Midlife health in Britain and the United States: a comparison of two nationally representative cohorts.

BACKGROUND: Older adults in the USA have worse health and wider socioeconomic inequalities in health compared with those in Britain. Less is known about how health in the two countries compares in mid-life, a time of emerging health decline, including inequalities in health. METHODS: We compare measures of current regular smoking status, obesity, self-rated health, cholesterol, blood pressure and glycated haemoglobin using population-weighted modified Poisson regression in the 1970 British Cohort Study (BCS70) in Britain (N = 9665) and the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the USA (N = 12 300), when cohort members were aged 34-46 and 33-43, respectively. We test whether associations vary by early- and mid-life socioeconomic position. RESULTS: US adults had higher levels of obesity, high blood pressure and high cholesterol. Prevalence of poor self-rated health and current regular smoking was worse in Britain. We found smaller socioeconomic inequalities in mid-life health in Britain compared with the USA. For some outcomes (e.g. smoking), the most socioeconomically advantaged group in the USA was healthier than the equivalent group in Britain. For other outcomes (hypertension and cholesterol), the most advantaged US group fared equal to or worse than the most disadvantaged groups in Britain. CONCLUSIONS: US adults have worse cardiometabolic health than British counterparts, even in early mid-life. The smaller socioeconomic inequalities and better overall health in Britain may reflect differences in access to health care, welfare systems or other environmental risk factors.

Midlife Health in Britain and the US: A comparison of Two Nationally Representative Cohorts.

Background: Older adults in the United States (US) have worse health and wider socioeconomic inequalities in health compared to Britain. Less is known about how health in the two countries compares in midlife, a time of emerging health decline, including inequalities in health. Methods: We compare measures of smoking status, alcohol consumption, obesity, self-rated health, cholesterol, blood pressure, and glycated haemoglobin using population-weighted modified Poisson regression in the 1970 British Cohort Study (BCS70) in Britain (N= 9,665) and the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the US (N=12,297), when cohort members were aged 34-46 and 33-43, respectively. We test whether associations vary by early- and mid-life socioeconomic position. Findings: US adults had higher levels of obesity, high blood pressure and high cholesterol. Prevalence of poor self-rated health, heavy drinking, and smoking was worse in Britain. We found smaller socioeconomic inequalities in midlife health in Britain compared to the US. For some outcomes (e.g., smoking), the most socioeconomically advantaged group in the US was healthier than the equivalent group in Britain. For other outcomes (hypertension and cholesterol), the most advantaged US group fared equal to or worse than the most disadvantaged groups in Britain. Interpretation: US adults have worse cardiometabolic health than British counterparts, even in early midlife. The smaller socioeconomic inequalities and better overall health in Britain may reflect differences in access to health care, welfare systems, or other environmental risk factors. Funding: ESRC, UKRI, MRC, NIH, European Research Council, Leverhulme Trust.

Stressful life events and depressive symptoms in mothers and fathers of young children.

BACKGROUND: Parents of young children generally report more depressive symptoms than parents of adult children or people without children, mainly because the presence of young children increases exposure to significant stressors (such as stressful life events). However, most studies on the depressogenic role of stressful life events in parents of young children have focussed on mothers. METHODS: Using data from 1138 families with young children in Norway, we investigated gender differences in the effect of stressful life events after a child's birth on the development of parental depressive symptoms in 3 follow-ups at child's ages 3-6 years. We also explored if gender differences in disposition (personality) may explain any gender differences in the depressogenic effect of life events. RESULTS: Nesting parents within families, we found a female gender bias for both neuroticism and depressive symptoms but no gender difference in the number of life events reported. Importantly, the number of stressful life events predicted the level and course of depressive symptoms similarly for mothers and fathers. Personality traits did not change the association between stressful life events and depressive symptoms in either mothers or fathers. LIMITATIONS: Given the study design, causality cannot be inferred. CONCLUSIONS: There was no gender difference in the depressogenic effect of stressful life events in our sample. There was no evidence for a female dispositional sensitivity to the depressogenic effect of stressful life events, either. Stressful life events put both mothers and fathers of young children at risk of depression.

Associations between maternal and paternal depressive symptoms and early child behavior problems: Testing a mutually adjusted prospective longitudinal model.

BACKGROUND: While there is substantial empirical work on maternal depression, less is known about how mothers' and fathers' depressive symptoms compare in their association with child behavior problems in early childhood. In particular, few studies have examined unique relationships in the postpartum period by controlling for the other parent, or looked at longitudinal change in either parent's depressive symptoms across the first living years as a predictor of child problems. METHODS: We examined depressive symptoms in parents at 6, 12, 24, 36 and 48 months following childbirth, and child behavior problems at 48 months. Linear growth curve analysis was used to model parents' initial levels and changes in symptoms across time and their associations with child outcomes. RESULTS: Mothers' depressive symptoms at 6 months predicted behavior problems at 48 months for all syndrome scales, while fathers' did not. Estimates for mothers' symptoms were significantly stronger on all subscales. Change in fathers' depressive symptoms over time was a significantly larger predictor of child aggressive behavior than corresponding change in mothers'. No interaction effects between parents' symptoms on behavior problems appeared, and few child gender differences. LIMITATIONS: Child behavior was assessed once precluding tests for bidirectional effects. We only looked at linear change in parental symptoms. CONCLUSIONS: Mothers' postpartum depressive symptoms are a stronger predictor for early child behavior problems than fathers'. Change in fathers' depressive symptoms across this developmental period was uniquely and strongly associated with child aggressive problems, and should therefore be addressed in future research and clinical practice.

The Relationship Between Father Involvement and Child Problem Behaviour in Intact Families: A 7-Year Cross-Lagged Study.

This study investigated the cross-lagged relationship between father involvement and child problem behaviour across early-to-middle childhood, and tested whether temperament modulated any cross-lagged child behaviour effects on father involvement. It used data from the first four waves of the UK's Millennium Cohort Study, when children (50.3 % male) were aged 9 months, and 3, 5 and 7 years. The sample was 8302 families where both biological parents were co-resident across the four waves. Father involvement (participation in play and physical and educational activities with the child) was measured at ages 3, 5 and 7, as was child problem behaviour (assessed with the Strengths and Difficulties Questionnaire). Key child and family covariates related to father involvement and child problem behaviour were controlled. Little evidence was found that more father involvement predicted less child problem behaviour two years later, with the exception of father involvement at child's age 5 having a significant, but small, effect on peer problems at age 7. There were two child effects. More hyperactive children at age 3 had more involved fathers at age 5, and children with more conduct problems at age 3 had more involved fathers at age 5. Child temperament did not moderate any child behaviour effects on father involvement. Thus, in young, intact UK families, child adjustment appears to predict, rather than be predicted by, father involvement in early childhood. When children showed more problematic behaviours, fathers did not become less involved. In fact, early hyperactivity and conduct problems in children seemed to elicit more involvement from fathers. At school age, father involvement appeared to affect children's social adjustment rather than vice versa.

Mediators of change in the Child/Adolescent Anxiety Multimodal Treatment Study.

OBJECTIVE: Test changes in (a) coping efficacy and (b) anxious self-talk as potential mediators of treatment gains at 3-month follow-up in the Child/Adolescent Anxiety Multimodal Treatment Study (CAMS). METHOD: Participants were 488 youth (ages 7-17; 50.4% male) randomized to cognitive-behavioral therapy (CBT; Coping cat program), pharmacotherapy (sertraline), their combination, or pill placebo. Participants met Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Coping efficacy (reported ability to manage anxiety provoking situations) was measured by youth and parent reports on the Coping Questionnaire, and anxious self-talk was measured by youth report on the Negative Affectivity Self-Statement Questionnaire. Outcome was measured using the Pediatric Anxiety Rating Scale (completed by Independent Evaluators blind to condition). For temporal precedence, residualized treatment gains were assessed at 3-month follow-up. RESULTS: Residualized gains in coping efficacy mediated gains in the CBT, sertraline, and combination conditions. In the combination condition, some unique effect of treatment remained. Treatment assignment was not associated with a reduction in anxious self-talk, nor did anxious self-talk predict changes in anxiety symptoms. CONCLUSIONS: The findings suggest that improvements in coping efficacy are a mediator of treatment gains. Anxious self-talk did not emerge as a mediator.