Do childhood and adult socioeconomic circumstances influence health and physical function in middle-age?

This study examines the joint and separate contribution of social class in early and adult life to differences in health and physical function in middle-aged men. We use data from the Metropolit project which includes men born in 1953 in Copenhagen and a study of middle-aged Danish twins (MADT). In total 6292 Metropolit participants in a follow-up survey on health in 2004 were included in the study together with 2198 male twins of which 1294 were part of a male twin pair (N = 647 pairs). Logistic regression was used to investigate the association between social class in early and adult life, respectively and health in midlife, measured as limitations in running 100 m, poor dental status, poor self-rated health, and fatigue. In both datasets, men with low childhood or adult social class had a higher risk of being unable to run 100 m, having poor dental status, having poor self-rated health and fatigue than men from the highest social classes. When childhood and adult social class were mutually adjusted, the estimates for both measures were attenuated. Adjustment for living without a partner, body mass index (BMI) and smoking in midlife, which were also related to the four outcomes, had marginal effects on the estimates for childhood social class, but attenuated the effect of adult social class somewhat. Among male twin pairs discordant on adult social class, the twin in the lowest class seemed to be unable to run 100 m, rate own health poorer and being fatigued more often than the high class co-twin, while there seemed to be no twin pair difference in dental status. This suggests that the associations of adult social class with functional limitations, poor self-rated health and fatigue may partly be due to causal effects related to adult social class exposures, while social class differences in dental status might be consistent with an effect of factors mainly operating early in life.     

Risk factors for overweight and obesity among Thai adults: results of the National Thai Food Consumption Survey

We evaluated the associations between overweight and obesity and socio-economic status (SES), behavioral factors, and dietary intake in Thai adults. A nationally representative sample of 6,445 Thais adults (18-70 years) was surveyed during 2004-2005. Information including demographics, SES characteristics, dietary intake, and anthropometrics were obtained. Overall, 35.0% of men, and 44.9% of women were overweight or obese (BMI ≥ 23 kg/m2) using the Asian cut-points. Regression models demonstrated that age was positively associated with being overweight in both genders. In gender-stratified analyses, male respondents who were older, lived in urban areas, had higher annual household income, and did not smoke were more likely to be classified as overweight and obese. Women who were older, had higher education, were not in a marriage-like relationship and were in semi-professional occupation were at greater risk for being overweight and obese. High carbohydrate and protein intake were found to be positively associated with BMI whereas the frequent use of dairy foods was found to be negatively associated with BMI among men. The present study found that SES factors are associated with being classified as overweight and obese in Thai adults, but associations were different between genders. Health promotion strategies regarding obesity and its related co-morbidity are necessary.     

E-books as a support for young children's language and literacy: the case of Hebrew-speaking children

In this paper, we present a series of studies performed in the last decade that examined the contribution of e-books reading to the language and literacy of young Hebrew-speaking children. Children worked with two e-books designed by the researchers to achieve this aim. We present the effect of reading these e-books on the language and literacy of young children: (a) in general, (b) in different socio-economic statues (SES) groups, (c) among children at risk for learning disabilities (ALD). Language progress was measured by phonological awareness, word meaning, story production and comprehension, and literacy progress was measured by letter naming, word reading and word writing. Results showed that the e-book reading supported all language and literacy skills, except letter naming. The progress of most skills appeared after three reading sessions. Children from middle- and low-SES families benefited from reading the e-books and in some cases, low-SES children were contributed more than those from a middle SES. ALD children improved their vocabulary, phonological awareness and concept about print when provided with an educational e-book. Further research and pedagogical implications for software developers and educators are discussed.     

Equity in Access to Health Care Services in Italy

ObjectiveTo provide new evidence on whether and how patterns of health care utilization deviate from horizontal equity in a country with a universal and egalitarian public health care system: Italy.ConclusionsDespite its universal and egalitarian public health care system, Italy exhibits a significant degree of SES-related horizontal inequity in health services utilization.     

航空官兵睡眠障碍状况及相关因素分析

目的:调查航空官兵睡眠障碍状况及相关因素,为改善航空官兵的睡眠质量提供依据。方法:采用整群分层抽样方法,以匹兹堡睡眠质量指数(PSQI)、自尊量表(SES)、压力知觉量表(PSS)、健康调查量表(SF-36)、艾森克人格问卷(EPQ)评定航空官兵的睡眠状况及其影响因素。结果:1PSQI7者390人,占29.37%,7≥PSQI5者229人,占17.24%;2PSQI总分与PSS总分(r=0.41,P0.01)、SES总分(r=0.22,P0.01)、生理机能(PF)(r=-0.14,P0.01)、生理职能(RP)(r=-0.28,P0.01)、躯体疼痛(BP)(r=-0.52,P0.01)、社会功能(SF)(r=0.23,P0.01)、情感职能(RE)(r=-0.326,P0.01)、健康变化(HT)(r=0.17,P0.01)、精神质(P)(F=2.32,P0.01)、神经质(N)(F=12.73,P0.01)、掩饰因子(L)(F=4.15,P0.01)存在相关性;3神经质、躯体疼痛、情感职能、健康变化、压力知觉量表总分进入线性回归方程。结论:航空官兵整体上存在睡眠障碍,应值得重视;其严重程度及发病情况受官兵的年龄、性格特点、对压力的感受性、心理状态及身体健康水平等多方面的影响,其中知觉压力的认知过程起到了介导作用。     

Dietary protein and protein-rich food in relation to severely depressed mood: A 10 year follow-up of a national cohort

High-protein diets are advocated to facilitate weight loss, and improve cardiovascular risk factors, but data on psychiatric effects are lacking. We analyzed data from 1947 men and 2909 women aged 25-74 years when examined in 1971-1975 as the baseline of the National Health and Nutrition Examination Follow-Up Study. The amounts of macronutrients were obtained from a 24-hour recall, and frequencies of eating protein-rich foods were estimated using a 3-month food frequency questionnaire. Severely depressed mood (SDM) was defined as Center for Epidemiologic Studies Depression Scale score ≥ 22 or taking anti-depression medication after an average of 10.6 years of follow-up. A significant gender difference was observed in the prevalence of SDM and its association with protein intake. The weighted prevalence of SDM was 11.45 (SE = 0.96) % and 17.45(1.05) % respectively among men and women. Among men, the relative risk (RRs) of SDM were 1.00, 0.46 (95% CI = 0.22-0.99) and 0.38 (0.16-0.92) respectively for the lowest, middle and highest third protein intake (p for trend = 0.0347). Among women, the RRs were 1.00, 1.93 (1.23-3.08) and 2.47 (1.24-4.90) respectively with lowest, middle and the highest third intakes (p for trend = 0.0023). These estimates were adjusted for cigarette smoking, alcohol consumption, BMI, socioeconomic status at baseline, and the history of cancer, stroke, heart attack and diabetes assessed at follow-up interview. The authors concluded that increased intake of protein demonstrated a protective effect among men but a deleterious effect among women.     

Socioeconomic and behavioral risk factors for mortality in a national 19-year prospective study of U.S. adults

Many demographic, socioeconomic, and behavioral risk factors predict mortality in the United States. However, very few population-based longitudinal studies are able to investigate simultaneously the impact of a variety of social factors on mortality. We investigated the degree to which demographic characteristics, socioeconomic variables and major health risk factors were associated with mortality in a nationally-representative sample of 3617 U.S. adults from 1986 to 2005, using data from the 4 waves of the Americans' Changing Lives study. Cox proportional hazard models with time-varying covariates were employed to predict all-cause mortality verified through the National Death Index and death certificate review. The results revealed that low educational attainment was not associated with mortality when income and health risk behaviors were included in the model. The association of low income with mortality remained after controlling for major behavioral risks. Compared to those in the “normal” weight category, neither overweight nor obesity was significantly associated with the risk of mortality. Among adults age 55 and older at baseline, the risk of mortality was actually reduced for those were overweight (hazard rate ratio = 0.83) and those who were obese (hazard rate ratio = 0.68), controlling for other health risk behaviors and health status. Having a low level of physical activity was a significant risk factor for mortality (hazard rate ratio = 1.58). The results from this national longitudinal study underscore the need for health policies and clinical interventions focusing on the social and behavioral determinants of health, with a particular focus on income security, smoking prevention/cessation, and physical activity.     

The relative importance of family socioeconomic status and school-based peer hierarchies for morning cortisol in youth: An exporatory study

This paper examines the relative importance of family socioeconomic status (SES) and school-based peer hierarchies for young people's psychoneuroendocrine response, represented by cortisol level. Data are drawn from a study of 2824, 15-year-olds in 22 Scottish secondary schools in 2006 who provided information on family SES (parental occupation, material deprivation and family affluence) and social position in school hierarchies, together with two morning salivary cortisol samples. School social position was assessed by participants placing themselves on seven ‘ladders’, from which three factors were derived, termed scholastic, peer and sports hierarchies. Controlling for confounds, there was little or no variation in cortisol by any SES measure. By contrast, each school hierarchy was independently associated with cortisol, but in different ways. For the scholastic hierarchy, an inverse linear relationship was found for females, cortisol increasing with lower position. For peer hierarchy, an opposite (direct) linear relationship occurred for males, while for females elevated cortisol was associated only with ‘top’ position. For sports, elevated cortisol among males was associated with ‘bottom’ position, among females with all except the ‘top’. These results are interpreted in the context of Sapolsky's (Sapolsky, 2005) predictions for stress responses to hierarchical position in stable and unstable social systems, the former represented by the scholastic hierarchy involving elevated cortisol in lower positions, the latter by peer hierarchy with elevated cortisol in higher positions. Overall, the results highlight the greater importance of school-based peer groups than family SES for young people's psychoneuroendocrine response.