Years Of Educational Attainment Research Articles

The role of lifestyle factors in the association between education and self-reported fibromyalgia: a mediation analysis

BackgroundSocioeconomic status as measured by education, income, or occupation, has been associated with fibromyalgia but the underlying mechanism and the role of lifestyle factors are unclear. Thus, we examine the role of modifiable lifestyle factors (body mass index, physical activity, alcohol consumption and smoking) in the association between education and self-reported fibromyalgia.MethodsWe used data from 74,157 participants in the population-based prospective Norwegian Women and Cancer (NOWAC) study. Socioeconomic position, operationalized as years of educational attainment, and lifestyle factors were assessed via self-reported questionnaires. Multiple mediation analysis was used to decompose total effects into direct and indirect effects. Estimates were reported as hazard ratios (HRs) with 95% confidence intervals (CIs).ResultsThe cumulative incidence of fibromyalgia was 3.2% after a median follow up time of 13 years. Fibromyalgia was inversely associated with years of educational attainment for ≤ 9 years (HR = 2.56; 95% CI 2.32–2.91) and for 10–12 years (HR = 1.84; 95% CI 1.72–2.02), compared with ≥ 13 years of education. Overall, all lifestyle factors together jointly mediated 17.3% (95% CI 14.3–21.6) and 14.1% (95% CI 11.3–18.9) of the total effect for ≤ 9 years and 10–12 years of education, respectively. Smoking and alcohol consumption contributed the most to the proportion mediated, for ≤ 9 years (5.0% and 7.0%) and 10–12 years (5.6% and 4.5%) of education.ConclusionThe association between education and self-reported fibromyalgia was partly explained through lifestyle factors, mainly smoking and alcohol consumption.

Intergenerational Mobility in South Asia

This article analyses the movement of intergenerational mobility (IGM) in South Asia from birth cohorts comprising 1950–1980 using the World Bank’s data on IGM. The article compares the IGM movements across countries to account for the causal factors of the IGM. Exploratory data analysis and Bayesian regression have been used in this study for empirical analysis. We note that in the past three decades, the share of primary parental education in South Asia constitutes 79% of the total, while the children who achieved the highest level of education constitute only 10%. Children in Sri Lanka have been enrolled in school for the greatest number of years, but the absolute IGM in India is greater than Sri Lanka. Bhutan lags in average years of educational attainment, yet their relative mobility surpasses every country in South Asia. The likelihood that Pakistani children’s status shall be independent of their parental status is as low as 20%. Despite variation in parental education, absolute IGM in India is highest in South Asia. Variation in parental education reduces the degree of independence in the next generation. Relative measure of mobility is a better indicator of social mobility than the absolute measure. JEL Codes: I21, I24, I28, J24, J62, N35

SECONDARY SCHOOL CURRICULAR RIGOR AND COGNITIVE FUNCTION AT AGE 81

Abstract A current goal is to identify how and for whom years of educational attainment translate into high cognitive function in later life. Recent work has found effects of school quality factors such as teacher experience and racial integration of schools. In this project, I examine secondary school curriculum. Not only is there variation in curriculum across school districts, but also adolescents within a single secondary school select different courses. Curricular opportunities and selections may change the developing brain in lasting ways, and/or may place the student on a path towards future academic and career opportunities that shape risk and resilience. I hypothesize that a rigorous secondary school curriculum positions students to attend college, which in turn promotes lifelong cognitive health. I tested this hypothesis by estimating multilevel structural equation models in data from the Wisconsin Longitudinal Study (WLS), which follows a randomly-selected one-third of all students who graduated from Wisconsin high schools in 1957 (N = 10,317). I created a latent measure of curricular rigor out of participants’ highest secondary school math course and number of semesters of English, science, and foreign language. In 2020 (most participants were age 81), participants completed a phone-based cognitive screening (Telephone Interview for Cognitive Status-Modified; TICS-m). Net of school-level factors, parental socioeconomic status, and academic achievement, higher curricular rigor predicted higher cognitive function at age 81. Educational attainment significantly mediated this effect, and a significant direct effect also remained. Both educational attainment and curricular rigor are desirable targets for policy interventions.

Longitudinal Trajectories of Normal versus Abnormal Cognitive Aging in the SIU Longitudinal Cognitive Aging Study as measured by the original Alzheimer’s disease Assessment Scale and a novel extended version

AbstractBackgroundThe original Alzheimer’s disease Assessment Scale‐cognitive subscale (oADAS) is a common measure of cognition used in Alzheimer’s disease (AD) clinical trials. The oADAS may not be sensitive to pre‐dementia syndromes such as mild cognitive impairment (MCI), possibly due to ceiling effects for many of the subtests. However, little is known about the trajectories of cognitive aging on the oADAS in cognitively‐normal individuals who decline over time. We used Linear Mixed Effects Modeling to examine trajectories of cognitive aging on the oADAS, a novel extended version (eADAS), and the MMSE. We hypothesized that, compared to non‐decliners, individuals who declined from normal to MCI and/or AD (decliners) would demonstrate increased error scores on the ADAS and lower scores on the MMSE over time.MethodsWe included data from 608 older adults (72% female, mean age = 69.0 years) who were enrolled in SIU Longitudinal Cognitive Aging Study (LCAS). Total years of educational attainment ranged from 8‐26 years. The vast majority of the participants were White/Not‐Hispanic. There were 50 decliners and 558 non‐decliners included in the present analysis. The eADAS included short‐delay recall/recognition trials for the first word list, a short‐delay true‐false word recognition trial for the second word list, a letter‐digit d psychomotor test, supermarket fluency, spontaneous clock drawing, three additional items to the object naming subtest, three additional figure copies, and a similarities test. All analyses were completed after controlling for gender, education, age at first visit, time between visits, and number of visits.ResultsThere was no significant difference between the groups for age at first visit. Greater age at first visit and lower education were associated with increased error scores for both ADAS versions and MMSE in the decliner group (p’s <0.001). There was no significant effect of the number of days between visits. The mean coefficients for the change in error score over time between visits for the oADAS, eADAS, and MMSE was 2.84, 10.30, and ‐1.09, respectively.ConclusionOur results indicate that the oADAS and eADAS are useful measures for examining trajectories of cognitive decline in cognitively‐normal individuals at increased risk for AD.

Effects of Oil spillage on the Socio-economic welbeing of Artisanal Fishermen in Akwa Ibom State, Nigeria

This study assessed the effect of oil spillage on the socio-economic wellbeing of artisanal fishermen in Akwa Ibom State, Nigeria. Primary data were obtained from 200 artisanal fishermen using multi-stage sampling procedure and analyzed using descriptive statistics and Likert scale ratings. Results showed that the mean age of fish farmers in the area was 40 years and majority (57.0%) were married. Fishermen were quite educated (93.5%) with a mean of 12 years of educational attainment, The mean household size, farming experience and income were 6 persons, 9 years and N600,000, respectively. The major causes of oil spillage were; drilling of oil well, illegal facilities, spill from storage facilities, corrosion of oil pipelines, faulty production equipment, natural disaster, leakages from oil tank, oil theft, shipping accidents, cleaning of oil tankers on the high sea and spills from vandalized oil pipelines. Findings showed that oil spillage reduced the income of fishing household, led to food insecurity, deteriorated the health status of fishermen, polluted the environment, led to migration of fishermen out of the affected areas and resulted in abandonment of artisanal fishing operation for other livelihood operation. Findings further showed artisanal fishermen’s coping strategies to include; migration to other communities, livelihood diversification, extension of fishing time, involvement in community and individual level savings, attending enlightenment programs on coping with effects of crude oil spillage and frequently changing the timing and location of fishing trips. This study therefore recommended that the federal government should implement an aggressive national oil spill contingency plan which includes the cleanup of polluted areas and payment of reparations to affected artisanal fishermen in Akwa Ibom State.

Examining cross-sectional and longitudinal relationships between multidomain physical fitness metrics, education, and cognition in Black older adults

ABSTRACT A limited number of studies examine cognitive aging in Black or African American older adults. The purpose of this study was to explore the relationship between health-related fitness metrics, education, and cognition at baseline and over a 4-year follow-up in a sample of 321 Black or African American older adults in the Health and Retirement Study (HRS). Physical fitness was assessed with measures of gait speed, peak expiratory flow, grip strength, and body mass index. Global cognition was assessed with an adapted version of the Telephone Interview for Cognitive Status (TICS). Analyses of relative importance and hierarchical multiple regression were used to examine baseline cross-sectional relationships. Multiple logistic regression was used to examine prospective relationships with longitudinal cognitive status. Education was the strongest predictor of global cognition at baseline and follow-up. More years of education significantly increased the odds of maintaining cognitive status at 4-year follow-up. After accounting for education, gait speed was independently associated with baseline cognitive performance and accounted for additional variance. Grip strength, peak expiratory flow, and body mass index were not significantly associated with cognition. The results indicated that modifiable variables, including years of educational attainment and gait speed, were more strongly associated with global cognition than other modifiable variables including body mass index, grip strength, and peak expiratory flow. The lack of observed associations between other fitness variables and cognition may be attributable to the brief assessment methods implemented, which was necessitated by the large-scale, epidemiological approach of the HRS.

Risk Factors Associated with Diabetes among Mexican-Origin Adults in Southern Arizona.

Diabetes is the seventh leading cause of death in the United States, and it is particularly problematic among the Latine population. This study employed multivariable logistic regression models to examine how hypertension, depression, and sociodemographics were associated with diabetes in a cross-sectional sample of Mexican-origin adults living in three counties of Southern Arizona. The overall prevalence of diabetes from this primary care sample was 39.4%. Holding covariates at fixed values, individuals having hypertension were 2.36 (95% CI: 1.15, 4.83) times more likely to have diabetes, when compared to individuals not having hypertension. The odds of having diabetes for individuals with ≥12 years of educational attainment were 0.29 (95% CI: 0.14, 0.61) times the corresponding odds of individuals with <12 years of educational attainment. For individuals with depression, the odds of having diabetes for those who were born in Mexico and had <30 years living in the US were 0.04 (95% CI: 0, 0.42) times the corresponding odds of individuals without depression and who were born in the US. Findings suggest clinical and public health systems should be aware of the potential increased risk of diabetes among Mexican-origin adults with hypertension and lower educational attainment.

The Use of F-18 FDG PET-Based Cognitive Reserve to Evaluate Cognitive Decline in Alzheimer's Disease, Independent of Educational Influence.

Background and Objectives: The optimal assessment of cognitive function, including the impact of education, is crucial in managing Alzheimer's disease (AD). This study aimed to evaluate the role of cognitive reserve (CR), represented by the metabolic status of regions of the cerebral cortex, to evaluate cognitive decline considering the educational attainment of patients with AD. Materials and Methods: We used data from the Alzheimer's Disease Neuroimaging Initiative database, and selected 124 patients who underwent both baseline F-18 fluorodeoxyglucose (FDG) and F-18 florbetaben (FBB) positron emission tomography (PET) scans. Demographics, cognitive function variables (Clinical Dementia Rating-Sum of Boxes [CDR]; AD Assessment Scale 11/13 [ADAS11/13] Mini-Mental State Examination [MMSE]), and the average standardized uptake value ratio (SUVR) of cerebral cortex regions to those of the cerebellum were obtained from the data. The participants' education level was divided into low and high education subgroups using four cut-offs of 12, 14, 16, and 18 years of educational attainment (G12, G14, G16, and G18, respectively). Demographic and cognitive function variables were compared between the two subgroups in each of the four groups, and their correlations with the SUVRs were evaluated. Results: There was no significant difference between the high and low education subgroups in each of the four groups, except for ADAS11/13 and MMSE in G14 and age in G16. The SUVRs of FDG PET (FDGSUVR) were significantly correlated with CDR, ADAS11/13, and MMSE scores. FDGSUVR showed different trajectories of neurodegeneration between the low and high education groups. Conclusions: FDGSUVR correlated moderately but significantly with neuropsychological test results, without being influenced by education level. Therefore, FDG PET may reflect CR independent of education level, and therefore could be a reliable tool to evaluate cognitive decline in AD.

Socioeconomic disparities in health outcomes in the United States in the late 2010s: results from four national population-based studies

BackgroundDespite the importance of monitoring health disparities by multiple socioeconomic categories, there have been no recent updates on the prevalence of general health indicators by socioeconomic categories. The present study aims to update the prevalence estimates of health indicators by education and income categories across three age groups (children, young and middle-aged adults, and older adults) in the late 2010s by using four nationally representative data sources. We also examine socioeconomic differences in health by race/ethnicity subgroups.MethodsData were obtained from four nationally representative data sources from the U.S.: The National Health Interview Survey (2015–2018); the National Health and Nutrition Examination Survey, NHANES (2017–2020); the Behavioral Risk Factor Surveillance System (2016–2020); and the Health & Retirement Study (2016). Respondent-rated health and obesity were selected as the health indicators of interest. Socioeconomic factors included percentages of the federal poverty level and years of educational attainment. We conducted logistic regression analyses to calculate adjusted prevalence rates of respondent-rated (or measured, in the case of obesity in NHANES) poor health and obesity by income and education categories after controlling for sociodemographic characteristics. The complex sampling designs were accounted for in all analyses.ResultsPrevalence rates across racial/ethnic groups and age groups demonstrated clear and consistent socioeconomic gradients in respondent-rated poor health, with the highest rates among those in the lowest income and education categories, and decreased rates as income and education levels increased. On the other hand, there were less evident socioeconomic differences in obesity rates across all data sources, racial/ethnic groups, and age groups.ConclusionsOur results confirmed earlier, persistent evidence indicating socioeconomic disparities in respondent-rated poor health across all age and race/ethnicity groups by using four nationally representative datasets. In comparison to a decade earlier, socioeconomic disparities in poor health appeared to shrink while they emerged or increased for obesity. The results suggest an urgent need for action to alleviate pervasive health disparities by socioeconomic status. Further research is needed to investigate potentially modifiable factors underlying socioeconomic disparities in health, which may help design targeted health promotion programs.

What was the Epidemiology and Global Burden of Disease of Hip Fractures From 1990 to 2019? Results From and Additional Analysis of the Global Burden of Disease Study 2019.

Hip fractures are associated with a high risk of death; among those who survive a hip fracture, many experience substantial decreases in quality of life. A comprehensive understanding of the epidemiology and burden of hip fractures by country, age, gender, and sociodemographic factors would provide valuable information for healthcare policymaking and clinical practice. The Global Burden of Disease (GBD) study 2019 was a global-level study estimating the burden of 369 diseases and injuries in 204 countries and territories. An exploration and additional analysis of the GBD 2019 would provide a clearer picture of the incidence and burden of hip fractures. Using data from the GBD 2019, we asked, (1) What are the global, regional, and national incidences of hip fractures, and how did they change over a recent 30-year span? (2) What is the global, regional, and national burden of hip fractures in terms of years lived with disability, and how did it change over that same period? (3) What is the leading cause of hip fractures? (4) How did the incidence and years lived with disability of patients with hip fractures change with age, gender, and sociodemographic factors? This was a cross-sectional study. Participant data were obtained from the GBD 2019 ( http://ghdx.healthdata.org/gbd-results-tool ). The GBD study is managed by the WHO, coordinated by the Institute of Health Metrics and Evaluation, and funded by the Bill and Melinda Gates Foundation. It estimates the burden of disease and injury for 204 countries by age, gender, and sociodemographic factors, and can serve as a valuable reference for health policymaking. All estimates and their 95% uncertainty interval (UI) were produced using DisMod-MR 2.1, a Bayesian meta-regression tool in the GBD 2019. In this study, we directly pulled the age-standardized incidence rate and years lived with disability rate of hip fractures by location, age, gender, and cause from the GBD 2019. Based on these data, we analyzed the association between the incidence rate and latitude of each country. Then, we calculated the estimated annual percentage change to represent trends from 1990 to 2019. We also used the Spearman rank-order correlation analysis to determine the correlation between the incidence or burden of hip fractures and the sociodemographic index, a composite index of the income per capita, average years of educational attainment, and fertility rates in a country. Globally, hip fracture incidences were estimated to be 14.2 million (95% UI 11.1 to 18.1), and the associated years lived with disability were 2.9 million (95% UI 2.0 to 4.0) in 2019, with an incidence of 182 (95% UI 142 to 231) and 37 (95% UI 25 to 50) per 100,000, respectively. A strong, positive correlation was observed between the incidence rate and the latitude of each country (rho = 0.65; p < 0.001). From 1990 to 2019, the global incidence rate for both genders remained unchanged (estimated annual percentage change 0.01 [95% confidence interval -0.08 to 0.11]), but was slightly increased in men (estimated annual percentage change 0.11 [95% CI 0.01 to 0.2]). The years lived with disability rate decreased slightly (estimated annual percentage change 0.66 [95% CI -0.73 to -0.6]). These rates were standardized by age. Falls were the leading cause of hip fractures, accounting for 66% of all patients and 55% of the total years lived with disability. The incidence of hip fractures was tightly and positively correlated with the sociodemographic index (rho 0.624; p < 0.001), while the years lived with disability rate was slightly negatively correlated (rho -0.247; p < 0.001). Most hip fractures occurred in people older than 70 years, and women had higher incidence rate (189.7 [95% UI 144.2 to 247.2] versus 166.2 [95% UI 133.2 to 205.8] per 100,000) and years lived with disability (38.4 [95% UI 26.9 to 51.6] versus 33.7 [95% UI 23.1 to 45.5] per 100,000) than men. Hip fractures are common, devastating to patients, and economically burdensome to healthcare systems globally, with falls being the leading cause. The age-standardized incidence rate has slightly increased in men. Many low-latitude countries have lower incidences, possibly because of prolonged sunlight exposure. Policies should be directed to promoting public health education about maintaining bone-protective lifestyles, enhancing the knowledge of osteoporosis management in young resident physicians and those in practice, increasing the awareness of osteoporosis screening and treatment in men, and developing more effective antiosteoporosis drugs for clinical use. Level III, prognostic study.

Abstract PO-181: Race, educational attainment and pancreatic cancer mortality among Latinos

Abstract Background: Socioeconomic status, race, and educational attainment are known to impact outcomes of various cancers. Pancreatic cancer is one of the most aggressive types of cancer and accounts for a high number of deaths worldwide. This study aims to describe the mortality for pancreatic cancer by sex, race/skin color, and educational attainment in Brazil in the past decade. Methods: Descriptive ecological study, which evaluated the mortality rate for pancreatic cancer in the Brazilian National Health System from 2010-2019. The mortality rate was evaluated by sex, race/skin color, and educational attainment using the national database (DATASUS – Department of Informatics of the Unified Health System). The official classification of race/skin color in Brazil is composed of five categories: White, Brown [Pardo], Black, Yellow, and Indigenous. Results: During this time period, there was a total of 94024 deaths from pancreatic cancer in the Brazilian National Health System, of which 47295 (50.3%) were female. Regarding race/skin color; 58802 (62.5%) considered themselves white, 24845 (26.4%) brown, 5883 (6.3%) black, 954 (1%) others, and 3540 (3.8%) did not answer the question. Regarding educational attainment (n=76343); 9658 (12.7%) never had formal education, 41157 (53.9%) had &amp;gt;0 to 7 years, 15632 (20.4%) had 8 to 11 years, and 9896 (13%) had &amp;gt;12 years of educational attainment. Conclusions: The majority of patients who died from pancreatic cancer in our study were female, white, and had &amp;gt;0 to 7 years of educational attainment. However, these associations are still little analyzed worldwide and need more attention. Citation Format: Tulio L. Correa, Mariana S.T.C. Guelli. Race, educational attainment and pancreatic cancer mortality among Latinos [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-181.

Associations of particulate matter with dementia and mild cognitive impairment in China: A multicenter cross-sectional study

SummaryAmbient air pollution has been shown to be associated with the pathogenesis of dementia and mild cognitive impairment (MCI). However, few studies have examined these associations in well-characterized populations with low residential mobility, similar living habits, and a standardized assessment of both air pollution exposure and clinical outcome. This study examined the associations of long-term exposure to particulate matter (PM) air pollution with dementia and MCI, using data from the Chinese Veteran Clinical Research Platform. The cognitive function of elderly veterans from 277 communities in 18 Chinese cities was examined. Participants' daily exposures to aerodynamic diameters ≤2.5 μm (PM2.5) and ≤10 μm (PM10) during the 3 years prior to the survey were estimated using a satellite-based prediction. The adjusted odds ratios (ORs) and 95% confidence intervals of MCI associated with each 10 μg/m3 increase in PM2.5 and PM10 were 1.52 (1.39, 1.67) and 1.04 (1.00, 1.08), and those of dementia associated with PM2.5 and PM10 were 1.27 (1.11, 1.46) and 1.13 (1.05, 1.21), respectively. This demonstrates that long-term exposure to PM2.5 and PM10 can increase the prevalence of dementia/MCI among veterans in China. Higher ORs were observed for those with ≤9 years of educational attainment, those who actively attended physical activities, those who never smoked, former drinkers, and those who did not suffer from cerebral infarction. Improvement of ambient air quality, especially decreasing levels of PM2.5, may help to decrease the risk of dementia/MCI. Given the statistically significant association between PM and cognitive impairment demonstrated here, future studies should focus on examining the causal effect of PM pollution on dementia and MCI.

Swedish Normative Data for Mindmore: A Comprehensive Cognitive Screening Battery, Both Digital and Self-Administrated.

Cognitive impairment is a key element in most mental disorders. Its objective assessment at initial patient contact in primary care can lead to better adjusted and timely care with personalised treatment and recovery. To enable this, we designed the Mindmore self-administrative cognitive screening battery. What is presented here is normative data for the Mindmore battery for the Swedish population. A total of 720 healthy adults (17 to 93 years) completed the Mindmore screening battery, which consists of 14 individual tests across five cognitive domains: attention and processing speed, memory, language, visuospatial functions and executive functions. Regression-based normative data were established for 42 test result measures, investigating linear, non-linear and interaction effects between age, education and sex. The test results were most affected by age and to a lesser extent by education and sex. All but one test displayed either linear or accelerated age-related decline, or a U-shaped association with age. All but two tests showed beneficial effects of education, either linear or subsiding after 12 years of educational attainment. Sex affected tests in the memory and executive domains. In three tests, an interaction between age and education revealed an increased benefit of education later in life. This study provides normative models for 14 traditional cognitive tests adapted for self-administration through a digital platform. The models will enable more accurate interpretation of test results, hopefully leading to improved clinical decision making and better care for patients with cognitive impairment.

Relationship between state‐level administrative school quality data, years of education, cognitive decline and dementia risk

AbstractBackgroundWe examined indicators of state‐level administrative school quality as predictors of cognitive decline and dementia risk in later life across racial/ethnic by sex/gender groups.MethodParticipants included 2,446 men and women enrolled in the Washington Heights/Inwood Columbia Aging Project (WHICAP) who attended elementary school in the U.S., including 858 non‐Hispanic Whites (NHWs) and 1,588 non‐Hispanic Blacks (Blacks) followed up to 21 years. Cognitive outcomes were memory and language trajectories. A school quality indicator was created using U.S. census microsample data to combine historical measures of state compulsory schooling (mandatory enrollment age, minimum drop out age, and minimum work permit age) and school quality (term length, student‐teacher ratio, and percent attendance) on a scale corresponding to years of education via regression. The school quality indicator values were linked to WHICAP individual data via birth state, birth year, sex/gender, and race/ethnicity (black or NHW). Multiple‐group growth curve modeling and multiple‐group Cox regressions analyses were used to examine associations between school quality, cognitive decline, and dementia risk across racial/ethnic by sex/gender groups.ResultAfter adjusting for age, childhood SES, and state of childhood residence, higher quality of early‐life education was associated with level and change in language performance across groups, level of memory performance in Black women, and change in memory for NHWs and Black women. Higher quality of education was associated with lower risk of dementia for NHW women, Black men and women. Quality of education was not associated with dementia risk for NHW men after accounting for covariates. When years of education was included in the models, the influence of school quality on dementia risk and level and change in memory and language performance was fully attenuated for Black men and partially attenuated for NHWs and Black women.ConclusionQuality of early‐life education positively impacts cognitive outcomes and dementia risk later in life. Our results suggest an indirect relationship of school quality to late‐life cognitive outcomes through enabling additional years of educational attainment. Associations also varied across racial/ethnic by sex/gender groups. These findings provide evidence that later life brain health is influenced by early‐life state educational policies.

Oil and gas production and spontaneous preterm birth in the San Joaquin Valley, CA: A case-control study.

Recent studies report an association between preterm birth and exposure to unconventional oil and gas wells. There has been limited previous study on exposure to conventional wells, which are common in California. Our objective was to determine whether exposure to well sites was associated with increased odds of spontaneous preterm birth (delivery at <37 weeks). We conducted a case-control study using data on 27,913 preterm birth cases and 197,461 term birth controls. All births were without maternal comorbidities and were located in the San Joaquin Valley, CA, between 1998 and 2011. We obtained data for 83,559 wells in preproduction or production during the study period. We assessed exposure using inverse distance-squared weighting and, for each birth and trimester, we assigned an exposure tertile. Using logistic regression, we estimated adjusted odds ratios (ORs) for the association between exposure to well sites and preterm birth at 20-27, 28-31, and 32-36 weeks. We observed increased ORs for preterm birth with high exposure to wells in the first and second trimesters for births delivered at ≤31 weeks (adjusted ORs, 1.08-1.14). In stratified analyses, the associations were confined to births to Hispanic and non-Hispanic Black women and to women with ≤12 years of educational attainment. In a secondary analysis, we found evidence that exposure to wells in preproduction is associated with higher concentrations of particulate matter. We found evidence that exposure to oil and gas well sites is associated with increased risk of spontaneous preterm birth.

Vision impairment and cognitive function among urban-dwelling malaysians aged 55 years and over from the Malaysian Elders Longitudinal Research (MELoR) study

IntroductionPublished literature on vision impairment and cognitive function amongst older Malaysians remains scarce. This study investigates the association between vision impairment and cognitive function in an older Malaysian population. MethodsSubjects aged 55 years and above from the Malaysian Elders Longitudinal Research (MELoR) study with available information on vision and Montreal Cognitive Assessment (MoCA) scores were included. Data were obtained through a home-based interview and hospital-based health check by trained researchers. Visual acuity (VA) was assessed with logMAR score with vision impairment defined as VA 6/18 or worse in the better-seeing eye. Cognition was evaluated using the MoCA-Blind scoring procedure. Those with a MoCA-Blind score of <19/22 were considered to have cognitive impairment. ResultsData was available for 1144 participants, mean (SD) age = 68.57 (±7.23) years. Vision impairment was present in 143 (12.5 %) and 758 (66.3 %) had MoCA-Blind score of <19. Subjects with vision impairment were less likely to have a MoCA-Blind score of ≥19 (16.8 % vs 36.2 %, p < 0.001). Vision impairment was associated with poorer MoCA-Blind scores after adjustments for age, gender, and ethnicity (β = 2.064; 95 % CI, −1.282 to 3.320; P = 0.003). In those who had > 6 years of education attainment, vision impairment was associated with a significant reduction of cognitive function and remained so after adjustment for age and gender (β = 1.863; 95 % CI, 1.081–3.209; P = 0.025). ConclusionOur results suggest that vision impairment correlates with cognitive decline. Therefore, maintaining good vision is an important interventional strategy for preventing cognitive decline in older adults.

Educational attainment and drinking behaviors: Mendelian randomization study in UK Biobank.

Educational attainment has been associated with drinking behaviors in observation studies. We performed Mendelian randomization analysis to determine whether educational attainment causally affected drinking behaviors, including amount of alcohol intakes (in total and various types), drinking frequency, and drinking with or without meals among 334 507 White British participants from the UK Biobank cohort. We found that genetically instrumented higher education (one additional year) was significantly related to higher total amount of alcohol intake (inverse variance weighted method (IVW): beta=0.44, 95% confidence interval (CI) 0.40 to 0.49, P=1.57E-93). The causal relations with total amount and frequency of alcohol drinking were more evident among women. In analyses of different types of alcohol, higher educational attainment showed the strongest causal relation with more consumption of red wine (IVW beta=0.34, 95% CI 0.32 to 0.36, P=2.65E-247), followed by white wine/champagne, in a gender-specific manner. An inverse association was found for beer/cider and spirits. In addition, we found that one additional year of educational attainment was causally related to higher drinking frequency (IVW beta=0.54, 95% CI 0.51 to 0.57, P=4.87E-230) and a higher likelihood to take alcohol with meals (IVW: odds ratio (OR)=3.10, 95% CI 2.93 to 3.29, P=0.00E+00). The results indicate causal relations of higher education with intake of more total alcohol especially red wine, and less beer/cider and spirits, more frequent drinking, and drinking with meals, suggesting the importance of improving drinking behaviors, especially among people with higher education.

DETERMINANTS OF FERTILITY IN THE LONG RUN

This study investigates the determinants of fertility using a panel data set for 43 countries from 1900 to 2010 at five-year intervals. The regression results show that fertility increases with infant mortality and national disasters and decreases with total years of educational attainment and political development. Fertility rates fall initially and then rise with an increase in income. Average years of schooling of females has a significantly negative effect on fertility rates, whereas that of males are statistically insignificant. A woman’s educational attainment at the primary and secondary levels has a pronounced negative effect on fertility rates. On the contrary, an increase in a woman’s tertiary educational attainment, with the level of a man’s remaining constant, tends to raise fertility rates, particularly in advanced countries, indicating that highly educated women can have a better environment for childrearing in a society with greater gender equality.

Property confiscation and the intergenerational transmission of education in post-1948 Eastern Europe

Using regression methods and propensity score matching applied to two different retrospective samples, this study finds evidence of a positive “property confiscation” effect on educational attainment. We use a 1993 survey of adults (aged 20–69) in the post-transition Eastern European countries of Bulgaria, the Czech Republic, Hungary, Poland and Slovakia. In countries experiencing the most private property losses, regression results indicate that years of schooling increase by about 0.19 for each member of an affected extended family (parents, maternal grandfathers, or paternal grandfathers). When all three sets of family members lost property, we find an increase in years of educational attainment of about 0.6. We also find an increase in the probability of post-high school education of about 0.02 for each extended family member whose property was confiscated. Those findings are confirmed using propensity score matching, which provides a larger and more pervasive positive confiscation effect. We also test our hypothesis using current and retrospective microeconomic panel data from Europe’s Survey of Health, Aging and Retirement (SHARE), a dataset that covers countries in Eastern and Western Europe. We again find that property confiscation leads to greater educational attainment in the children of the affected households. We apply propensity score matching to the data and find, again, positive and statistically significant evidence of a confiscation effect on years of educational attainment. Auxiliary work indicates a separate channel for property confiscation’s effects. Our explanation for the empirical results reported herein can be found in families’ ability to pay bribes to advance their children’s education.

Quality and quantity: The association of state-level educational policies with later life cardiovascular disease

Education is a powerful predictor of cardiovascular morbidity and mortality. While the majority of the literature has focused on years of educational attainment or degree attainment, fewer studies examine the role of educational quality in the prevention of cardiovascular disease (CVD). We tested the hypothesis that average state-level educational quality was associated with CVD, linking state-level data on educational quality with individual demographic and health data from multiple waves of the National Health and Nutrition Examination Survey (N = 34,770). We examined thirteen CVD-related outcomes—including blood pressure, cholesterol, and heart attack—to understand the multiple pathways through which educational quality may influence CVD. The primary predictor was a composite index of educational quality, combining state-level measures of student-teacher ratios, per-pupil expenditures, and school term length. We fit multivariable models, regressing each outcome on the educational quality composite index and adjusting for individual- and state-level covariates. We also assessed whether the association between state educational quality and CVD differed for less educated individuals. Overall, higher educational quality was associated with less smoking (OR = 0.86, 95%CI: 0.77, 0.97), but there was no statistically significant association for the other 12 outcomes. Interaction tests indicated that less educated individuals benefited less from higher educational quality relative to those with more education for several outcomes. Our study suggests that state-level educational quality is not strongly associated with CVD, and that this null association overall may mask heterogeneous benefits that accrue disproportionately to those with higher levels of education.