Sociodemographic Inequalities Research Articles

Inequalities in emergency care use across transition from paediatric to adult care: a retrospective cohort study of young people with chronic kidney disease in England.

Sociodemographic inequalities in emergency secondary care usage were evident in this cohort across the transition period, independent of age, with some variation between admissions and A&E use, and evidence of effect modification by transfer. Such inequalities likely have multifactorial origin, but importantly, could represent differential meetings of care needs. • In chronic kidney disease (CKD), transfer from paediatric to adult healthcare is associated with declining health outcomes. • Known differences in CKD outcomes by sociodemographic factors have limited prior exploration in the context of transfer. • Population-level data was used to examine the impacts of transfer and sociodemographic factors on unplanned secondary care utilisation in CKD. • Healthcare utilisation trends may not reflect known CKD pathophysiology and there may be unexplored sociodemographic inequalities in the experiences of young people across transfer.

Differential trends and patterns of sociodemographic disparities in burden of mental disorders, substance use disorder and self-harm across age groups: ecological study in 204 countries using the Global Burden of Disease Study 2019.

It is well-known that socioeconomic status is associated with mental illness at both the individual and population levels, but there is a less clear understanding of whether socioeconomic development is related to poor mental health at the country level. We aimed to investigate sociodemographic disparities in burden of mental disorders, substance use disorders and self-harm by age group. Estimates of age-specific disability-adjusted life years (DALY) rates for mental disorders, substance use disorders and self-harm from 1990 to 2019 for 204 countries were obtained. The sociodemographic index (SDI) was used to assess sociodemographic development. Associations between burden of mental health and sociodemographic development in 1990 and 2019 were investigated, and sociodemographic inequalities in burden of mental health from 1990 to 2019 by age were estimated using the concentration index. Differential trends in sociodemographic disparities in diseases across age groups were observed. For mental disorders, particularly depressive disorder and substance use disorders, DALY rates in high SDI countries were higher and increased more than those in countries with other SDI levels among individuals aged 10-24 and 25-49 years. By contrast, DALY rates for those over 50 years were lower in high SDI countries than in countries with other SDI levels between 1990 and 2019. A higher DALY rate among younger individuals accompanied a higher SDI at the country level. However, increased sociodemographic development was associated with decreased disease burden for adults aged ≥70 years. Strategies for improving mental health and strengthening mental health system should consider a broader sociocultural context.

Diabetes subgroups and sociodemographic inequalities in Mexico: a cross-sectional analysis of nationally representative surveys from 2016 to 2022

Differences in the prevalence of four diabetes subgroups have been reported in Mexico compared to other populations, but factors that may contribute to these differences are poorly understood. Here, we estimate the prevalence of diabetes subgroups in Mexico and evaluate their correlates with indicators of social disadvantage using data from national representative surveys. We analyzed serial, cross-sectional Mexican National Health and Nutrition Surveys spanning 2016, 2018, 2020, 2021, and 2022, including 23,354 adults (>20 years). Diabetes subgroups (obesity-related [MOD], severe insulin-deficient [SIDD], severe insulin-resistant [SIRD], and age-related [MARD]) were classified using self-normalizing neural networks based on a previously validated algorithm. We used the density-independent social lag index (DISLI) as a proxy of state-level social disadvantage. We identified 4204 adults (median age: 57, IQR: 47-66, women: 64%) living with diabetes, yielding a pooled prevalence of 16.04% [95% CI: 14.92-17.17]. When stratified by diabetes subgroup, prevalence was 6.62% (5.69-7.55) for SIDD, 5.25% (4.52-5.97) for MOD, 2.39% (1.95-2.83) for MARD, and 1.27% (1.00-1.54) for SIRD. SIDD and MOD clustered in Southern Mexico, whereas MARD and SIRD clustered in Northern Mexico and Mexico City. Each standard deviation increase in DISLI was associated with higher odds of SIDD (OR: 1.12, 95% CI: 1.06-1.12) and lower odds of MOD (OR: 0.93, 0.88-0.99). Speaking an indigenous language was associated with higher odds of SIDD (OR: 1.35, 1.16-1.57) and lower odds of MARD (OR 0.58, 0.45-0.74). Diabetes prevalence in Mexico is rising in the context of regional and sociodemographic inequalities across distinct diabetes subgroups. SIDD is a subgroup of concern that may be associated with inadequate diabetes management, mainly in marginalized states. This research was supported by Instituto Nacional de Geriatría in Mexico.

Sociodemographic inequities in food allergy: Insights on food allergy from birth cohorts.

A large and growing corpus of epidemiologic studies suggests that the population-level burden of pediatric FA is not equitably distributed across major sociodemographic groups, including race, ethnicity, household income, parental educational attainment, and sex. As is the case for more extensively studied allergic disease states such as asthma and atopic dermatitis epidemiologic data suggest that FA may be more prevalent among certain populations experiencing lower socioeconomic status (SES), particularly those with specific racial and ethnic minority backgrounds living in highly urbanized regions. Emerging data also indicate that these patients may also experience more severe FA-related physical health, psychosocial, and economic outcomes relating to chronic disease management. However, many studies that have identified sociodemographic inequities in FA burden are limited by cross-sectional designs that are subject to numerous biases. Compared with cross-sectional study designs or cohorts established later in life, birth cohorts offer advantages relative to other study designs when investigators seek to understand causal relationships between exposures occurring during the prenatal or postnatal period and the atopic disease status of individuals later in life. Numerous birth cohorts have been established across recent decades, which include evaluation of food allergy-related outcomes, and a subset of these also have measured sociodemographic variables that, together, have the potential to shed light on the existence and possible etiology of sociodemographic inequities in food allergy. This manuscript reports the findings of a comprehensive survey of the current state of this birth cohort literature and draws insights into what is currently known, and what further information can potentially be gleaned from thoughtful examination and further follow-up of ongoing birth cohorts across the globe.

An exploratory review of the fintech influence field

Fintech as a three-dimensional phenomenon reflects the rapidly changing technological, financial and business environment. The bibliometric analysis of scientific articles allowed us to identify the main themes and create a map of the field of fintech influences. Systematization of scientific articles revealed the influence of economic development and socio-demographic inequality on fintech development. Government regulatory policies can accelerate the digitisation of financial services and financial inclusion and help the fintech sector face geopolitical challenges. Fintech’s impact was divided into three areas: financial stability and sustainable development, the business ecosystem and human behaviour. The research we summarised allowed us to identify the mechanisms through which fintech influences various fields. A complex approach to the influence of fintech enables us to understand the phenomenon and make better decisions.

Sociodemographic inequities in COVID-19 vaccination among adults in the United States, 2022

BackgroundDespite the availability of COVID-19 vaccines since December 2020, sociodemographic inequities in vaccination and preventable COVID-related deaths persist. To inform efforts for equitable COVID-19 vaccination campaigns, a comprehensive national evaluation of existing inequities is necessary. ObjectiveTo examine sociodemographic inequities in COVID-19 vaccination receipt using data from the 2022 National Health Interview Survey (NHIS). MethodsThis secondary data analysis used cross-sectional nationally-representative data from the 2022 NHIS to assess vaccination inequities among 27,126 adults. Separate Poisson regressions adjusted for clinical factors (e.g., age, sex, high-risk health conditions) were used to evaluate vaccination inequities across sociographic factors (e.g., race/ethnicity, poverty, health insurance). ResultsIn 2022, 79.6% of adults received at ≥ 1 vaccine dose, 75.0% received ≥ 2 doses (“fully vaccinated”), 45.7% received ≥ 3 doses (≥ 1 booster), and 17.2% received ≥ 4 doses (≥ 2 boosters). Marked inequities were evident in COVID-19 vaccination across primary and booster doses, especially receipt of at least 1 booster dose (≥ 3 doses). Black (35.7%, prevalence ratio [PR] 0.78 [95% CI 0.74-0.83]) and Latinx (35.5%, PR 0.82 [CI 0.78-0.86]) adults were less likely to receive ≥ 3 doses than Asian (66.5%, PR 1.41 [CI 1.35-1.48]) and White (48.8%) adults. Poverty (31.1% [PR 0.65 {CI 0.61-0.69}] vs. 50.7%) and food insecurity (27.1% [PR 0.63 {CI 0.58-0.68}] vs. 47.3%) were negatively associated with receipt of ≥ 3 vaccine doses. Adults without usual source of care (24.9%, PR 0.61 [CI 0.57-0.65]) or health insurance (17.4%, PR 0.40 [CI 0.36-0.45]) had much lower rates of ≥ 3 doses than those with appropriate health care access (48.7% and 51.9%, respectively). ConclusionAs of 2022, 1-in-5 U.S. adults remain unvaccinated, and more than half have not received any recommended booster doses. Economically/socially marginalized populations—including Black and Latinx adults and those with structural barriers such as poverty, food insecurity, and poor health care access—were less likely to receive a booster. Addressing these vaccination inequities is crucial to achieve equitable COVID-19 protection and reduce preventable deaths among economically/socially marginalized populations.

Adverse Childhood Experiences Among U.S. Adults: National and State Estimates by Adversity Type, 2019–2020

Although adverse childhood experiences (ACEs) are associated with lifelong health harms, current surveillance data on exposures to childhood adversity among adults are either unavailable or incomplete for many states. In this study, recent data from a nationally representative survey were used to obtain the current and complete estimates of ACEs at the national and state levels. Current, complete, by-state estimates of adverse childhood experiences were obtained by applying small area estimation technique to individual-level data on adults aged ≥18 years from 2019-2020 Behavioral Risk Factor Surveillance System survey. The standardized questions about childhood adversity included in the 2019-2020 survey allowed for obtaining estimates of ACE consistent across states. All missing responses to childhood adversity questions (states did not offer such questions or offered them to only some respondents; respondents skipped questions) were predicted through multilevel mixed-effects logistic small area estimation regressions. The analyses were conducted between October 2022 and May 2023. An estimated 62.8% of U.S. adults had past exposure to ACEs (range: 54.9% in Connecticut; 72.5% in Maine). Emotional abuse (34.5%) was the most common; household member incarceration (10.6%) was the least common. Sexual abuse varied markedly between females (22.2%) and males (5.4%). Exposure to most types of adverse childhood experiences was lowest for adults who were non-Hispanic White, had the highest level of education (college degree) or income (annual income ≥$50,000), or had access to a personal healthcare provider. Current complete estimates of ACEs demonstrate high countrywide exposures and stark sociodemographic inequalities in the burden, highlighting opportunities to prevent adverse childhood experiences by focusing social, educational, medical, and public health interventions on populations disproportionately impacted.

Sociodemographic inequalities of suicide: a population-based cohort study of adults in England and Wales 2011-21.

The risk of suicide is complex and often a result of multiple interacting factors. Understanding which groups of the population are most at risk of suicide is important to inform the development of targeted public health interventions. We used a novel linked dataset that combined the 2011 Census with the population-level mortality data in England and Wales. We fitted generalized linear models with a Poisson link function to estimate the rates of suicide across different sociodemographic groups and to identify which characteristics are independent predictors of suicide. Overall, the highest rates of suicide were among men aged 40-50 years, individuals who reported having a disability or long-term health problem, those who were unemployed long term or never had worked, and those who were single or separated. After adjusting for other characteristics such as employment status, having a disability or long-term health problem, was still found to increase the incidence of suicide relative to those without impairment [incidence rate ratio minimally adjusted (women) = 3.5, 95% confidence interval (CI) = 3.3-3.6; fully adjusted (women) 3.1, 95% CI = 3.0-3.3]. Additionally, while the absolute rate of suicide was lower in women compared with men, the relative risk in people reporting impairments compared with those who do not was higher in women compared with men. The findings of this work provide novel population-level insights into the risk of suicide by sociodemographic characteristics in England and Wales. Our results highlight several sociodemographic groups who may benefit from more targeted suicide prevention policies and practices.

Socio-demographic inequalities in stage at diagnosis of lung cancer: A French population-based study

BackgroundDiagnosing patients at a non-advanced stage has become a mainstay of lung cancer prevention and control strategies. Understanding socio-demographic inequalities in stage at diagnosis may improve the targeting of interventions on patients at higher risk. This study aimed to identify these socio-demographic determinants in a large-scale French population-based cancer registry. MethodsAll incident lung cancers diagnosed between 2008 and 2019 identified from the Poitou-Charentes Cancer Registry (south-west France) were included. Stage at diagnosis was categorised as advanced/non-advanced (TNM III/IV vs I/II) according to the 8th TNM edition, the objective being to ensure a consistent level of prognosis over time. Socio-demographic variables included age, sex, the French European Deprivation Index (EDI) and patient’s place of residence. Their impact on stage at diagnosis was quantified by multivariate logistic regression models with subgroup analyses by histological subtype. ResultsOut of the 15,487 included patients, 75% were diagnosed at an advanced stage (66% to 95% depending on the histological subtype), 17% at a non-advanced stage and 10% at a non-specified stage. Multivariate analysis showed different patterns according to histological subtypes. In patients with adenocarcinoma, a higher risk of advanced stage was found for younger and older patients (u-shape), those most deprived, and those living in rural areas. The same effect of age was reported for squamous cell carcinomas, while no association was found for small-cell lung carcinomas. ConclusionsThis study highlighted substantial socio-demographic inequalities in stage at diagnosis, specifically for adenocarcinoma patients. Diagnosis strategies could be refined and strengthened in the non-smoker population, in which adenocarcinomas are mainly reported.

Sociodemographic inequities in the burden of carcinogenic industrial air emissions in the United States.

Industrial facilities are not located uniformly across communities in the United States, but how the burden of exposure to carcinogenic air emissions may vary across population characteristics is unclear. We evaluated differences in carcinogenic industrial pollution among major sociodemographic groups in the United States and Puerto Rico. We evaluated cross-sectional associations of population characteristics including race and ethnicity, educational attainment, and poverty at the census tract level with point-source industrial emissions of 21 known human carcinogens using regulatory data from the US Environmental Protection Agency. Odds ratios and 95% confidence intervals comparing the highest emissions (tertile or quintile) to the referent group (zero emissions [ie, nonexposed]) for all sociodemographic characteristics were estimated using multinomial, population density-adjusted logistic regression models. In 2018, approximately 7.4 million people lived in census tracts with nearly 12 million pounds of carcinogenic air releases. The odds of tracts having the greatest burden of benzene, 1,3-butadiene, ethylene oxide, formaldehyde, trichloroethylene, and nickel emissions compared with nonexposed were 10%-20% higher for African American populations, whereas White populations were up to 18% less likely to live in tracts with the highest emissions. Among Hispanic and Latino populations, odds were 16%-21% higher for benzene, 1,3-butadiene, and ethylene oxide. Populations experiencing poverty or with less than high school education were associated with up to 51% higher burden, irrespective of race and ethnicity. Carcinogenic industrial emissions disproportionately impact African American and Hispanic and Latino populations and people with limited education or experiencing poverty thus representing a source of pollution that may contribute to observed cancer disparities.

Sociodemographic inequalities in the incidence of COVID-19 in National Household Sample Survey cohort, Brazil, 2020

RESUMO Objetivo: Verificar a associação entre fatores sociodemográficos e o tempo até a ocorrência de novos casos de COVID-19 e de testes positivos para Sars-CoV-2 no Brasil, durante o período de maio a novembro de 2020, com base em uma coorte dos brasileiros participantes da Pesquisa Nacional por Amostra de Domicílios COVID-19. Métodos: Foi constituída uma coorte concorrente e fechada utilizando dados mensais da Pnad COVID-19, realizada por inquérito telefônico. Um caso novo foi definido com base no relato da ocorrência de um quadro de síndrome gripal, associado à perda de olfato ou paladar; e a positividade foi definida com base no relato de um teste positivo, entre os que referiram ter sido testados. Foram aplicados modelos de regressão de Cox para verificar associações, considerando a ponderação amostral, calibrada para a distribuição etária, de sexos e de escolaridade. Resultados: A incidência acumulada de casos na coorte fixa geral foi de 2,4%, enquanto a de testes positivos na coorte fixa testada foi de 27,1%. Verificou-se maiores riscos nas regiões Centro-Oeste, Norte e Nordeste, entre mulheres, residentes em áreas urbanas, pessoas com escolaridade até o ensino médio, com a cor da pele declarada como preta e trabalhadores da área da saúde. Indivíduos com menor escolaridade e profissionais de saúde apresentaram maior frequência de novos testes positivos. Novos testes positivos ocorreram com maior frequência em indivíduos com menor escolaridade e trabalhadores da área da saúde. Conclusão: Foram observados riscos desiguais entre os estratos populacionais comparados. Destaca-se a importância da realização de inquéritos nacionais prospectivos na investigação de iniquidades em saúde.

Self-rated health and sociodemographic inequalities among Venezuelan adults: a study based on the National Survey of Living Conditions (ENCOVI 2021).

Self-rated health is an indicator that can be easily identified in health surveys, widely used to measure physical, social, mental, and health aspects of the population, and predict premature mortality. In Venezuela, this information only began to be collected recently, in the National Survey of Living Conditions (ENCOVI). In this context, our study aims to analyze the demographic and socioeconomic factors associated with non-positive self-rated health among Venezuelan adults. The ENCOVI 2021 (n = 16,803) was used as a data source, assessing a probability stratified sample with questions about health, education, emigration, and other social and economic aspects. Crude and adjusted prevalence ratio analyses were performed using Poisson regression models with robust variance. The prevalence of fair/bad self-rated health among Venezuelans was 17.8%. The results indicated a strong association between outcome prevalence and age group, 3.81 times higher (95%CI: 3.29-4.41) among individuals aged 60 or more when compared to individuals aged 18 to 29 years. Also, participants experiencing severe food insecurity had a prevalence 2 times higher (95%CI: 1.61-2.47) than those who did not have any level of food insecurity. Factors such as poverty, education, recent emigration of family members, and sex also showed a significant influence, also when analyzed independently. The results show that special attention should be dedicated to the health of individuals facing hunger and of the older people.

Sociodemographic inequalities in the incidence of COVID-19 in National Household Sample Survey cohort, Brazil, 2020.

To verify the association between sociodemographic factors and the time until the occurrence of new cases of COVID-19 and positive tests for SARS-CoV-2 in Brazil, during the period from May to November 2020, based on a cohort of Brazilians participating in the COVID-19 National Household Sample Survey. A concurrent and closed cohort was created using monthly data from the PNAD COVID-19, carried out via telephone survey. A new case was defined based on the report of the occurrence of a flu-like syndrome, associated with loss of smell or taste; and positivity was defined based on the report of a positive test, among those who reported having been tested. Cox regression models were applied to verify associations. The analyzes took into account sample weighting, calibrated for age, gender and education distribution. The cumulative incidence of cases in the overall fixed cohort was 2.4%, while that of positive tests in the fixed tested cohort was 27.1%. Higher incidences were observed in the North region, in females, in residents of urban areas and in individuals with black skin color. New positive tests occurred more frequently in individuals with less education and healthcare workers. The importance of prospective national surveys is highlighted, contributing to detailed analyzes of social inequalities in reports focused on public health policies.

Exploring mental health literacy among prospective university students using GIS techniques in Bangladesh: an exploratory study.

Prospective university students experience substantial academic stressors and psychological vulnerabilities, yet their mental health literacy (MHL) remains inadequately explored. This study investigates four dimensions of MHL - help-seeking behaviors, stigma, knowledge about mental health and understanding of mental illnesses. Besides, Geographic Information System (GIS) techniques are employed to analyze spatial disparities in MHL, which is the first in the context of MHL research. A total of 1,485 students were assessed for sociodemographic characteristics, admission-related variables, health behaviors and family histories of mental health issues. Data were analyzed using SPSS and ArcGIS software. Multivariable linear regression analyses unveiled predictors of the MHL dimensions, with gender, family income, admission test performance, smoking, alcohol and drug use, physical and mental health history, current depression or anxiety and family history of mental health and suicide incidents emerging as common predictors. GIS analysis unraveled notable regional disparities in MHL, particularly in knowledge of mental health and mental illness, with northern and some southern districts displaying higher literacy levels. In conclusion, these findings accentuate significant gender and sociodemographic inequalities in MHL among prospective university students, highlighting the imperative for targeted interventions to enhance MHL and foster mental well-being in this cohort.

Prevalence and sociodemographic inequalities in developing type 2 diabetes multimorbidities in Serbia

Prevalence and sociodemographic inequalities in developing type 2 diabetes multimorbidities in Serbia

Inequality among residents and enterprises in the Latvian online market of digital marketing

Despite the widespread adoption of digital technologies and their potential to break down traditional barriers in business and communication, many Latvian residents and enterprises still lack access to digital marketing tools and the advantages they offer. This article aims to analyze inequality among residents and enterprises in the Latvian online market of digital marketing. The conceptual basis of the study is the technology acceptance model (TAM), the theory of digital divide and the resource approach based on the theory of social fields. For dynamic analysis of statistical data, the con(di)vergence of indicators of the involvement of various socio-demographic and geographical groups of Latvian residents and enterprises in the online market of digital marketing is assessed. The empirical study is based on Latvian statistics for 2013—2022 (for some indicators — 2023). The results of the study show that the development of digital marketing in Latvia is happening very quickly, but the potential for development still remains very large, since with 90 % of Latvian residents regularly (at least once a week) using the internet, more than 30 % of Latvians have not yet made a purchase or order on the internet. The development of digital marketing in Latvia reduces socio-demographic and geographical inequalities among residents and enterprises in the online market in relation to the ‘digital inequality of input’ (access to the online market), but in relation to the ‘digital inequality of output’ (returns from this access) the equalizing opportunities of digital marketing in Latvia (especially in its regions) are limited by the specifics of the functioning of the economy based on social capital. In this economy, models and theories developed for the economy based on innovation practically do not work. The novelty of this study is a comprehensive analysis of the general background and dynamics of the development of the Latvian online market of digital marketing in the context of digital inequality among residents and enterprises.

Paradoxes in food quality: an analysis of sociodemographic inequalities

Resumo Introdução: As desigualdades sociais afetam historicamente as condições de vida e saúde das populações, e o padrão alimentar associa-se à situação socioeconômica dos indivíduos. Objetivo: Avaliar a magnitude das desigualdades sociais em indicadores de qualidade alimentar na população de Campinas-SP. Método: Estudo transversal, de base populacional, com 1.710 adultos e idosos entrevistados em 2014/15. Foram estimadas as prevalências e as razões de prevalência do consumo de alimentos avaliado por um questionário de frequência alimentar; além disso, foram verificadas as disparidades sociais segundo sexo, idade, escolaridade, renda e posse de plano de saúde. Resultados: Maior frequência de consumo de alimentos saudáveis foi verificada nas mulheres, nos idosos, nos estratos de maior nível de escolaridade e renda e no segmento social com plano de saúde. Por outro lado, paradoxalmente, os grupos sociais mais favorecidos não apresentaram menor consumo de refrigerantes, sucos artificiais, embutidos e biscoitos e bolachas nem apresentaram consumo maior de alimentos não saudáveis. Os idosos apresentam qualidade alimentar superior a todos os segmentos estudados. O segmento sem plano de saúde (usuários do SUS) teve pior perfil de consumo de alimentos, exceto para feijão e fast food. Conclusão: Expressivas desigualdades sociodemográficas foram detectadas, e os perfis combinaram o consumo de alimentos saudáveis e não saudáveis.

Disparities in preconception health indicators in U.S. women: a cross-sectional analysis of the behavioral risk factor surveillance system 2019.

Optimized preconception care improves birth outcomes and women's health. Yet, little research exists identifying inequities impacting preconception health. This study identifies age, race/ethnicity, education, urbanicity, and income inequities in preconception health. We performed a cross-sectional analysis of the Center for Disease Control and Prevention's (CDC) 2019 Behavioral Risk Factor Surveillance System (BRFSS). This study included women aged 18-49 years who (1) reported they were not using any type of contraceptive measure during their last sexual encounter (usage of condoms, birth control, etc.) and (2) reported wanting to become pregnant from the BRFSS Family Planning module. Sociodemographic variables included age, race/ethnicity, education, urbanicity, and annual household income. Preconception health indicators were subdivided into three categories of Physical/Mental Health, Healthcare Access, and Behavioral Health. Chi-squared statistical analysis was utilized to identify sociodemographic inequities in preconception health indicators. Within the Physical/Mental Health category, we found statistically significant differences among depressive disorder, obesity, high blood pressure, and diabetes. In the Healthcare Access category, we found statistically significant differences in health insurance status, having a primary care doctor, and being able to afford a medical visit. Within the Behavioral Health category, we found statistically significant differences in smoking tobacco, consuming alcohol, exercising in the past 30 days, and fruit and vegetable consumption. Maternal mortality and poor maternal health outcomes are influenced by many factors. Further research efforts to identify contributing factors will improve the implementation of targeted preventative measures in directly affected populations to alleviate the current maternal health crisis.

BIOSOCIAL PATHWAYS AFFECTING HEALTH AND AGING IN THE HEALTH AND RETIREMENT STUDY

Abstract Representative population studies, like the Health and Retirement Study (HRS), are gathering large amounts of biomarker and multi-omic data. This presents a unique opportunity to investigate how population-level aging effects is driven by social inequality. This research has the capacity to uncover targets for intervention that could result in extending longevity and healthy life span and reducing inequalities in aging. There has been substantial research and progress in identifying biological processes underlying age-related decline, morbidity, and mortality (the so-called biological hallmarks of aging); however, despite this progress, demographic, social, and psychological factors (the so-called social hallmarks of aging) are substantially associated with cognitive aging and ADRD above-and-beyond genetic and biological factors There is, therefore, a need for research that carefully integrates the social and biological hallmarks of the human aging processes. This symposium highlights research that investigates interactions between biological and social processes that lead to inequalities in health and aging among older adults utilizing recently released data from the HRS Venous Blood Study (a nationally representative sample of US adults over age 55). Included are papers investigating the role of timing of childhood adversity in affecting adult DNA methylation patterns, how childhood parental loss is associated with accelerated epigenetic aging, how socioeconomic status patterns expression of genes related to inflammation and cellular senescence, and how sets of age-related biomarkers can explain sociodemographic inequalities in mortality. These studies contribute to an emerging literature integrating social and biological sciences to better understand inequalities in the aging process.

Spouses of individuals living with mild cognitive impairment or dementia in the United States: A descriptive, population-based study.

Little is known about the population of individuals who live with a spouse with cognitive impairment (CI) or dementia. Using the US Health and Retirement Study, 2000 to 2018, we estimated the population of adults ≥ 50 years old co-residing with a spouse with probable CI/dementia. We described their socio-demographic and health characteristics and quantified socio-demographic inequities. Among community-dwelling adults ≥ 50 years old, 6% of women and 4% of men co-resided with a spouse with probable CI/dementia. Among those who were married/partnered, the prevalence of spousal dementia was greater for Black and Hispanic adults compared to their White counterparts, and for those with lower versus higher educational attainment. Among spouses, activities of daily living disability, depression, and past 2-year hospitalization was common. Millions of older adults, disproportionately Black and Hispanic people and people with lower levels of educational attainment, live with a spouse with CI while also facing their own major health challenges.