed and developing countries that have struggled historically to overcome enormous national disparities in economic structure and well-being. This paper examines how one major, explicit rural policy ostensibly aimed at rural advancement—land reform—can impact uneven development in the countryside. It does so in Italy, where a major land reform redistributed large landholdings to individual peasant families after World War II. Based on original fine-grained data on land redistribution and a geographical regression discontinuity analysis that takes advantage of Italy’s zonal land reform approach, I find that greater land reform fueled comparative underdevelopment and precarity locally over the long term. Several related mechanisms delayed development in land reform zones: a slower transition out of agriculture, lower labor mobility, and an aging demographic. These are generalizable mechanisms that could operate in other cases of land reform beyond Italy.

Addressing race and racism in editorial policy

Addressing race and racism in editorial policy