Early childhood health,reproduction of economic inequalities and the persistence of health and mortality differentials

The persistence of adult health and mortality socioeconomic inequalities and the equally stubborn reproduction of social class inequalities are salient features in modern societies that puzzle researchers in seemingly unconnected research fields. Neither can be satisfactorily explained with standard theoretical frameworks. In the domain of health and mortality, it is unclear if and to what an extent adult health and mortality disparities across socioeconomic status (SES) are the product of attributes of the positions themselves, the partial result of health conditions established earlier in life that influence both adult health and economic success, or the outcome of the reverse impact of health status on SES. In the domain of social stratification, the transmission of inequalities across generations has been remarkably resistant to satisfactory explanations. Although the literature on social stratification is by and large silent about the role played by early health status in shaping adult socioeconomic opportunities, new research on human capital formation suggests this is a serious error of omission. In this paper we propose to investigate the connections between these two domains. We use data from male respondents of the 1958 British Cohort to estimate (a) the influence of early health conditions on adult SES and (b) the contribution of early health status to observed adult health differentials. The model incorporates early conditions as determinants of traits that enhance (inhibit) social mobility and also conventional and unconventional factors that affect adult health and socioeconomic status. Our findings reveal that early childhood health plays a small, but non-trivial role as a determinant of adult SES and the adult socioeconomic gradient in health. These findings enrich current explanations of SES inequalities and of adult health and mortality disparities.     

Trajectories of BMI and internalizing symptoms: Associations across adolescence

The present study examined the longitudinal relations between body mass index (BMI) and internalizing symptoms among youth ages 10–17. Adolescents were selected from Statistics Canada's National Longitudinal Survey of Children and Youth (NLSCY). Latent growth curve modeling was used to investigate: 1) whether initial level (at age 10) or change in BMI were associated with changes in internalizing symptoms; and, 2) whether initial level or change in internalizing symptoms were associated with changes in BMI across adolescence. Associations between trajectories differed for boys and girls. Boys who started out with higher BMI experienced more internalizing symptoms across early- to mid-adolescence, but not more depressive symptoms at ages 16 and 17. For girls, there was a bidirectional relation between BMI and internalizing symptoms which persisted into later adolescence. Results suggest the bidirectional relation between BMI and internalizing symptoms is more salient for girls than for boys.     

理性情绪疗法对精神分裂症后抑郁患者心理状态的影响

目的：探讨理性情绪疗法对精神分裂症后抑郁患者心理状态的影响。方法将84例精神分裂症后抑郁患者分为两组,每组42例。两组均予以精神科常规治疗及健康宣教,研究组在此基础上联合理性情绪疗法治疗。观察6周。于治疗前后采用自尊量表、自我接纳问卷、汉密顿抑郁量表评定干预效果。结果治疗后两组汉密顿抑郁量表评分均较治疗前显著降低（P＜0．05或0．01）,研究组显著低于对照组（ P＜0．05）;自尊量表、自我接纳问卷评分均较治疗前显著升高（P＜0．05或0．01）,研究组显著高于对照组（P＜0．05）。结论理性情绪疗法能显著改善精神分裂症后抑郁患者的抑郁情绪,提高其自尊水平及自我接纳程度。     

Prevalence and Distribution of Caries in a Jerusalem Adolescent Population by Age, Sex, and Family Income

Four hundred and fourteen high school students aged 12-17 were examined clinically using the DMFS index and bitewing radiographs. Analyses by age, sex, economic status, and types of teeth and tooth surfaces were performed and results were compared with other international studies. Only 7.5 percent of the study population had a zero DMFS score. Females had a significantly higher DMFS score than males (13.21 vs 9.59). Caries experience increased with age and a general trend of increasing DMFS was observed with increasing levels of income. Socioeconomic status (SES) was related directly to DMFS in Israel, in contrast to an inverse relationship observed in most other western countries. First molars were most susceptible to caries attack and accounted for 41.2 percent of the total DMFS. Almost 50 percent of all affected surfaces were occlusal and 29.4 percent were proximal. Caries prevalence in general and proximal caries in particular were found to be much higher in the study population than corresponding figures in other industrialized countries. A significant decrease in caries prevalence could be expected in Israel in the next decade if primary preventive measures are implemented immediately.     

Explaining social inequalities in health by sleep: the Japanese civil servants study

BACKGROUND: Individuals of low socioeconomic status (SES) are likely to have poor sleep and poor health. This study aims to evaluate whether and how much of the socioeconomic differences in health are explained by sleep. METHODS: The subjects were 3684 (2471 males and 1213 females) employees aged 20-65 working in local government in Japan. A questionnaire survey was conducted in January 2003. Analysis of covariance (ANCOVA) was performed to examine the association of employment-grade with sleep, measured by the Pittsburgh Sleep Quality Index (PSQI), and with health, measured by the Physical and Mental Component Summary Scales (PCS and MCS) of the Short Form-36 (SF-36). RESULTS: In men, higher grade employees had better sleep and better health. The age-adjusted difference between the highest and the lowest grade employees was 1.9 points (95% confidence interval = 1.0-3.0) in the PCS and 3.4 points (1.8-4.9) in the MCS. The grade difference in health reduced to 1.5 points (0.5-2.5) in the PCS (21.1% reduction) and 2.0 points (0.6-3.4) in the MCS (41.2% reduction), when the PSQI global score was adjusted for. The grade differences in sleep quality contributed more to the health inequalities than sleep quantity. Among women, no significant grade differences were observed in the PSQI global score. The grade differences in the PCS and MCS were weaker and less consistent than those of men, and the differences hardly changed when the PSQI global score was adjusted for. CONCLUSION: Sleep quality may mediate the relationship between SES and physical and, in particular, mental health in men.     

Low birth weight and psychiatric morbidity; stability and change between adolescence and young adulthood

Background

Being born with low birth weight is a risk factor for psychiatric morbidity.Few longitudinal studies have included diagnostic assessment and followed subjects into adulthood.

Aim

To assess stability and change in psychiatric morbidity between adolescence and young adulthood in low birth weight subjects, and explore whether screening in adolescence can predict subsequent psychopathology in these groups.

Study design

Prospective geographically based follow-up study of two low birth weight groups and a control group born between 1986 and 1988, assessed at 14 (T1) and 20 (T2) years of age.

Subjects

Thirty eight subjects born preterm with very low birth weight (VLBW: ≤ 1500 g), 43 born at term but small for gestational age (SGA: < 10th percentile) and 64 controls with normal birth weight participated.

Outcome measures

Mental health was assessed using diagnostic psychiatric interview at both study points supplemented with the Achenbach System of Empirically Based Assessment and Children's Global Assessment Scale at T1.

Results

There was a trend towards increasing morbidity from T1 among VLBW (p = 0.086) and a significant increase among SGA (p = 0.003) participants. Supplementary assessment at T1 discriminated satisfactory between persons with and without psychiatric disorders at T2 (area under ROC curve: 0.66 to 0.89), but was most effective in the VLBW group.

Conclusion

High psychiatric morbidity continued into young adulthood in the VLBW group and increased significantly in the SGA group. Screening in adolescence can be used to detect individuals at risk especially among those born at very low birth weight.     

完美主义与自尊、应对方式的关系研究

目的探讨大学生完美主义与自尊和应对方式的关系。方法以南京3所大学的496名大学生为研究对象,采用大学生完美主义量表修订版、自尊量表(SES)以及应付方式问卷施测,用SPSS与AMOS进行统计分析。结果相关分析与结构方程模型检验显示完美主义与自尊呈显著负相关,自尊与消极应对方式呈显著负相关,以自尊为中介变量的部分中介模型的拟合指数:χ2=135.146、df=33、χ2/df=4.095、RMSEA=0.079、CFI=0.937、NFI=0.920。各项指标比较理想,较准确的反映了三者之间的关系。结论自尊在完美主义与消极应对之间起部分中介作用。自尊较好地缓解了完美主义者高标准没有达到时的负性心理,使其向积极的情绪转化,从而采取积极的应对方式。     

Socioeconomic Status and Alcohol Use Among Urban and Rural Residents in China

The association between socioeconomic status (SES) and current regular alcohol use was examined separately for urban and rural residents of Hubei, China, using the third Chinese National Health Service Survey conducted in 2003. A probability sample of 15,609 respondents, ages 15 through 101 years, was selected from the study base. Alcohol use was a dichotomized variable (current regular users vs. others). Multivariate analyses incorporated four SES indicators: income, education, occupation, and house size. Investigation of status discrepancy indicated that income was positively associated with the likelihood of current regular alcohol use, whereas education was negatively associated. For both urban and rural residents, likelihood of current regular alcohol use was smallest for those in the highest education and lowest income category. Further research, which factors in quantity and frequency, is needed to understand how alcohol use among Chinese urban and rural populations impacts their health.