Life Course Perspective Research Articles

Older adults’ experiences of loneliness over the lifecourse: An exploratory study using the BBC loneliness experiment

Purpose: To explore older adults’ experiences of loneliness across the lifecourse and the relationship with current loneliness. Methods: Our sample is 6,708 people aged 65 years and older, resident in the UK, who participated in the BBC Loneliness Experiment in spring 2018. Loneliness was assessed using the 3 item UCLA Loneliness Scale, using a threshold score of 6+ to define loneliness. Participants were asked if they had experienced loneliness in 5 life-stages ranging from childhood to old age and, if so, at which stage had they experienced loneliness most intensely. Multivariate logistic regression analysis was used to estimate the odds ratios of experiencing loneliness in relation to previous experiences of loneliness and key covariates. Findings: 41% of participants reported current feelings of loneliness and were more likely than those who did not to spend time alone, have poorer self-rated health, be unmarried, have fewer financial resources, and lower levels of neighbourhood trust. 71% reported they had experienced loneliness at some previous stage in their life, with 26% experiencing it in childhood (5–15 years and 39% as a young adult (16–24 years). Having had three or more prior life stage experiences of loneliness was an independent risk factor for current loneliness. Conclusion: We highlight the potential importance of examining older adults’ experience of loneliness within a lifecourse perspective. We suggest a research agenda that examines the importance of the number and timing of previous loneliness experiences and investigates the strategies used to cope with loneliness across the lifecourse as a pathway to developing more effective and personalised loneliness interventions.

Parenting styles and health in mid- and late life: evidence from the China health and retirement longitudinal study

BackgroundsThe impact of relationships in early childhood may be long-lasting and reaching to mid to late life. Limited studies have investigated the associations between parenting style and different aspects of well-being beyond adolescence. The current study aims to examine the association between parenting styles and multiple dimensions of functioning in mid-and later-life adults.MethodsWe used data from China Health and Retirement Longitudinal Study (CHARLS). Generalized Estimating Equation (GEE) was applied to examine the association between retrospective parenting styles/behaviors in childhood and health outcome.ResultsCompared with authoritative style, authoritarian style predicted worse self-rated health (coefficient = − 0.13, P < 0.001), cognitive function (− 0.23, P < 0.05) and depressive symptom (0.87, P < 0.001). Paternal affection was associated with more health outcome in mid- and late life than maternal affection. Only paternal affection was a significant predictor of mid- and late life health among male adults, while both paternal and maternal affection were strong predictors among female adults. Authoritative style was associated more positive health outcomes in mid- and late life among adults with literate parents than those with illiterate parents.ConclusionThis study provides evidence for the link between parenting behaviors in early life stage and physical and psychological functioning in mid- to late adulthood. Authoritative style, and the memory of parental affection, particularly from father and educated parents, could have long-lasting positive influence on children’s physical and mental well-being, which further support the life-course perspective on human development.

Temporary employment in Europe: stagnating rates and rising risks

ABSTRACT There is a perception that temporary employment is rising in Europe but there is little evidence to support this. If one takes the position that temporary employment should be rising due to large structural changes in European labor markets, then stagnating trends represents something of a puzzle. I examine the puzzle by applying a life-course approach to understand the distribution and trends in temporary employment among prime-age workers in 31 European countries. I compare and contrast changes in the temporary employment rate in a single period of time using cross-sectional data from the European Labour Force Survey (LFS), with changes in the risk of experiencing temporary employment in multiple periods of time using longitudinal data from the European Survey of Income and Living Conditions (SILC). Results from cross-sectional data suggest that between 1996 and 2007, the temporary employment rate increased in Europe by 28%, but between 2007 and 2019, there was little change. By contrast, results from panel data suggest that between 2013 and 2019, the risk of experiencing at least one temporary employment contract rose 36%. Over time, the temporary employment rate stagnated, but the temporary employment risk rose. The contribution provides insight into the nature of employment experiences associated with insecurity.

The concept of social determinants of health in health promotion policies in Thailand, Sweden, England, USA, and Japan: A narrative review

Objectives The Commission on Social Determinants of Health (CSDH) of the World Health Organization (WHO) recommends that national and municipal governments take adequate steps to "improve daily living conditions," "(create governance to) tackle the inequitable distribution of power, money, and resources," and "measure and understand the problem and assess the impact of" government actions. This study provides an analysis of the health promotion policies of Japan and other countries and examines their conformance to these recommendations, and offers suggestions for developing a conducive social environment for Japan's health promotion policies.Methods We reviewed grey literature on health promotion policies in Japan, the USA, England, Sweden, and Thailand, extracting the definitions of health inequalities and their characterization in each policy, and analyzing each document vis-á-vis the CSDH's three recommendations and "comprehensive national health equity surveillance framework."Results The health promotion policies of Japan, England, Sweden, and the USA had similar definitions of health inequality, emphasizing fairness and prioritizing the reduction of health inequality as the key strategy for health promotion. However, their primary approaches to improve daily living conditions varied: In Japan, the primary approach is to create opportunities for participation and ensure access to social resources. Meanwhile, the USA relies largely on objective assessments and scientific evidence-based actions. England focused on enhancing support for socially disadvantaged individuals and areas. In Sweden, a universal intervention based on life-course perspectives was stressed, while Thailand attached much value to a multi-sectoral collaboration. All these countries, however, had a health policy implementation plan in quest of the elimination of unfair distributions of power, money, and resources. The USA planned to monitor a total of 187 social factors, the largest number among the 6 subject countries. It also had a wide range of perspectives on health inequalities, including income and disability, as well as conducting assessments using information from outside the health sector, with items assessed at various levels, including individual, regional, and national policies.Conclusion With reference to these approaches in other countries, for Japan's health promotion policies, we recommend: (1) grasping of health inequalities from more diversified perspectives and adopting measures to address them, (2) setting targets based on multi-level social determinants of individual behavior and health status, including individual socioeconomic status, and (3) promoting collaborative initiatives and use of indicators with entities outside the health sector.

Self-employment career patterns in the Netherlands: exploring individual and regional differences

Although the self-employed represent 16.7% of the Dutch labor force (OECD 2020), their internal heterogeneity in profiles regarding motivations, characteristics and career trajectories remains unclear. Yet, understanding self-employment profiles and their spatial distribution may help understand differences in career progression of the self-employed. This study identifies and describes patterns in long-term career trajectories of the Dutch self-employed, and it explores spatial differences along the urban hierarchy. The study uses a life-course approach and register data of the whole population to find common patterns of careers among a sample of Dutch self-employed (N = 42,028) and their spatial distribution. We investigated careers through sequence and cluster analysis of individuals’ socio-economic statuses between 2003–2018. The analysis identifies 7 career clusters that collapse into three main career profiles: Mixed self-employment careers that combine self-employment with wage-employment, stable self-employment, and precarious self-employment. The clusters differ importantly in terms of the individual characteristics of the self-employed including age, gender, educational level and income. In terms of spatial distribution, the study shows that self-employment career profiles follow the urban hierarchy. Urban regions give way to all types of self-employment, while rural regions mainly exhibit stable self-employment. Precarious self-employment presents differently in urban and rural areas; in urban labor markets, we find self-employed individuals vulnerable to economic shocks, losing their jobs as a consequence of the financial crisis in 2007/08. In rural regions, formerly inactive workers become self-employed following the crisis.

Low-level lead exposure during development differentially affects neurobehavioral responses in male and female mouse offspring: A longitudinal study

Early life low-level lead (Pb) exposure is still an alarming child health issue. To date, animal studies investigating the effects of low doses of Pb since early stages of life to adulthood are scarce. We investigated in a mouse model the behavioral effects of developmental exposure to low-level Pb yielding blood levels similar to those observed in child clinical literature. CD1 outbred mouse dams received Pb (25- or 100-ppm) via drinking water from two weeks pre-mating until the end of lactation. Offspring of both sexes underwent a longitudinal assessment of motor, socio-emotional, and cognitive endpoints from neonatal to adult stage. Pb levels were determined in several matrices (blood, brain and bone) up to six months after the end of exposure. We found that new born pups exposed to Pb have slightly altered motor patterns and reduced preference for the nest odor. Offspring of both sexes exposed to the lowest Pb dose showed diminished interest for social novelty stimuli as adults. Moreover, sex-dependent effects of Pb exposure were observed in the spatial learning and memory task, where males were selectively impaired. Finally, blood, brain and bone Pb levels were elevated in a dose dependent fashion up to six months after termination of exposure. We observed marked accumulation of Pb in bones, with higher Pb levels in 100-ppm exposed females than in males at 7 months of age. In conclusion, developmental Pb exposure caused mild alterations in early- and late-life behavioral domains, particularly involving olfactory and cognitive responses. These findings confirm the importance of animal models to understand how early chronic low-level lead exposure impacts on health in a life-course perspective.

Exploring age-related changes in the realisation of (t)

AbstractAn understanding of linguistic heterogeneity in older speakers is crucial for the study of language variation and change. To date, intra-speaker malleability in older populations remains under-researched, in varieties of English and more generally. This paper contributes panel data to the question of how aging individuals engage with ongoing changes in the realisation of (t) in the Tyneside region in the North-East of England. We examine the variable ways in which six speakers recorded in their 20s/30s and re-interviewed in their 60s/70s adapt to community-wide change. The finding that some speakers exhibit malleability in their variable realisation of (t) substantiates a life-course perspective over a strict maturational explanation. More specifically, our analysis explores the contribution of long-term (in)stability to lifespan-specific identity construction in the Tyneside area. Our findings support calls for the incorporation of sophisticated statistical methods in combination with social constructivist approaches into panel research on older age populations.

Learning from the process evaluation of a complex, pre-conception randomised controlled trial in Malaysia: the Jom Mama project

Background Seen from a life-course perspective, pre-conception interventions are essential to reduce transmission to the next generation of obesity as a risk factor for later non-communicable diseases. The Malaysian Jom Mama project investigated the effectiveness of a combined behaviour change communication and e-health intervention in young married couples prior to first pregnancy. This paper reports on the extensive process evaluation (PE) that accompanied the Jom Mama trial. Methods In accordance with the realistic evaluation approach, a programme theory was developed for the Jom Mama project, based on key functions selected for six PE sub-studies, namely: recruitment; attrition; behaviour change communication (BCC); e-health (the Jom app); peer-support for community health promoters (CHPs); and contextual factors. The results of the first four sub-studies are reported here. Three cycles of data collection were conducted based on triangulation and a mixed-methods approach. Results The findings permitted distinguishing between theory and implementation challenges in interpreting the outcome of the Jom Mama trial.1 Recruitment and attrition proved to be challenges, and although the PE allowed Jom Mama investigators to improve procedures in order to achieve a sufficient sample size, it also has implications for engaging this age group in future pre-conception interventions. PE sub-studies showed that there were challenges in applying the BCC, and that the uptake of the Jom app varied. In one way this can be seen as an indication of limited fidelity, but it also leads to questions about how best to change the communication culture within the Malaysian health care system. Conclusions The Jom Mama PE highlighted the challenges of recruiting newly-wed couples for a pre-conception intervention. Despite thorough intervention development preparations, the PE revealed the difficulty of lifestyle behaviour change through Malaysian community health wokers who were trained on new communication strategies combined with e-health solutions, and that six intervention sessions of eight months do not constitute a sufficient dose to affect change. &lt;div style=“page-break-after: always;”&gt;&lt;/div&gt;

Multiple events case\u2013control study in a prospective cohort to identify systemic, cellular, and molecular biomarkers of obesity-induced accelerated aging in 30-years-olds: the ObAGE study protocol

BackgroundAging is characterized by a progressive loss of capacities linked to fundamental alterations/damage in multiple cellular and molecular pathways. It is the most significant risk factor for all non-communicable diseases (NCDs). Another contributing factor to the rise in NCDs is obesity. It has been suggested that obesity not only accelerates the onset of metabolic imbalances but also decreases lifespan and impacts cellular and molecular processes in a manner similar to aging. Obesity might accelerate the pace of aging. Guided by a lifecourse approach, we will explore how exposure to obesity in critical developmental stages disrupt homeostatic resilience mechanisms that preserve physiological integrity, inducing an early expression of aging phenotypes. Also, we will determine whether exposure to early psychosocial adversity influences vulnerability to obesity as a risk factor for accelerated aging.MethodsMultiple events case–control study embedded in a prospective cohort of Chileans at 30-31y, 50% females, of low- to-middle socioeconomic status, who participated in nutrition research since birth. At 23y, 25% had obesity and cardiometabolic risk was high. We will use a multi-layer approach including: anthropometric assessment; DXA scan for body composition; abdominal ultrasound of the liver; stool samples collection and sequencing of the ribosomal RNA 16S gene to characterize the gut microbiome; determination of age-related pro-inflammatory cytokynes and anti-inflammatory miokynes. For the first time in Chile, we will address age-related epigenetic changes using the Horvath´s epigenetic clock. In a subset we will conduct a controlled physical challenge to characterize physical resilience (autophagy).DiscussionObAGE is in an excellent position to: approach aging as a process whose expression involves multiple factors from the early stages of a person's life; understand how longitudinal changes in health trajectories impact the biological mechanisms of aging; identify potential resilience mechanisms that help prevent unhealthy aging. Because SLS participants are still young, our research setting combined with advanced scientific techniques may identify individuals or groups at risk of early onset health issues. Results from ObAGE may pave the way to address the contribution of obesity to aging through lifespan from cells to systems and might be instrumental to developing interventions to improve health span in the Chilean population.Trial registrationThe proposed study does not consider any health care intervention on human participants.

Family Health Development in Life Course Research: A Scoping Review of Family Functioning Measures.

Our objective is to identify common family functioning measurement tools and assess their compatibility with family-health development and life-course perspectives. Data sources include PubMed, ERIC, CINAHL, Families and Societies Worldwide, PsychInfo, Web of Science, PsychNet, and Health and Psychosocial Instruments. Title and abstract screening and full-text review of articles were conducted by multiple reviewers based on prespecified inclusion criteria. Data extraction focused on features of identified measurements tools, including: (1) name (2) domains of family functioning measured, (3)established psychometric properties, and (4) original context of psychometric evaluation (eg, details about the study sample). Of the 50 measurement tools identified, 94% measured organizational patterns (eg, flexibility, connectedness, or resources), 46% measured belief systems (eg, making meaning of adversity, or positive outlook), and 54% measured communication processes (eg, open emotional sharing, or collaborative problem-solving). Existing measures of family functioning can aid life-course researchers in understanding family processes as contexts for health and well-being. There also remain opportunities to refine or develop measures of family functioning more compatible with a life-course perspective that assess family processes (1) at various life stages; (2) with various backgrounds, identities, structures, and experiences; and (3) embedded in or impacted by various contexts that may facilitate or hinder family functioning.

Quantifying Older Black Americans’ Exposure to Structural Racial Discrimination: How Can We Measure the Water In Which We Swim?

The USA was built on legalized racism that started with enslavement and continues in the form of structural racial discrimination. This discrimination is difficult to measure because its many manifestations are hard to observe and dynamic. A useful tool would measure across settings, institutions, time periods in a person’s life and the country’s history. The purpose of this study was to design a measure of structural racial discrimination that meets those criteria and can be used in large national datasets. To do this, we started with an exploratory mixed-methods instrument design, including qualitative interviews with 15 older Black adults and focus groups with 38 discrimination researchers and other key stakeholders. We then identified 27 indicators of structural racial discrimination across nine theorized discrimination contexts. We matched these with historical administrative data sets to develop an instrument that could quantify older Black Americans’ exposure to structural racial discrimination across contexts, the life course, and geographies. These can be mapped to the life course of structural discrimination based on the home addresses of those surveyed. Linking these to available indicators is a promising approach. It is a low burden for participants and enables increasingly multifaceted and focused measurement as more national datasets become available. A flexible, feasible comprehensive measure of structural discrimination could allow not only more thorough documentation of inequities but also allow informed decision making about policies and programs intended to promote racial equity.Significance StatementTo our knowledge, this is the first study that presents a framework for assessing structural racial discrimination across contexts, life course, and geography that is grounded in theory and in the lived experience of intended participants. Leading researchers and policy makers have called for improved measures of structural racism and discrimination and specifically for a lifecourse approach to measurement. This study is a step in that direction.ClassificationSocial Sciences

Life-Course Perspective on Personality Traits and Fertility with Sequence Analysis

Abstract We investigate the link between personality traits (PTs) and fertility, accounting for the possible interplay with other key life course events. Using data from German Socio-Economic Panel survey, we build sequence-type representations of fertility, union and job careers between the ages of 20 and 40. We rely on multichannel sequence analysis (MSA) and on the Partitioning around Medoids algorithm to cluster individuals with similar experiences, and relate clusters to PTs via multinomial regression. We also develop a procedure to apply standard and MSA to truncated trajectories. This enables inclusion of individuals whose trajectories were otherwise observed for a limited age span, notably belonging to younger cohorts. We show that PTs relate to these (portions of) life-course trajectories, of which fertility is only one outcome.

Chinese students at U.K. universities: Transnational education mobilities as a stepping‐stone to adulthood

AbstractThis article explores transnational Chinese students' education migration to the United Kingdom through a lifecourse perspective. Drawing on in‐depth interviews with 43 transnational Chinese graduates from U.K. universities, I found that participants regarded their transnational education migration as a stepping‐stone to adulthood. Influenced by the mobilities paradigm, this paper elaborates on the transitions to adulthood experienced by transnational Chinese students. The findings illustrate how transnational education mobilities transform social networks, in which transnational Chinese students rehearse their role as an adult in everyday social interactions, and how the intersection of Confucian collectivism and students' class background influences their experiences and understandings of transitions to adulthood. Therefore, this paper advances existing scholarship on transnational Chinese students by proposing a lifecourse perspective and exemplifies the complexities of mobile youth's lifecourse transitions by emphasising the cultural and social construction of transnational Chinese students' adulthood.

Inclusive Living: ageing, adaptations and future-proofing homes

Inclusive Living is a concept and practical intervention developed from a systematic literature review and co-produced by the Scottish housing sector. The approach aims to implement inclusive change in areas of development, repair, maintenance and service delivery by facilitating longer term planning within housing organisations to create homes that are accessible and allow for ageing-in-place. This synthesis paper critically examines the theories that support the Inclusive Living framework, focusing on adaptations (also known as home and environmental modifications to support accessibility). Current challenges around accessibility are explored: poor-quality homes, disinvestment in repair and maintenance, and the fragmented policy landscape and funding around adaptations. Proactive approaches to adaptations are found to lead to better outcomes for individuals and they need to be understood as a ‘public issue’ not a ‘private trouble’ to encourage investment in housing sector solutions. <em><strong>Practice relevance</strong></em> An Inclusive Living approach supports housing strategy holistically, examining not only physical modifications but also how housing facilitates social relationships and connections, tackling structural inequalities, and supporting social inclusion. This entails a life-course approach, where inclusivity in planning for the future can benefit all groups. A more systematic approach to planning for housing and ageing will be impactful, inclusive and proactive.

Early-life exposure to Chinese famine and stroke risk in mid- to late life: the mediating roles of cognitive function and depression

BackgroundLimited research has examined the role that famine exposure plays in adulthood stroke risk. We aim to explore the causal implications of early exposure to the Great Chinese Famine on stroke risk and determine whether these associations were mediated by cognitive function, and depression.MethodsWe sampled 12,681 individuals aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS) and divided them into fetally exposed, childhood-exposed, adolescence/adulthood-exposed and unexposed groups. Stroke was defined by self- or proxy-reported physician diagnosis. Based on a counterfactual framework, marginal structural models were used to estimate the natural direct effect and the natural indirect effects through cognitive function and depression for causal inference.ResultsWe found that early-life exposure to Chinese famine was directly related to increased stroke risk in mid- to late life. Cognitive function and depression accounted for a greater part of the effect for childhood famine exposure, mediating 36.35% (95%CI: 14.19, 96.19%) of the overall association between famine exposure and incident stroke, than for the fetal, adolescence/adulthood famine exposure groups. However, the natural indirect effect through depression was not significant in the fetally exposed group. The results were robust in the sensitivity analysis of model specification and unobserved confounding.ConclusionsOur findings are consistent with the latency, pathway, and accumulation models, supporting the life-course theory. Early stages of life exposed to the Chinese Famine were associated with higher risk of stroke in mid- to late life. Enhanced cognitive and depression interventions may reduce stroke risk in middle-aged and older Chinese adults who exposure to famine in early life.

Aging in Nepal.

Like many countries, the increase in the population of older adults in Nepal has led to national policies and programs to address their needs. It would, however, also be fair to say that not enough is yet known about older adults and hence it is unclear if government programs truly address those needs. Nepal is a very poor country that is still largely rural and characterized by extremes of inequality based on caste/ethnicity, gender, region, and income/wealth. In this paper, we describe the demographic and social conditions of older adults in Nepal, inequality, sources, and limitations of the data about older adults, and public policy and programs for older adults. We believe that studies of older adults in Nepal would benefit from adopting social determinants of health, healthy aging, and life-course perspectives to both identify needs and formulate policy for older adults in Nepal.

Commentary: Infant Mortality Among African Americans, Using Life Course Perspective to Encourage Transformation.

Commentary: Infant Mortality Among African Americans, Using Life Course Perspective to Encourage Transformation.

Sexual Risk Behavior and Lifetime HIV Testing: The Role of Adverse Childhood Experiences.

Despite the success of HIV prevention drugs such as PrEP, HIV incident transmission rates remain a significant problem in the United States. A life-course perspective, including experiences of childhood adversity, may be useful in addressing the HIV epidemic. This paper used 2019 BRFSS data to elucidate the role that childhood adversity plays in the relationship between HIV risk and HIV testing. Participants (n = 58,258) completed self-report measures of HIV risk behaviors, HIV testing, and adverse childhood experiences (ACEs). The median number ACEs in the sample was 1, with verbal abuse (33.9%), and parental separation (31.3%) being the most common ACEs reported. Bivariate findings showed that all ACEs were associated with increased HIV risk and testing. However, increased risk was not correlated with increased HIV testing, with the highest incongruence related to mental health problems of household member (53.48%). While both self-reported HIV risk and ACEs were positively associated with HIV testing, their interaction had a negative association with testing (aPR = 0.51, 95%CI 0.42, 0.62). The results highlight the need for targeted HIV prevention strategies for at-risk individuals with a history of childhood adversity.

“I'm definitely not socially excluded!”- Perceptions of social exclusion among Australian government housing residents aged 80 and older who live alone

The oldest old - those aged 80 years and over - are the fastest growing sector of the Australian population and are generally assumed to be at risk of social exclusion which impedes healthy aging. The voices of those thought to be vulnerable to social exclusion are seldom heard. Informed by a critical gerontology framework, socio-ecological model of health and life-course perspectives, this research involved semi-structured in-depth interviews with a purposive sample of 13 people aged 80 and older living alone in government housing, in a socio-economically disadvantaged neighborhood in Melbourne, Australia. Interview transcripts were analyzed using thematic analysis. The findings reveal a positive picture of survival despite hardship, supportive relationships, a sense of autonomy from living independently, and contributing to society. These findings challenge ageist assumptions, which equate advanced age with social exclusion.

Study protocol: MyoFit46\u2014the cardiac sub-study of the MRC National Survey of Health and Development

BackgroundThe life course accumulation of overt and subclinical myocardial dysfunction contributes to older age mortality, frailty, disability and loss of independence. The Medical Research Council National Survey of Health and Development (NSHD) is the world’s longest running continued surveillance birth cohort providing a unique opportunity to understand life course determinants of myocardial dysfunction as part of MyoFit46–the cardiac sub-study of the NSHD.MethodsWe aim to recruit 550 NSHD participants of approximately 75 years+ to undertake high-density surface electrocardiographic imaging (ECGI) and stress perfusion cardiovascular magnetic resonance (CMR). Through comprehensive myocardial tissue characterization and 4-dimensional flow we hope to better understand the burden of clinical and subclinical cardiovascular disease. Supercomputers will be used to combine the multi-scale ECGI and CMR datasets per participant. Rarely available, prospectively collected whole-of-life data on exposures, traditional risk factors and multimorbidity will be studied to identify risk trajectories, critical change periods, mediators and cumulative impacts on the myocardium.DiscussionBy combining well curated, prospectively acquired longitudinal data of the NSHD with novel CMR–ECGI data and sharing these results and associated pipelines with the CMR community, MyoFit46 seeks to transform our understanding of how early, mid and later-life risk factor trajectories interact to determine the state of cardiovascular health in older age.Trial registration: Prospectively registered on ClinicalTrials.gov with trial ID: 19/LO/1774 Multimorbidity Life-Course Approach to Myocardial Health- A Cardiac Sub-Study of the MCRC National Survey of Health and Development (NSHD).