The Long Arm of Childhood: Does It Vary According to Health Care System Quality?

Increasing evidence points to the salience of early life experiences in shaping health inequalities, but scant research has considered the role of institutional resources as buffers in this relationship. Health care systems in particular are an understudied yet important context for the generation of inequalities from childhood into adulthood. This research investigates associations between childhood disadvantage and adult morbidity and examines the role of health care system quality in this relationship. We also consider the role of adult socioeconomic status. We merge individual-level data on major disease (2014 European Social Survey) with nation-level health care indicators. Results across subjective and objective approaches to health care system quality are similar, indicating a reduced association between childhood socioeconomic status and adult disease in countries with higher quality health care. In total, our results reiterate the long-term influence of childhood disadvantage on health while suggesting health care's specific role as an institutional resource for ameliorating life course health inequalities.

How painful is a recession? An assessment of two future-oriented buffering mechanisms.

RATIONALE AND OBJECTIVE: Guided by stress process theory, this study investigates the association between the economic downturn and chronic pain interference, as well as the role of two future-oriented buffering mechanisms (anticipated stressor duration and pre-recession financial optimism) in this relationship. This research integrates both an objective measure of the recession based on negative personal experiences, as well as subjective event-based appraisals of how the recession impacted people's lives. METHOD: Drawing on longitudinal data from the National Survey of Midlife Development in the United States, linear lagged dependent variable models are used to estimate associations between recession-era stressors and chronic pain interference among 1113 adults. The analysis further examines the moderating influences of anticipated stressor duration and pre-recession financial optimism. RESULTS: Findings reveal that both an accumulation of adverse experiences and global appraisals of the economic recession have harmful associations with chronic pain interference; however, their magnitude varied according to future-oriented moderating factors. Specifically, people with high pre-recession financial optimism fared better when confronted with recession-related stressors than did those with low levels of financial optimism. Moreover, pain interference was greater among individuals who appraised the recession as having a negative impact on their lives, but only if they perceived the recession would extend into the future. CONCLUSIONS: This study demonstrates distinctive links between two recession-related measures and pain interference. Findings suggest that positive future orientations can be protective during an economic crisis, whereas negative orientations heighten the pain.

Leveraging Household Structure for Increasing Adult Physical Activity in a Low-Income, African American Community.

Health behavior changes often require focusing on factors beyond the individual, particularly in low-income and underresourced areas. The purpose of this article was to assess associations between household structure and adult physical activity levels. Data were collected using Community Assessment for Public Health Emergency Response methodology to administer a household survey (n = 100). Household structure was calculated from summing the number of adults (⩾18 years) and children (<18 years) reported living in the house. Physical activity was measured using the International Physical Activity Questionnaire-Short Form. Adults living in households with two or more adults reported more MET (metabolic equivalent of task) minutes of physical activity per week than adults from households with only one adult. Adults living in households with two or more adults were twice as likely to meet aerobic guidelines for physical activity compared to adults living in households with only adult. Findings suggest the need for developing ecologic approaches in low-income communities to increase social support for physical activity in adults.

Does the Association Between Age and Major Illness Vary by Healthcare System Quality?

This study builds on research into global aging, by offering a multiple-indicator test of whether national healthcare system quality modifies the association between age and major illness. Recent individual-level data on morbidity among respondents aged 50 or older (16 countries; 2014 European Social Survey) are merged with nation-level healthcare indicators. Healthcare system quality is assessed using a subjective, evaluation-based approach and an objective, attributable-mortality approach. Lagged nation-level economic and health indicators are controlled to help isolate healthcare system effects. Results across subjective and objective approaches to healthcare system quality are strikingly consistent. While older individuals showed approximately a 10% reduction in probability of major illness when residing in countries with higher healthcare quality, associations between age and morbidity indices combining number and severity of illness showed greater modification by healthcare quality, with reductions around 18%. Taken together, results are suggestive of healthcare's protective role in reducing age-related illness and disability.

Long-Term Effects of Age Discrimination on Mental Health: The Role of Perceived Financial Strain.

OBJECTIVES: This study examines the role of work-related perceived age discrimination on women's mental health over the life course and tests whether financial strain mediates this relationship. METHODS: Using the National Longitudinal Survey of Mature Women (1967-2003), we employ nested growth curve models to evaluate whether perceived age discrimination at work influences women's depressive symptoms and life satisfaction and whether perceived financial strain mediates this relationship. RESULTS: Women who experienced age discrimination had greater overall depressive symptoms but not after controlling for financial strain. We found evidence that age discrimination affected financial strain, which, in turn, increased women's depressive symptoms. Women who reported age discrimination had lower odds of being in higher categories of overall life satisfaction; financial strain partially mediated the relationship but age discrimination remained a significant predictor. DISCUSSION: Despite legal protection, age discrimination at work is frequent and has significant effects on women's mental health over the life course. Financial strain partially mediates this relationship, pointing to financial implications of perceived age discrimination for women and their families. Our findings have important policy and workplace implications, calling attention to ageism as a potent stressor for working women's mental health beyond those tied to sex or race.

Wealth in Middle and Later Life: Examining the Life Course Timing of Women's Health Limitations.

BACKGROUND AND OBJECTIVES: Guided by cumulative inequality theory, this study poses two main questions: (a) Does women's poor health compromise household financial assets? (b) If yes, is wealth sensitive to the timing of women's health limitations? In addressing these questions, we consider the effect of health limitations on wealth at older ages, as well as examine how health limitations influence wealth over particular segments of the life course, giving attention to both the onset and duration of health limitations. RESEARCH DESIGN AND METHODS: Using 36 years of data from the National Longitudinal Survey of Mature Women, piecewise growth curve and linear regression models were used to estimate the effects of life course timing and duration of health limitations on household wealth. RESULTS: The findings reveal that women who experienced health limitations accumulated substantially less wealth over time, especially if the health limitations were manifest during childhood or early adulthood. DISCUSSION AND IMPLICATIONS: This study identifies how early-life health problems lead to less wealth in later life.

Financial Strain and Mental Health Among Older Adults During the Great Recession.

OBJECTIVES: The economic recession has garnered the interest of many scholars, with much attention being drawn to how the recession has affected labor force participation, household wealth, and even retirement decisions. Certainly, the Great Recession has influenced the financial well-being of older adults, but has it had discernible effects on mental health? METHOD: This study draws on 5,366 respondents from the Health and Retirement Study (2006-2010) to examine objective and subjective measures of financial well-being in the period surrounding the Great Recession. Guided by cumulative inequality theory, this research investigates whether the economic downturn contributed to worsening anxiety and depressive symptoms over a 4-year period. RESULTS: Results from linear fixed effects models reveal that decreases in objective financial resources were associated with increased financial strain during the Great Recession. Unlike the objective indicators, however, financial strain was a strong and robust predictor of worsening mental health between 2006 and 2010. DISCUSSION: Building on prior research, this study elucidates the factors that shape financial strain and provides evidence that the Great Recession not only affected the financial well-being of older adults but also had adverse effects on mental health.

Accumulated financial strain and women's health over three decades.

OBJECTIVE: Drawing from cumulative inequality theory, this research examines how accumulated financial strain affects women's self-rated health in middle and later life. METHOD: Using data from the National Longitudinal Survey of Mature Women (1967-2003), we employ random-coefficient growth curve models to examine whether recurring financial strain influences women's health, above and beyond several measures of objective social status. Predicted probabilities of poor health were estimated by the frequency of financial strain. RESULTS: Financial strain is associated with rapid declines in women's health during middle and later life, especially for those women who reported recurrent strain. Changes in household income and household wealth were also associated with women's health but did not eliminate the effects due to accumulated financial strain. DISCUSSION: Accumulated financial strain has long-term effects on women's health during middle and later life. The findings demonstrate the importance of measuring life course exposure to stressors in studies of health trajectories.