Risk factors for natural menopause before the age of 45: evidence from two British population-based birth cohort studies.

BACKGROUND: Menopause that occurs before the age of 45 and is not medically induced (referred to here as 'early natural menopause') affects around one in 10 women and has serious health consequences. These consequences include increased risk of all-cause mortality, cardiovascular disease, osteoporosis, and type 2 diabetes. METHODS: We investigate risk factors for the onset of natural menopause before the age of 45 in two population-based prospective cohort studies in Britain: the 1958 cohort following 8959 women and the 1970 cohort following 8655 women. These studies follow women from birth to adulthood, and we use harmonized data on birth and early life characteristics, reproductive health, health behaviour, and socioeconomic characteristics for 6805 women who were pre-menopausal, peri-menopausal or had undergone natural menopause. Of these 6805 women, 3614 participated in the 1958 cohort (of which 368 had early menopause) and 3191 participated in the 1970 cohort (of which 206 had early menopause). Taking a life course approach, we focus on three distinct life stages - birth/early life, childhood, and early adulthood - to understand when risk factors are most harmful. Respecting the temporal sequence of exposures, we use a series of multivariable logistic regression models to estimate associations between early menopause and each potential risk factor adjusted for confounders. RESULTS: We find that early menopause is influenced by circumstances at birth. Women born in lower social class families, whose mother smoked during the pregnancy or who were breastfed 1 month or less were more likely to undergo early menopause. Early menopause is also associated with poorer cognitive ability and smoking in childhood. Adult health behaviour also matters. Smoking is positively correlated with early menopause, while regular exercise and moderate frequency of alcohol drinking in women's early thirties are associated with reduced risk of early menopause. The occurrence of gynaecological problems by women's early thirties is also linked to early menopause. CONCLUSIONS: We demonstrate that characteristics at different periods of life are associated with early menopause. Some of these associations relate to modifiable behaviours and thus the risks of early menopause and the adverse health outcomes associated with it may be preventable.

Does education protect against depression? Evidence from the Young Finns Study using Mendelian randomization.

Using participants (N = 1733) drawn from the nationally representative longitudinal Young Finns Study (YFS) we estimate the effect of education on depressive symptoms. In 2007, when the participants were between 30 and 45 years old, they reported their depressive symptoms using a revised version of Beck's Depression Inventory. Education was measured using register information on the highest completed level of education in 2007, which was converted to years of education. To identify a causal relationship between education and depressive symptoms we use an instrumental variables approach (Mendelian randomization, MR) with a genetic risk score as an instrument for years of education. The genetic risk score was based on 74 genetic variants, which were associated with years of education in a genome-wide association study (GWAS). Because the genetic variants are randomly assigned at conception, they induce exogenous variation in years of education and thus identify a causal effect if the assumptions of the MR approach are met. In Ordinary Least Squares (OLS) estimation years of education in 2007 were negatively associated with depressive symptoms in 2007 (b = -0.027, 95% Confidence Interval (CI) = -0.040, -0.015). However, the results based on Mendelian randomization suggested that the effect is not causal (b = 0.017; 95% CI = -0.144, 0.178). This indicates that omitted variables correlated with education and depression may bias the linear regression coefficients and exogenous variation in education caused by differences in genetic make-up does not seem to protect against depressive symptoms.

School mobility during childhood predicts psychotic symptoms in late adolescence.

BACKGROUND: Recently, school mobility was identified as a risk factor for psychotic symptoms in early adolescence. The extent to which this risk continues into late adolescence and the trajectories via which this risk manifests remain unexplored. METHODS: Psychotic symptoms in 4,720 adolescents aged 18 were ascertained by trained psychologists using the Psychosis-Like Symptoms Interview. Mothers reported on sociodemographic factors (i.e., family adversity, ethnicity and urbanicity) from pregnancy to 4 years; child's involvement in bullying at age 6-7 years; residential mobility at 11 years and school mobility at 11-12 years. Young people reported on their friendships at 8 years, and antisocial behaviour and cannabis use at 15 years. RESULTS: School mobility across childhood significantly predicted psychotic symptoms at 18 years (adjusted odds ratio = 2.15; 95% confidence intervals = 1.06, 4.40). Within path analysis, school mobility (ß = .183, p = .035), involvement in bullying (ß = .133, p = .013), antisocial behaviour (ß = .052, p = .004), cannabis use (ß = .254, p = .020) and female sex (ß = .420, p < .001) significantly predicted psychotic symptoms. Residential mobility (ß = .375, p < .001), involvement in bullying (ß = .120, p = .022) and poor friendships (ß = .038, p = .014) significantly predicted school mobility. Residential mobility indirectly increased the risk of psychotic symptoms via school mobility (ß = .069, p = .041). CONCLUSIONS: Children who move schools often are more likely to have experienced peer problems. School mobility, in turn, appears to be a robust marker for psychotic symptoms in late adolescence. Clinicians and teachers should consider school mobility as an important risk indicator for both peer problems and psychopathology.

Share capitalism and worker wellbeing.

We show that worker wellbeing is determined not only by the amount of compensation workers receive but also by how compensation is determined. While previous theoretical and empirical work has often been preoccupied with individual performance-related pay, we find that the receipt of a range of group-performance schemes (profit shares, group bonuses and share ownership) is associated with higher job satisfaction. This holds conditional on wage levels, so that pay methods are associated with greater job satisfaction in addition to that coming from higher wages. We use a variety of methods to control for unobserved individual and job-specific characteristics. We suggest that half of the share-capitalism effect is accounted for by employees reciprocating for the "gift"; we also show that share capitalism helps dampen the negative wellbeing effects of what we typically think of as "bad" aspects of job quality.

The adult consequences of being bullied in childhood.

Most studies examining the impact of bullying on wellbeing in adulthood rely on retrospective measures of bullying and concentrate primarily on psychological outcomes. Instead, we examine the effects of bullying at ages 7 and 11, collected prospectively by the child's mother, on subjective wellbeing, labour market prospects, and physical wellbeing over the life-course. We exploit 12 sweeps of interview data through to age 62 for a cohort born in a single week in Britain in 1958. Bullying negatively impacts subjective well-being between ages 16 and 62 and raises the probability of mortality before age 55. It also lowers the probability of having a job in adulthood. These effects are independent of other adverse childhood experiences.

Seasonality and the female happiness paradox.

Most studies tracking wellbeing do not collect data across all the months in a year. This leads to error in estimating gender differences in wellbeing for three reasons. First, there are seasonal patterns in wellbeing (particularly life satisfaction and happiness) which are gendered, so failure to account for those confounds estimates of gender differences over time. Second, studies fielded in discrete parts of the year cannot extrapolate to gender differences in other parts of the year. Making inferences about trends over time is particularly problematic when a survey changes its field survey dates across years. Third, without monthly data, surveys miss big shifts in wellbeing that occur for short periods. This is a problem because women's wellbeing is more variable over short periods of time than men's wellbeing. It also bounces back faster. We show that simply splitting the data by months in a happiness equation generates a positive male coefficient in one subset of months from September to January and a negative coefficient in months February to August. Such a split has no impact on the male coefficients in an anxiety equation. Months matter.

Long COVID in the United States.

Although yet to be clearly identified as a clinical condition, there is immense concern at the health and wellbeing consequences of long COVID. Using data collected from nearly half a million Americans in the period June 2022-December 2022 in the US Census Bureau's Household Pulse Survey (HPS), we find 14 percent reported suffering long COVID at some point, half of whom reported it at the time of the survey. Its incidence varies markedly across the United States-from 11 percent in Hawaii to 18 percent in West Virginia-and is higher for women than men, among Whites compared with Blacks and Asians, and declines with rising education and income. It is at its highest in midlife in the same way as negative affect. Ever having had long COVID is strongly associated with negative affect (anxiety, depression, worry and a lack of interest in things), with the correlation being strongest among those who currently report long COVID, especially if they report severe symptoms. In contrast, those who report having had short COVID report higher wellbeing than those who report never having had COVID. Long COVID is also strongly associated with physical mobility problems, and with problems dressing and bathing. It is also associated with mental problems as indicated by recall and understanding difficulties. Again, the associations are strongest among those who currently report long COVID, while those who said they had had short COVID have fewer physical and mental problems than those who report never having had COVID. Vaccination is associated with lower negative affect, including among those who reported having had long COVID.

Exploring the reasons for labour market gender inequality a year into the COVID-19 pandemic: evidence from the UK cohort studies.

The COVID-19 pandemic has caused unexpected disruptions to Western countries which affected women more adversely than men. Previous studies suggest that gender differences are attributable to: women being over-represented in the most affected sectors of the economy, women's labour market disadvantage as compared to their partners, and mothers taking a bigger share childcare responsibilities following school closures. Using the data from four British nationally representative cohort studies, we test these propositions. Our findings confirm that the adverse labour market effects were still experienced by women a year into the COVID-19 pandemic and that these effects were the most severe for women who lived with a partner and children, even if they worked in critical occupations. We show that adjusting for pre-pandemic job characteristics attenuates the gaps, suggesting that women were over-represented in jobs disproportionately affected by COVID-19 pandemic. However, the remaining gaps are not further attenuated by adjusting for the partner's job and children characteristics, suggesting that the adversities experienced by women were not driven by their relative labour market position, as compared to their partners or childcare responsibilities. The residual gender differences observed in the rates of active, paid work and furlough for those who live with partner and children point to the importance of unobserved factors such as social norms, preferences, or discrimination. These effects may be long-lasting and jeopardise women's longer-term position through the loss of experience, leading to reinforcement of gender inequalities or even reversal of the progress towards gender equality.

Taking the pulse of nations: A biometric measure of well-being.

A growing literature identifies associations between subjective and biometric indicators of wellbeing. These associations, together with the ability of subjective wellbeing metrics to predict health and behavioral outcomes, have spawned increasing interest in wellbeing as an important concept in its own right. However, some social scientists continue to question the usefulness of wellbeing metrics. We contribute to this literature in three ways. First, we introduce a biometric measure of wellbeing - pulse - that hs been little used. Using nationally representative data on 165,000 individuals from the Health Survey for England and Scottish Health Surveys we show that its correlates are similar in a number of ways to those for happiness, and that it is highly correlated with wellbeing metrics, as well as self-assessed health. Second, we examine the determinants of pulse rates in mid-life (age 42) among the 9000 members of the National Child Development Study, a birth cohort born in a single week in 1958 in Britain. Third, we track the impact of pulse measured in mid-life (age 42) on health and labor market outcomes at age 50 in 2008 and age 55 in 2013. The probability of working at age 55 is negatively impacted by pulse rate a decade earlier. The pulse rate has an impact over and above chronic pain measured at age 42. General health at 55 is lower the higher the pulse rate at age 42, while those with higher pulse rates at 42 also express lower life satisfaction and more pessimism about the future at age 50. Taken together, these results suggest social scientists can learn a great deal by adding pulse rates to the metrics they use when evaluating people's wellbeing.

Further decoding the mystery of American pain: The importance of work.

A recent paper showed that, whereas we expect pain to rise with age due to accumulated injury, physical wear and tear, and disease, the elderly in America report less pain than those in midlife. Further exploration revealed this pattern was confined to the less educated. The authors called this the 'mystery of American pain' since pain appears to rise with age in other countries irrespective of education. Revisiting this issue with the same cross-sectional data we show that what matters in explaining pain through to age 65 is whether one is working or not. The incidence of pain across the life-course is nearly identical for workers in America and elsewhere, but it is greater for non-working Americans than it is for non-workers elsewhere. As in other countries, pain is hump-shaped in age among those Americans out of work but rises a little over the life-course for those in work. Furthermore, these patterns are apparent within educational groups. We show that, if one ascribes age-specific employment rates from other OECD countries to Americans, the age profile of pain in the United States is more similar to that found elsewhere in the OECD. This is because employment rates are lower in the United States than elsewhere between ages 30 and 60: the simulation reduces the pain contribution of these non-workers to overall pain in America, so it looks somewhat similar to pain elsewhere. We conclude that what matters in explaining pain over the life-course is whether one is working or not and once that is accounted for, the patterns are consistent across the United States and the rest of the OECD.

Chronic pain: Evidence from the national child development study.

Using data from all those born in a single week in 1958 in Britain we track associations between short pain and chronic pain in mid-life (age 44) and subsequent health, wellbeing and labor market outcomes in later life. We focus on data taken at age 50 in 2008, when the Great Recession hit and then five years later at age 55 in 2013 and again at age 62 in 2021 during the Covid pandemic. We find those suffering both short-term and chronic pain at age 44 continue to report pain and poor general health in their 50s and 60s. However, the associations are much stronger for those with chronic pain. Furthermore, chronic pain at age 44 is associated with a range of poor mental health outcomes, pessimism about the future and joblessness at age 55 whereas short-duration pain at age 44 is not. Pain has strong predictive power for pain later in life: pain in childhood predicts pain in mid-life, even when one controls for pain in early adulthood. Pain appears to reflect other vulnerabilities as we find that chronic pain at age 44 predicts whether or not a respondent has Covid nearly twenty years later.

Covid and mental health in America.

Using 44 sweeps of the US Census Household Pulse Survey data for the period April 2020 to April 22 we track the evolution of the mental health of just over three million Americans during the COVID-19 pandemic. We find anxiety, depression and worry had two major peaks in 2020 but improved in 2021 and 2022. We show that a variable we construct based on daily inflows of COVID cases by county, aggregated up to state, is positively associated with worse mental health, having conditioned on state fixed effects and seasonality in mental health. However, the size of the effect declines in 2021 and 2022 as vaccination rates rise. For women and college educated men having a vaccine improved mental health. However, being vaccinated worsens mental health among less educated men.

The consequences of early menopause and menopause symptoms for labour market participation.

Using a difference-in-difference estimator we identify the causal impact of early menopause and menopause symptoms on the time women spend in employment through to their mid-50s. We find the onset of early natural menopause (before age 45) reduces months spent in employment by 9 percentage points once women enter their 50s compared with women who do not experience early menopause. Early menopause is not associated with a difference in full-time employment rates. The number of menopause symptoms women face at age 50 is associated with lower employment rates: each additional symptom lowers employment rates and full-time employment rates by around half a percentage point. But not all symptoms have the same effects. Vasomotor symptoms tend not to be associated with lower employment rates, whereas the employment of women who suffer psychological problems due to menopause is adversely affected. Every additional psychological problem associated with menopause reduces employment and full-time employment rates by 1-2 percentage points, rising to 2-4 percentage points when those symptoms are reported as particularly bothersome.

Does better education mitigate risky health behavior? A mendelian randomization study.

Education and risky health behaviors are strongly negatively correlated. Education may affect health behaviors by enabling healthier choices through higher disposable income, increasing information about the harmful effects of risky health behaviors, or altering time preferences. Alternatively, the observed negative correlation may stem from reverse causality or unobserved confounders. Based on the data from the Cardiovascular Risk in Young Finns Study linked to register-based information on educational attainment and family background, this paper identifies the causal effect of education on risky health behaviors. To examine causal effects, we used a genetic score as an instrument for years of education. We found that individuals with higher education allocated more attention to healthy habits. In terms of health behaviors, highly educated people were less likely to smoke. Some model specifications also indicated that the highly educated consumed more fruit and vegetables, but the results were imprecise in this regard. No causal effect was found between education and abusive drinking. In brief, inference based on genetic instruments showed that higher education leads to better choices in some but not all dimensions of health behaviors.

Unemployment and sleep: evidence from the United States and Europe.

Using data for over 2.5 million individuals in the United States over the period 2006-2019 from the Behavioral Risk Factor Surveillance System (BRFSS) survey series we show the unemployed suffer sleep disruption. The unemployed suffer more short and long sleep than the employed and are more likely to suffer from disturbed sleep. These are especially problematic for the long-term unemployed and for the jobless who say they are unable to work. Similar findings on unemployment and poor sleep quality are found in European data. Increases in the unemployment rate raise the incidence of short sleep and lower sleep durations.

Do childhood infections affect labour market outcomes in adulthood and, if so, how?

A burgeoning body of literature suggests that poor childhood health leads to adverse health outcomes, lower educational attainment and weaker labour market outcomes in adulthood. We focus on an important but under-researched topic, which is the role played by infection-related hospitalization (IRH) in childhood and its links to labour market outcomes later in life. The participants aged 24-30 years in 2001 N = 1706 were drawn from the Young Finns Study, which includes comprehensive registry data on IRHs in childhood at ages 0-18 years. These data are linked to longitudinal registry information on labour market outcomes (2001-2012) and parental background (1980). The estimations were performed using ordinary least squares (OLS). The results showed that having an additional IRH is associated with lower log earnings (b = -0.110, 95 % confidence interval (CI): -0.193; -0.026), fewer years of being employed (b = -0.018, 95 % CI: -0.031; -0.005), a higher probability of receiving any social income transfers (b = 0.012, 95 % CI: -0.002; 0.026) and larger social income transfers, conditional on receiving any (b = 0.085, 95 % CI: 0.025; 0.145). IRHs are negatively linked to human capital accumulation, which explains a considerable part of the observed associations between IRHs and labour market outcomes. We did not find support for the hypothesis that adult health mediates the link.

The biometric antecedents to happiness.

It has been suggested that biological markers are associated with human happiness. We contribute to the empirical literature by examining the independent association between various aspects of biometric wellbeing measured in childhood and happiness in adulthood. Using Young Finns Study data (n = 1905) and nationally representative linked data we examine whether eight biomarkers measured in childhood (1980) are associated with happiness in adulthood (2001). Using linked data we account for a very rich set of confounders including age, sex, body size, family background, nutritional intake, physical activity, income, education and labour market experiences. We find that there is a negative relationship between triglycerides and subjective well-being but it is both gender- and age-specific and the relationship does not prevail using the later measurements (1983/1986) on triglycerides. In summary, we conclude that none of the eight biomarkers measured in childhood predict happiness robustly in adulthood.

School mobility and prospective pathways to psychotic-like symptoms in early adolescence: a prospective birth cohort study.

OBJECTIVE: Social adversity and urban upbringing increase the risk of psychosis. We tested the hypothesis that these risks may be partly attributable to school mobility and examined the potential pathways linking school mobility to psychotic-like symptoms. METHOD: A community sample of 6,448 mothers and their children born between 1991 and 1992 were assessed for psychosocial adversities (i.e., ethnicity, urbanicity, family adversity) from birth to 2 years, school and residential mobility up to 9 years, and peer difficulties (i.e., bullying involvement and friendship difficulties) at 10 years. Psychotic-like symptoms were assessed at age 12 years using the Psychosis-like Symptoms Interview (PLIKSi). RESULTS: In regression analyses, school mobility was significantly associated with definite psychotic-like symptoms (odds ratio [OR] =1.60; 95% CI =1.07-2.38) after controlling for all confounders. Within path analyses, school mobility (probit coefficient [ß] = 0.108; p = .039), involvement in bullying (ß = 0.241; p < .001), urbanicity (ß = 0.342; p = .016), and family adversity (ß = 0.034; p < .001) were all independently associated with definite psychotic-like symptoms. School mobility was indirectly associated with definite psychotic-like symptoms via involvement in bullying (ß = 0.018; p = .034). CONCLUSIONS: School mobility is associated with increased risk of psychotic-like symptoms, both directly and indirectly. The findings highlight the potential benefit of strategies to help mobile students to establish themselves within new school environments to reduce peer difficulties and to diminish the risk of psychotic-like symptoms. Awareness of mobile students as a possible high-risk population, and routine inquiry regarding school changes and bullying experiences, may be advisable in mental health care settings.