Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 32
Filtrar
1.
Prev Med ; 185: 108048, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38906275

RESUMO

OBJECTIVE: Utilizing national longitudinal data, this study examines how polygenic depression risk and childhood abuse interactively influence the life-course development of depressive conditions from middle to late adulthood. METHOD: Data from 7512 participants (4323 females and 3189 males) of European ancestry aged 51-90, retrieved from the U.S. Health and Retirement Study (1992-2020), were analyzed. Childhood physical abuse and polygenic depression score were the primary predictors. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression (CESD) scale, and clinical depression risk was a binary indicator. Growth-curve linear mixed and logit mixed-effects models were conducted for analysis. RESULTS: Increasing polygenic depression scores were associated with elevated CES-D levels and potential risks of clinical depression. Males experienced more detrimental effects of childhood abuse on depression development from ages 51 to 90 years. In contract, non-maltreated females generally exhibited higher depressive symptoms and clinical depression risk than males. A significant interactive effect was found between polygenic depression risk and childhood abuse among males. Higher depression levels and clinical risk were observed with increasing polygenic depression score among maltreated males, surpassing those of females with standardized polygenic score ≥0 from age 51 to 90 years. CONCLUSIONS: The interaction between childhood abuse and genetic factors significantly shaped lifelong depression trajectories in males, while the negative impact of abusive parenting remained constant regardless of polygenic depression risk among females. Individualized prevention and intervention strategies could be crucial in mitigating lifelong depression development, especially for high-genetic-risk males with a history of childhood physical abuse.


Assuntos
Depressão , Interação Gene-Ambiente , Humanos , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Estudos Longitudinais , Depressão/epidemiologia , Depressão/genética , Estados Unidos/epidemiologia , Idoso de 80 Anos ou mais , Herança Multifatorial , Fatores de Risco , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia
2.
J Affect Disord ; 359: 277-286, 2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-38772508

RESUMO

BACKGROUND: Mental health deteriorated in the early stages of the COVID-19 pandemic, but improved relatively quickly as restrictions were eased, suggesting overall resilience. However, longer-term follow-up of mental health in the general population is scarce. METHODS: We examined mental health trajectories in 5624 adults (58 % women; aged 18-97 years) from the Specchio-COVID19 cohort, using the Generalized Anxiety Disorder scale-2 and the Patient Health Questionnaire-2, administered each month from February to June 2021, and in Spring 2022 and 2023. RESULTS: Depressive and anxiety symptoms declined during a pandemic wave from February to May 2021 (ß = -0.06 [-0.07, -0.06]; -0.06 [-0.07, -0.05]), and remained lower at longer-term follow-up than at the start of the wave. Loneliness also declined over time, with the greatest decline during the pandemic wave (ß = -0.25 [-0.26, -0.24]). Many higher-risk groups, including socioeconomically disadvantaged individuals, those with a chronic condition, and those living alone had poorer mental health levels throughout the study period. Women and younger individuals had a faster improvement in mental health during the pandemic wave. Loneliness trajectories were associated with mental health trajectories throughout the study period. LIMITATIONS: We cannot definitively conclude that the observed changes in mental health were due to experiences of the pandemic. CONCLUSIONS: While there was a need for additional mental health support during stricter policy responses to COVID-19, overall, mental health improved relatively soon after measures were eased. Nevertheless, the persistence of mental health disparities highlights the need for further efforts from the government and healthcare practitioners to support vulnerable groups beyond the pandemic.


Assuntos
Ansiedade , COVID-19 , Depressão , Solidão , Saúde Mental , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Feminino , Adulto , Pessoa de Meia-Idade , Masculino , Idoso , Suíça/epidemiologia , Idoso de 80 Anos ou mais , Adolescente , Adulto Jovem , Saúde Mental/estatística & dados numéricos , Ansiedade/epidemiologia , Ansiedade/psicologia , Solidão/psicologia , Depressão/epidemiologia , Depressão/psicologia , SARS-CoV-2 , Fatores de Risco
3.
Neurosci Biobehav Rev ; 162: 105697, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38710422

RESUMO

The lifespan is influenced by adverse childhood experiences that create predispositions to poor health outcomes. Here we propose an allostatic framework of childhood experiences and their impact on health across the lifespan, focusing on Latin American and Caribbean countries. This region is marked by significant social and health inequalities nested in environmental and social stressors, such as exposure to pollution, violence, and nutritional deficiencies, which critically influence current and later-life health outcomes. We review several manifestations across cognition, behavior, and the body, observed at the psychological (e.g., cognitive, socioemotional, and behavioral dysfunctions), brain (e.g., alteration of the development, structure, and function of the brain), and physiological levels (e.g., dysregulation of the body systems and damage to organs). To address the complexity of the interactions between environmental and health-related factors, we present an allostatic framework regarding the cumulative burden of environmental stressors on physiological systems (e.g., cardiovascular, metabolic, immune, and neuroendocrine) related to health across the life course. Lastly, we explore the relevance of this allostatic integrative approach in informing regional interventions and public policy recommendations. We also propose a research agenda, potentially providing detailed profiling and personalized care by assessing the social and environmental conditions. This framework could facilitate the delivery of evidence-based interventions and informed childhood-centered policy-making.


Assuntos
Alostase , Humanos , Alostase/fisiologia , América Latina/epidemiologia , Experiências Adversas da Infância , Estresse Psicológico
4.
J Aging Health ; : 8982643241255739, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38768641

RESUMO

OBJECTIVES: Guided by a life course perspective and fundamental cause theory, this study aims to visualize co-trajectories of health between partners and examine how changes in one spouse's cognitive status can cohesively impact the health of the other spouse along three dimensions (functional, mental, and cognitive). METHODS: Drawing longitudinal data from the Health and Retirement Study 2000-2016 (N = 3582), we measure women's health profiles by functional limitation (physical health), depression (mental health), and cognitive function (cognitive health). We use multivariate linear mixed models to summarize these paths in the same visual representation. RESULTS: The approach provides a visualization tool that depicts data and model in the same spatial representation allowing assessment of model fit and comparison. This study advances the traditional life course studies by representing underlying processes as a multidimensional time vector of health outcomes. DISCUSSION: The described approach provides a blueprint for studying complex health profiles or trajectories.

5.
Health Psychol Res ; 12: 115356, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38533343

RESUMO

Objective: This study aims to identify motivators influencing individuals' commitment to maintaining positive health trajectories across different demographics. The primary objective is to leverage this knowledge to enhance patient-physician relationships and improve the quality of care. Methods: A web-based survey collected data from 204 randomly selected participants aged 16 and older. The survey assessed participants' self-rated health, health-related habits, and motivators for a healthy lifestyle. Open-ended responses were included. Results: Participants had a mean self-rated health score of 6.24 (scale: one to ten). Motivation scores for health-related factors averaged 3.25 (scale: one to five), with caregiving responsibility scoring 3.07 (scale: one to five), mainly among women. Motivators related to personal productivity and values scored 3.44 (scale: one to five), while cultural or religious beliefs scored lowest at 2.89 (scale: one to five). Common themes from free responses included longevity, quality of life, personal well-being, family, independence, prevention of complications, health goals, finances, and faith, listed by frequency. Among participants, only 30% had chronic diseases, but 80% of those with chronic conditions were motivated to improve their health. Conclusion: This survey gathered valuable data on motivators for maintaining positive health trajectories. The findings have implications for improving patient-physician relationships and healthcare delivery. Understanding individuals' motivators can inform tailored interventions and personalized care approaches.

6.
Lancet Reg Health Eur ; 34: 100717, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37927425

RESUMO

Background: Chronic obstructive pulmonary disease (COPD) is the most common indication for long-term domiciliary non-invasive ventilation (NIV) but there is uncertainty in data supporting current guidelines. This study described health trajectories before initiation of at-home NIV in people with COPD, and compared mortality outcomes between groups with different pre-NIV health trajectories. Methods: Data were from the French national health insurance reimbursement system database for individuals with COPD aged ≥40 years and ≥1 reimbursement for NIV between 1 January 2015 and 31 December 2019. Common health trajectories were determined using time sequence analysis through K-clustering (TAK analysis). Findings: Data from 54,545 individuals were analysed; the population was elderly (median age 70 years) with multiple comorbidities. Four clusters were generated. Cluster 1 (n = 35,975/54,545; 66%) had NIV initiated in ambulatory settings or after the first acute event/exacerbation. Cluster 2 (6653/54,545; 12%) started NIV after ≥2 severe exacerbations in the previous 6 months. Cluster 3 (11,375/54,545; 21%) started NIV after frequent severe COPD-related exacerbations in the previous year. Cluster 4 (652/54,545; 1%) started NIV after many long-lasting severe exacerbations. The four clusters differed in age, sex, comorbidities, pre-NIV investigations, and prescriber/location of NIV initiation. Mortality differed significantly between clusters: highest in Cluster 4 and lowest in Cluster 1. Interpretation: The significant heterogeneity in clinical initiation of NIV probably reflects the current lack of strong evidence and guideline recommendations. Knowledge about the characteristics and outcomes in different clusters should be used to address inequities and facilitate more consistent and personalised use domiciliary NIV in COPD. Funding: JLP and SB are supported by the French National Research Agency in the framework of the "Investissements d'avenir" program (ANR-15-IDEX-02) and the "e-health and integrated care and trajectories medicine and MIAI artificial intelligence (ANR-19-P3IA-0003)" Chairs of excellence from the Grenoble Alpes University Foundation. This work was supported by ResMed.

7.
Front Public Health ; 11: 1214141, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37927862

RESUMO

Introduction: Applying variable-centered analytical approaches, several studies have found an association between civic engagement and youth mental health. In the present study, we used a person-centered approach to explore whether civic engagement was related to optimal trajectories of mental health compared to other trajectories. We also examined how sociodemographic factors, such as socioeconomic status (SES), gender and age were related to youth mental health trajectories. Methods: Our sample comprised 675 students (aged 16-22) who had participated in three waves of data collection (Mage = 18.85, SD = 0.55; 43% males) in the COMPLETE project, a cluster-randomized controlled trial that involved Norwegian upper secondary schools. Results: The results revealed three trajectories of mental health (reflecting a combination of mental distress and mental well-being): optimal, intermediate, and sub-optimal. Contrary to our expectations, higher levels of civic engagement were not related to the optimal trajectory of mental health vs. other trajectories. However, we found that students who reported higher levels of SES and males were more likely to follow the optimal trajectory compared to other trajectories. Discussion: While the findings on civic engagement could be due to our measurement's inability to capture the concept of "dugnad," a well-established civic activity in the Norwegian society, the findings regarding the influence of SES and gender suggest that there is still more work to be done concerning the assessment and advancement of factors that can address mental health inequalities across SES and gender.


Assuntos
Comportamento do Adolescente , Saúde Mental , Masculino , Humanos , Adolescente , Feminino , Comportamento do Adolescente/psicologia , Classe Social , Estudantes/psicologia , Instituições Acadêmicas
8.
Qual Life Res ; 32(10): 2899-2909, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37140774

RESUMO

PURPOSE: Mental health and well-being trajectories are not expected to be homogeneous in diverse clinical populations. This exploratory study aims to identify subgroups of patients with cancer receiving radiation therapy who have different mental health and well-being trajectories, and examine which socio-demographic, physical symptoms, and clinical variables are associated with such trajectories. METHODS: Retrospective analysis of radiation therapy patients diagnosed with cancer in 2017 was conducted using data from the Ontario Cancer Registry (Canada) and linked with administrative health data. Mental health and well-being were measured using items from the Edmonton Symptom Assessment System-revised questionnaire. Patients completed up to 6 repeated measurements. We used latent class growth mixture models to identify heterogeneous mental health trajectories of anxiety, depression, and well-being. Bivariate multinomial logistic regressions were conducted to explore variables associated with the latent classes (subgroups). RESULTS: The cohort (N = 3416) with a mean age of 64.5 years consisted of 51.7% females. Respiratory cancer was the most common diagnosis (30.4%) with moderate to severe comorbidity burden. Four latent classes with distinct anxiety, depression, and well-being trajectories were identified. Decreasing mental health and well-being trajectories are associated with being female; living in neighborhoods with lower income, greater population density, and higher proportion of foreign-born individuals; and having higher comorbidity burden. CONCLUSIONS: The findings highlight the importance of considering social determinants of mental health and well-being, in addition to symptoms and clinical variables, when providing care for patients undergoing radiation therapy.


Assuntos
Saúde Mental , Neoplasias , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Estudos Retrospectivos , Ontário/epidemiologia , Qualidade de Vida/psicologia , Estudos de Coortes , Neoplasias/radioterapia , Medidas de Resultados Relatados pelo Paciente , Depressão/epidemiologia , Depressão/psicologia
9.
J Child Psychol Psychiatry ; 63(8): 948-956, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34856637

RESUMO

BACKGROUND: Joint developmental trajectories of internalizing and externalizing problems show considerable heterogeneity; however, this can be parsed into a small number of meaningful subgroups. Doing so offered insights into risk factors that lead to different patterns of internalizing/externalizing trajectories. However, despite both domains of problems showing strong heritability, no study has yet considered genetic risks as predictors of joint internalizing/externalizing problem trajectories. METHODS: Using parallel process latent class growth analysis, we estimated joint developmental trajectories of internalizing and externalizing difficulties assessed across ages 4 to 16 using the Strengths and Difficulties Questionnaire. Multinomial logistic regression was used to evaluate a range of demographic, perinatal, maternal mental health, and child and maternal polygenic predictors of group membership. Participants included 11,049 children taking part in the Avon Longitudinal Study of Parents and Children. Polygenic data were available for 7,127 children and 6,836 mothers. RESULTS: A 5-class model was judged optimal: Unaffected, Moderate Externalizing Symptoms, High Externalizing Symptoms, Moderate Internalizing and Externalizing Symptoms and High Internalizing and Externalizing Symptoms. Male sex, lower maternal age, maternal mental health problems, maternal smoking during pregnancy, higher child polygenic risk scores for ADHD and lower polygenic scores for IQ distinguished affected classes from the unaffected class. CONCLUSIONS: While affected classes could be relatively well separated from the unaffected class, phenotypic and polygenic predictors were limited in their ability to distinguish between different affected classes. Results thus add to existing evidence that internalizing and externalizing problems have mostly shared risk factors.


Assuntos
Mães , Herança Multifatorial , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Gravidez , Fatores de Risco , Fumar
10.
J Am Med Dir Assoc ; 23(5): 858-864.e5, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34555338

RESUMO

OBJECTIVES: It is inconsistent in the literature on whether inequalities of health in older age widen or narrow over time. We assessed the associations of socioeconomic status (SES), physical functioning, and mortality in an older age cohort in Hong Kong. DESIGN: Longitudinal cohort study. SETTING AND PARTICIPANTS: We recruited 2032 older adults aged 70+ in 1991 to 1992 and followed them for 10 years. METHODS: SES was operationalized as education, baseline individual income, and longest-held occupation in lifetime. Physical functioning was measured by Barthel's Index for activities of daily living (ADL), from which disability was defined as ADL score <20. Mortality data were obtained from the Death Registry. Bayesian joint modeling with 2 sub-models, mixed-effect, and Cox proportional hazard model, were used to respectively model the associations of SES and disability, and SES and mortality, accounting for selection by mortality. RESULTS: Education and income at baseline were not clearly related to disability, but those with lower education level and income at baseline tended to have their risks increased with time. Older adults who had been mostly economically inactive or unemployed in their lifetime had higher risk of disability [odds ratio 3.24; 95% credible interval (95%CrI) 1.29 to 7.97], and such risk increased over time. For mortality, older adults with no schooling were at higher risk compared with those with secondary education or above (hazard ratio 1.25; 95%CrI 1.00 to 1.57). Income at baseline and longest-held occupation in lifetime were not clearly related to mortality. CONCLUSIONS AND IMPLICATIONS: We observed inequalities of health of older adults in Hong Kong that widened as they age. Community and medical interventions targeting the older adults with the lowest SES would be important to prevent their more rapid decline in physical functioning.


Assuntos
Atividades Cotidianas , Classe Social , Idoso , Teorema de Bayes , Estudos de Coortes , Hong Kong/epidemiologia , Humanos , Estudos Longitudinais , Fatores Socioeconômicos
11.
Adv Life Course Res ; 49: 100415, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34733129

RESUMO

Drawing on life course theory and research, we explored how socioeconomic circumstances during childhood and adulthood shape self-reported health trajectories among older Mexican adults. We used data from the Mexican Health and Aging Study panel survey (2001-2015) and used sequence analysis to estimate types of self-reported health trajectories in older adulthood. We then explored the association between those health trajectories and socioeconomic determinants at different life stages, including education, occupation, employment, economic status, parental education, and adverse living conditions and illnesses during childhood. Our contributions are threefold. First, we identified four types of health trajectories for men and eight for women, representing a more nuanced longitudinal health status profile than previously shown. Second, we found that childhood and adult socioeconomic circumstances influence self-reported health trajectories at older age. Third, our results suggest there is no simple monotonic relationship between life course circumstances and self-reported health trajectories.


Assuntos
Emprego , Nível de Saúde , Adulto , Idoso , Envelhecimento , Escolaridade , Feminino , Humanos , Masculino , Fatores Socioeconômicos
12.
Prev Med Rep ; 24: 101510, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34430192

RESUMO

Self-rated health (SRH), individuals' overall perception of their health, is a key predictor of health events. To target disease prevention efforts, it is important to understand how SRH develops over time. The goal of this short communication is to find prototypic SRH trajectories by applying dynamic time warping, a time series comparison technique initially developed for speech recognition. Revealing prototypic SRH trajectories can help direct disease prevention efforts towards trajectories that are more likely to result in adverse health events. Based on data from a Dutch representative sample of 2,154 individuals, our dynamic time warp analysis suggests that Dutch individuals do not typically show a steady growth or decline in SRH. Instead, we identified four relatively stable SRH trajectories that differed in average SRH. One of these trajectories is a path of consistent low SRH.

13.
Biometrics ; 77(1): 78-90, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32162300

RESUMO

Large amounts of longitudinal health records are now available for dynamic monitoring of the underlying processes governing the observations. However, the health status progression across time is not typically observed directly: records are observed only when a subject interacts with the system, yielding irregular and often sparse observations. This suggests that the observed trajectories should be modeled via a latent continuous-time process potentially as a function of time-varying covariates. We develop a continuous-time hidden Markov model to analyze longitudinal data accounting for irregular visits and different types of observations. By employing a specific missing data likelihood formulation, we can construct an efficient computational algorithm. We focus on Bayesian inference for the model: this is facilitated by an expectation-maximization algorithm and Markov chain Monte Carlo methods. Simulation studies demonstrate that these approaches can be implemented efficiently for large data sets in a fully Bayesian setting. We apply this model to a real cohort where patients suffer from chronic obstructive pulmonary disease with the outcome being the number of drugs taken, using health care utilization indicators and patient characteristics as covariates.


Assuntos
Algoritmos , Registros Eletrônicos de Saúde , Teorema de Bayes , Humanos , Cadeias de Markov , Método de Monte Carlo
14.
Health Soc Care Community ; 28(5): 1448-1458, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32097535

RESUMO

Commercially sexually exploited youth and young adults (hereafter CSEY) are at high risk for various health adversities, but little is known about interventions that can improve their health outcomes. This study reports changes in health behaviours-positive health behaviours, drug use and risky sexual behaviour-in the first stages of treatment of 122 participants in a comprehensive multi-module program for CSEY in Israel. Data included sociodemographic and background information upon program entry, monthly reports on the treatment the participants received and their status. Data were collected monthly through online questionnaires completed by case managers for each of the CSEY in their care. A three-part analytic strategy assessed changes in repeated measures over time and their contributors. Latent class analysis helped identify differential trajectories of change over time among different participant groups. Findings showed overall significant decrease in risky sexual behaviours and improvement in positive health behaviours among certain CSEY groups. Participants with higher levels of health-risk situations and behaviour at program entry (e.g. more victimisation, less residential safety) were more likely to show improvement in health behaviours during intervention, but less likely to change their moderately risky sexual behaviours. Program participants with high levels of drug use did not show improvement in drug use patterns over time. This study demonstrates that a comprehensive multi-module intervention for CSEY can significantly improve health behaviour outcomes among serviced CSEY, and highlights the value of person-oriented care, and of research that can detect vulnerable subpopulations within CSEY who require uniquely tailored interventions. Personalising treatment to specific differential needs of CSEY, coupled with early detection and intervention, can improve program outcomes. Further research is needed to understand contributors to change and changes in subsequent health outcomes.


Assuntos
Comportamentos Relacionados com a Saúde , Assunção de Riscos , Trabalho Sexual/psicologia , Comportamento Sexual/psicologia , Adolescente , Feminino , Humanos , Israel , Masculino , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
15.
Prev Med ; 133: 106025, 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32061683

RESUMO

Health projections often extrapolate from observations in current ageing cohorts, but health in older age may depend not only on individual characteristics but also on a person's historical context. Our objective was to investigate how health deficit accumulation trajectories after age 65 differed in five adjacent birth cohorts and according to individual life course characteristics. Data originate from the 2008/09 KORA (Cooperative Health Research in the Region of Augsburg)-Age cohort study from Southern Germany and their 2012 and 2016 follow-ups. Deficit accumulation was assessed using a Frailty Index. The effects of birth cohort membership and individual life course characteristics on deficit accumulation trajectories were analyzed using generalized linear mixed models. Out of 2701 participants (49% male) from five birth cohorts (1919-23, 1924-28, 1929-33, 1934-38, 1939-43), we included 2512 individuals with 5560 observations. Frailty Index levels were higher for women, smokers, alcohol abstainers, obese participants and persons with a sedentary lifestyle or living below the poverty threshold. We found higher age-specific Frailty Index levels for the two most recent birth cohorts (e.g. 61%, CI: [13%; 130%] for the 1934-38 as compared to the 1919-23 cohort), but the rate of deficit accumulation with age (7% per life year, (CI: [5%, 9%]) was cohort-independent. Results indicate that the historical context (birth cohort membership) may influence the number of accumulated health deficits after age 65 in addition to poverty and other individual life course characteristics, but BMI, physical activity and smoking remain the modifiable risk factors offering the highest prevention potential.

16.
Eur Child Adolesc Psychiatry ; 28(12): 1671-1682, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31004294

RESUMO

Unaccompanied refugee minors are a particularly vulnerable group. The aim of this study is to increase our knowledge about possible pathways to well-being and integration for unaccompanied refugee minors as they strive to establish new lives in a host county. The present study followed a group of youth who fled to Norway without their caregivers at three time points; 6 months (n = 95; M age = 13.8, 80% boys), 2 years (n = 78; M age = 16.5, 83% boys), and 5 years (n = 47; M age 20.0, 83% boys) after arrival. Linear mixed effects models were used to assess whether age, gender, and trauma exposure prior to arrival were associated with levels and changes in symptoms of posttraumatic stress (PTS), depression, anxiety, and externalizing symptoms over time. Regression analyses were conducted to examine whether daily hassles, perceived social support, and new trauma experiences predict PTS, internalization, externalization, and somatization. The mean levels of depression had decreased significantly at 5 years, but mean levels of anxiety, PTS, and externalizing symptoms did not. Females and severely trauma exposed had higher levels of symptoms. Higher age was associated with less change in symptoms of depression and posttraumatic stress over time. Five years after arrival, many still experienced clinical levels of mental health problems, and level of daily hassles was an important predictor. Support may be needed not only at arrival to handle mental health problems in general and posttraumatic stress in particular, but also after resettlement. Help to manage daily hassles may be especially important to ensure well-being and integration.


Assuntos
Saúde Mental/tendências , Menores de Idade/psicologia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Feminino , Humanos , Masculino
17.
Soc Sci Med ; 230: 246-255, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31030015

RESUMO

This study aims to investigate whether and to what extent income inequality of country of origin modifies the health trajectories of immigrants to the United States (U.S.). Much previous research has found a negative association between income inequality and health across nations. A separate, large literature shows that characteristics of immigrants' countries of origin affect their health status after migration. However, there is no evidence about whether income inequality of countries of origin affects postmigration health trajectories. Merging individual data from the Current Population's Annual Social and Economic Supplement (ASEC CPS) (2013) with macro-level data, I find that income inequality exerts a statistically significant negative effect on immigrants' health trajectories. While immigrants arriving from countries with greater income inequality tend to be healthier than immigrants arriving from countries that are more egalitarian, their health tends to decline at a faster rate over time. The results are consistent with at least two mechanisms. Immigrants from higher-inequality countries may arrive in the U.S. with fewer transferable skills and take up low-paid jobs, with negative consequences for their long-term health. Alternatively, the harmful consequences of early exposure to high-income inequality in home countries before immigration may persist over the life course, damaging individuals' health even after they have left their home nations.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Renda/estatística & dados numéricos , Fatores Socioeconômicos , Países Desenvolvidos , Emigração e Imigração , Etnicidade , Feminino , Humanos , Masculino , Política Pública , Estados Unidos
18.
J Gerontol B Psychol Sci Soc Sci ; 74(7): 1245-1255, 2019 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-28575472

RESUMO

OBJECTIVE: This study examines relationships between municipal age structure and two types of self-rated health: general (SRH) and comparison with similar-aged peers (C-SRH). METHODS: Using a national sample of almost 5,000 Japanese older adults over two decades, we employ hierarchical growth curve models to estimate health trajectories. For municipal age structure, we consider both the relative prevalence of elderly adults in the local population and the pace of aging over time. RESULTS: Living in the oldest municipalities was generally associated with worse health, particularly between the ages of 70 and 80 years. For SRH, the speed of municipal population aging was also independently associated with worse health. For C-SRH, worse health in older areas was partially explained by less favorable economic conditions in those municipalities. Results also suggest that higher levels of employment and social integration among older adults living in the oldest municipalities operate in the opposite direction. That is, these attributes partially "protect" individuals from other factors that contribute to worse health. DISCUSSION: Relative differences in municipal age structure and the pace of population aging are largely unexplored and potentially important correlates of older adult health. This line of research is increasingly salient in a world with substantial and growing regional variation in population aging.


Assuntos
Envelhecimento , Autoavaliação Diagnóstica , Nível de Saúde , Meio Social , População Urbana/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Cidades/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Japão , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
19.
Public Health ; 157: 135-141, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29524811

RESUMO

OBJECTIVES: Social inequalities in health have been largely documented in social science research. Members of the most disadvantaged groups experience worse health and higher mortality from birth throughout adulthood. However, it is not clear whether this association persists at older ages. Some studies have found a narrowing of the social gradient in health, at least when 'traditional' measures of socio-economic status (SES)-income, education, and occupation-are used. The main goal of the article is to highlight similarities and discrepancies in the age trend of social inequalities in health that arise when multiple measures of SES are considered. STUDY DESIGN: The present study uses a longitudinal sample of over 7000 individuals age 50+ from the Survey of Health, Ageing, and Retirement in Europe to examine the age trend of social inequalities in health. METHODS: By using growth curve models, individual trajectories of self-rated health and physical functioning were analyzed. SES is measured through wealth, income, and education. RESULTS: The findings show that for both health outcomes, the choice of the indicator of SES is very consequential, as the age trend of social inequalities in health is substantially different for different measures of SES. CONCLUSION: Using multiple measures of SES is recommended, as using only one measure would give only a partial account of the age trend of social inequalities in health. In particular, wealth seems to better capture individual's socio-economic position, as it is able to detect health gradients even where education and income fail to do so.


Assuntos
Fatores Etários , Disparidades nos Níveis de Saúde , Classe Social , Idoso , Idoso de 80 Anos ou mais , Europa (Continente) , Feminino , Inquéritos Epidemiológicos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
20.
J Gerontol B Psychol Sci Soc Sci ; 73(2): 349-360, 2018 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-27140821

RESUMO

Objective: This article examines the association between childhood and adult socioeconomic status (SES) and late-life health trajectories for older adults in Mexico. Method: Data are from the Mexican Health and Aging Study, a panel survey that began with a nationally representative sample of Mexican adults 50 years and older at baseline (2001), with follow-up in 2003 and 2012. We use a hierarchical repeated measures model to estimate the relationship between SES and depressive symptoms, functional limitations, and self-rated health, respectively. We tested both discrete measures of SES in childhood and adulthood, as well as a combined indicator of lifetime SES. Results: Childhood SES was significantly associated with later-life health trajectories net of adulthood SES indicators. Adult SES was significantly associated with late-life health trajectories, with some differences by gender and outcome. There were significant SES disparities in health outcomes over the 11-year study period. However, there were no significant multiplicative interactions between SES and age, which would have indicated either diminishing or widening SES health disparities with age. Discussion: Socioeconomic disparities in health appear to persist into old age in the Mexican context. Efforts to reduce late-life health disparities in Mexico should target socioeconomic and material conditions across the life course.


Assuntos
Nível de Saúde , Classe Social , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Criança , Feminino , Disparidades nos Níveis de Saúde , Humanos , Estudos Longitudinais , Masculino , México/epidemiologia , Pessoa de Meia-Idade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA