RESUMEN
To investigate temporal patterns, sociodemographic gradients, and structural breaks in adolescent marijuana use in the United States from 1991 to 2018, we used hierarchical age-period-cohort logistic regression models to distinguish temporal effects of marijuana use among 8th, 10th, and 12th graders from 28 waves of the Monitoring the Future survey (1991-2018). Structural breaks in period effects were further detected via a dynamic-programing-based method. Net of other effects, we found a clear age-related increase in the probability of marijuana use (10.46%, 23.17%, and 31.19% for 8th, 10th, and 12th graders, respectively). Period effects showed a substantial increase over time (from 16.23% in 2006 to 26.38% in 2018), while cohort effects remained stable throughout the study period. Risk of adolescent marijuana use varied by sex, racial group, family status, and parental education. Significant structural breaks during 1995-1996, 2006-2008, and 2011-2013 were identified in different subpopulations. A steady increase in marijuana use among adolescents during the latter years of this time period was identified. Adolescents who were male, were non-Black, lived in nonintact families, and had less educated parents were especially at risk of marijuana usage. Trends in adolescent marijuana use changed significantly during times of economic crisis.
Asunto(s)
Conducta del Adolescente/psicología , Uso de la Marihuana/tendencias , Adolescente , Estudios de Cohortes , Femenino , Encuestas Epidemiológicas , Humanos , Modelos Logísticos , Masculino , Factores de Riesgo , Factores de Tiempo , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVE: To quantify associations between four types of social support and measured adiposity among women and men. DESIGN: The cross-sectional sample from the Canadian Longitudinal Study on Aging (CLSA, 2012-2015). Height, weight and waist circumference (WC) were clinically measured, and perceived availability of informational, tangible, emotional and belonging social supports was self-reported. SETTING: Canada. PARTICIPANTS: 28 779 adults aged 45-85 years from the CLSA. RESULTS: All social support types were associated with WC and BMI among women but not among men. Women reporting the lowest informational support had significantly higher mean BMI (28·84 kg/m2 (95 % CI 28·63, 29·05)) and WC (90·81 cm (95 % CI 90·31, 91·30)) compared with women reporting maximum support (respectively, 28·09 kg/m2 (95 % CI 27·88, 28·30) and 88·92 cm (95 % CI 88·43, 89·4)). Women's abdominal obesity was associated with low levels of informational, emotional and belonging support, and women's general obesity with informational and emotional support. Notably, informational and emotional support were associated with both obesity outcomes independent of other supports among women. Only a low level of informational support was significantly independently associated with higher odds of obesity among men. CONCLUSIONS: Our study provides novel insights into gender-specific associations between different types of social support and adiposity. Prospective studies are needed to further investigate potential causality of these associations between the specific social supports and future weight status, especially among women.
Asunto(s)
Adiposidad , Obesidad , Adulto , Anciano , Anciano de 80 o más Años , Envejecimiento , Índice de Masa Corporal , Canadá/epidemiología , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/epidemiología , Apoyo Social , Circunferencia de la CinturaRESUMEN
OBJECTIVE: While plant-based dietary practices (PBDPs) have been recommended to improve both population health and environmental sustainability outcomes, no nationally representative Canadian studies have described the prevalence or correlates of excluding animal source foods. The current study therefore: (1) created operationalised definitions of PBDPs based on animal source food exclusions to estimate the prevalence of Canadians who adhere to PBDPs and (2) examined key correlates of PBDPs. DESIGN: Population representative, cross-sectional data were from the 2015 Canadian Community Health Survey-Nutrition. Respondents' PBDPs were categorised as: (1) vegan (excluded red meat, poultry, fish, eggs and dairy); (2) vegetarian (excluded red meat, poultry and fish); (3) pescatarian (excluded red meat and poultry) and (4) red meat excluder (excluded red meat). Descriptive statistics and multivariable regression analyses were used to examine the prevalence and correlates of these PBDP categories. SETTING: All ten provinces in Canada. PARTICIPANTS: Canadians aged 2 years and above (n 20 477). RESULTS: In 2015, approximately 5 % of Canadians reported adhering to any PBDP (all categories combined) with the majority (2·8 %) categorised as a red meat excluder, 1·3 % as vegetarian, 0·7 % as pescatarian and 0·3 % as vegan. South Asian cultural identity (OR 19·70 (95 % CI 9·53, 40·69)) and higher educational attainment (OR 1·97 (95 % CI 1·02, 3·80)) were significantly associated with reporting a vegetarian/vegan PBDP. CONCLUSIONS: Despite growing public discourse around PBDPs, only 5 % of Canadians reported PBDPs in 2015. Understanding the social and cultural factors that influence PBDPs is valuable for informing future strategies to promote environmentally sustainable dietary practices.
Asunto(s)
Carne , Salud Pública , Animales , Canadá , Estudios Transversales , Humanos , Encuestas Nutricionales , PrevalenciaRESUMEN
Objectives: The study aim was to investigate whether household income mediates the association between education and health in a nationally representative sample of Canadian adults. Methods: The data came from the Longitudinal and International Study of Adults linked to income data from the Canada Revenue Agency. Odds ratios and predicted probabilities from binary logistic regression models were used to describe associations between education and (a) self-rated health, (b) longstanding illness or health problem, (c) emotional, psychological or mental health problem and (d) symptoms of psychological distress. The Karlson-Holm-Breen decomposition method was used to investigate the potentially mediating role of household income in these associations. The analyses were conducted separately for women and men. Results: Education was significantly associated with all four health indicators for both women and men. Of the four health indicators, education was most strongly associated with self-rated health for both women and men. Education was more strongly associated with self-rated health and the presence of an emotional, psychological or mental health problem for women than for men. Curiously, men with a postgraduate degree were significantly more likely than men with a bachelor degree to report symptoms of psychological distress. Only modest proportions of the associations between education and health could be attributed to differences in household income. Education and household income manifested independent associations with all four health indicators among women and with three of four health indicators among men. Conclusions: Education and household income are joint and independent predictors of health in Canada. Accordingly, both should be included in research on socioeconomic health inequalities in this context.
Asunto(s)
Renta , Adulto , Canadá , Escolaridad , Femenino , Humanos , Modelos Logísticos , Masculino , Oportunidad Relativa , Factores SocioeconómicosRESUMEN
BACKGROUND: Extensive research has shown strong associations between income and health. However, the health effects of income dynamics over time are less known. We investigated how stability, volatility and trajectory in family incomes from 2002 to 2011 predicted (1) fair/poor self-rated health and (2) the presence of a longstanding illness or health problem in 2012. METHODS: The data came from the 2012 wave of the Longitudinal and International Study of Adults linked to annual family income data for 2002 to 2011 from the Canada Revenue Agency. We executed a series of binary logistic regressions to examine associations between health and average family income over the decade (Model 1), number of years in the bottom quartile (Model 2) and top quartile (Model 3) of family incomes, standard deviation of family incomes (Model 4), absolute difference between family income at the end and start of the period (Model 5), and number of years in which inflation-adjusted family income went down by more than 1% (Model 6) and up by more than 1% (Model 7) from 1 year to the next. The analyses were conducted separately for women and men. RESULTS: Average family income over the decade was strongly associated with both self-rated health and the presence of a longstanding illness or health problem. More years spent in the bottom quartile of family incomes corresponded to elevated odds of fair/poor self-rated health and the presence of a longstanding illness or health problem. Steady decreases in family income over the decade corresponded to elevated odds of fair/poor self-rated health for men and more years spent in the top quartile of family incomes over the decade corresponded to elevated odds of fair/poor self-rated health for women. CONCLUSION: Previous studies of the association between family income and health in Canada may have overlooked important issues pertaining to family income stability and change that are impactful for health.
Asunto(s)
Estado de Salud , Renta , Adulto , Canadá/epidemiología , Femenino , Humanos , Modelos Logísticos , Estudios Longitudinales , MasculinoRESUMEN
We explore the ramifications of applying Pierre Bourdieu's theory of capitals to epidemiological research on socioeconomic health inequalities. Capitals are resources used by individuals and groups to maintain and enhance their positions in the social order. The notion of capital interplay refers to the interconnectedness of multiple forms of capital in the production of good health. We provide definitions of economic, cultural and social capitals and describe a variety of causally distal processes-namely, capital acquisition, multiplier and transmission interplays-from which new hypotheses can be developed to guide future study of socioeconomic health inequalities in modern societies.
Asunto(s)
Disparidades en el Estado de Salud , Capital Social , Determinantes Sociales de la Salud , Humanos , Teoría Social , Factores SocioeconómicosRESUMEN
Objectives: To document inequalities in hypertension, self-rated health, and self-rated mental health between Canadian adults who identify as Black, White, or Black and White and determine whether differences in educational attainment and household income explain them. Design: The dataset was comprised of ten cycles (2001-2013) of the Canadian Community Health Survey. The health inequalities were examined by way of binary logistic regression modeling of hypertension and multinomial logistic regression modeling of self-rated health and self-rated mental health. Educational attainment and household income were investigated as potentially mediating factors using nested models and the Karlson-Holm-Breen decomposition technique. Results: Black respondents were significantly more likely than White respondents to report hypertension, a disparity that was partly attributable to differences in income. White respondents reported the best and Black respondents reported the worst overall self-rated health, a disparity that was entirely attributable to income differences. Respondents who identified as both Black and White were significantly more likely than White respondents to report fair or poor mental health, a disparity that was partly attributable to income differences. After controlling for income, Black respondents were significantly less likely than White respondents to report fair or poor mental health. Educational attainment did not contribute to explaining any of these associations. Conclusion: Canadians who identify as both Black and White fall between Black Canadians and White Canadians in regards to self-rated overall health, report the worst self-rated mental health of the three populations, and, with White Canadians, are the least likely to report hypertension. These heterogeneous findings are indicative of a range of diverse processes operative in the production of Black-White health inequalities in Canada.
Asunto(s)
Población Negra/estadística & datos numéricos , Disparidades en el Estado de Salud , Población Blanca/estadística & datos numéricos , Adolescente , Adulto , Anciano , Canadá/epidemiología , Estudios Transversales , Femenino , Estado de Salud , Encuestas Epidemiológicas , Humanos , Hipertensión/epidemiología , Hipertensión/etnología , Modelos Logísticos , Masculino , Salud Mental/etnología , Salud Mental/estadística & datos numéricos , Persona de Mediana Edad , Autoinforme , Adulto JovenRESUMEN
The theory of fundamental causes is one of the more influential attempts to provide a theoretical infrastructure for the strong associations between indicators of socioeconomic status (education, income, occupation) and health. It maintains that people of higher socioeconomic status have greater access to flexible resources such as money, knowledge, prestige, power, and beneficial social connections that they can use to reduce their risks of morbidity and mortality and minimize the consequences of disease once it occurs. However, several key aspects of the theory remain underspecified, compromising its ability to provide truly compelling explanations for socioeconomic health inequalities. In particular, socioeconomic status is an assembly of indicators that do not necessarily cohere in a straightforward way, the flexible resources that disproportionately accrue to higher status people are not clearly defined, and the distinction between socioeconomic status and resources is ambiguous. I attempt to address these definitional issues by infusing fundamental cause theory with features of a well-known theory of socioeconomic stratification in the sociological literature-Pierre Bourdieu's theory of symbolic power.
Asunto(s)
Teoría Psicológica , Determinantes Sociales de la Salud , Teoría Social , Humanos , Poder Psicológico , Clase Social , SimbolismoRESUMEN
Pierre Bourdieu's theory of practice situates social practices in the relational interplay between experiential mental phenomena (habitus), resources (capitals) and objective social structures (fields). When applied to class-based practices in particular, the overarching field of power within which social classes are potentially made manifest is the primary field of interest. Applying relational statistical techniques to original survey data from Toronto and Vancouver, Canada, we investigated whether smoking, engaging in physical activity and consuming fruit and vegetables are dispersed in a three-dimensional field of power shaped by economic and cultural capitals and cultural dispositions and practices. We find that aesthetic dispositions and flexibility of developing and established dispositions are associated with positioning in the Canadian field of power and embedded in the logics of the health practices dispersed in the field. From this field-theoretic perspective, behavioural change requires the disruption of existing relations of harmony between the habitus of agents, the fields within which the practices are enacted and the capitals that inform and enforce the mores and regularities of the fields. The three-dimensional model can be explored at: http://relational-health.ca/margins-freedom.
Asunto(s)
Libertad , Conductas Relacionadas con la Salud , Estilo de Vida , Clase Social , Adulto , Anciano , Canadá , Cultura , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ciencias Sociales , Encuestas y CuestionariosRESUMEN
A growing body of research from the United States informed by intersectionality theory indicates that racial identity, gender, and income are often entwined with one another as determinants of health in unexpectedly complex ways. Research of this kind from Canada is scarce, however. Using data pooled from ten cycles (2001-2013) of the Canadian Community Health Survey, we regressed hypertension (HT) and diabetes (DM) on income in subsamples of Black women (n = 3,506), White women (n = 336,341), Black men (n = 2,806) and White men (n = 271,260). An increase of one decile in income was associated with lower odds of hypertension and diabetes among White men (ORHT = .98, 95% CI (.97, .99); ORDM = .93, 95% CI (.92, .94)) and White women (ORHT = .95, 95% CI (.95, .96); ORDM = .90, 95% CI (.89, .91)). In contrast, an increase of one decile in income was not associated with either health outcome among Black men (ORHT = .99, 95% CI (.92, 1.06); ORDM = .99, 95% CI (.91, 1.08)) and strongly associated with both outcomes among Black women (ORHT = .86, 95% CI (.80, .92); ORDM = .83, 95% CI (.75, .92)). Our findings highlight the complexity of the unequal distribution of hypertension and diabetes, which includes inordinately high risks of both outcomes for poor Black women and an absence of associations between income and both outcomes for Black men in Canada. These results suggest that an intersectionality framework can contribute to uncovering health inequalities in Canada.
Asunto(s)
Diabetes Mellitus/etnología , Encuestas Epidemiológicas , Hipertensión/etnología , Grupos Raciales , Factores Socioeconómicos , Canadá/epidemiología , Estudios Transversales , Diabetes Mellitus/economía , Femenino , Humanos , Hipertensión/economía , Renta , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores Sexuales , Estados Unidos/epidemiologíaRESUMEN
Leisure-based physical activity is socially stratified in Canada. To date, inequalities in physical activity by race or ethnicity, gender, class or sexual orientation, in Canada and elsewhere, have largely been investigated as distinct, additive phenomena. Informed by intersectionality theory, this paper examines whether racial identity, gender, class and sexuality 'intersect' with one another to predict physical activity in data from Cycles 2.1 and 3.1 of the Canadian Community Health Survey (n= 149 574). In particular, we apply the intersectional principle of multiplicativity which suggests that people's experiences of their gender identities are raced, classed and sexualized; their racial experiences are gendered, classed and sexualized, and so forth. We find that the positive effect of income on being physically active is strong among visible minority men, of moderate strength among White men and women and weak to non-existent among visible minority women. We also find that a lesbian, gay or bisexual orientation corresponds with a higher likelihood of being physically active among women (especially among less educated women) but not among men. These multiplicative findings undermine additive approaches to investigating social inequalities in leisure-based physical activity and pave the way for future intersectional analyses of axes of inequality and their diverse, intersecting effects.
Asunto(s)
Ejercicio Físico , Actividades Recreativas , Canadá , Femenino , Identidad de Género , Encuestas Epidemiológicas , Humanos , Masculino , Grupos Minoritarios/estadística & datos numéricos , Grupos Raciales/estadística & datos numéricos , Factores Sexuales , Factores SocioeconómicosRESUMEN
OBJECTIVES: We apply intersectionality theory to health inequalities in Canada by investigating whether South Asian-White health inequalities are conditioned by gender and immigrant status in a synergistic way. DESIGN: Our dataset comprised 10 cycles (2001-2013) of the Canadian Community Health Survey. Using binary logistic regression modeling, we examined South Asian-White inequalities in self-rated health, diabetes, hypertension and asthma before and after controlling for potentially explanatory factors. Models were calculated separately in subsamples of native-born women, native-born men, immigrant women and immigrant men. RESULTS: South Asian immigrants had higher odds of fair/poor self-rated health, diabetes and hypertension than White immigrants. Native-born South Asian men had higher odds of fair/poor self-rated health than native-born White men and native-born South Asian women had lower odds of hypertension than native-born White women. Education, household income, smoking, physical activity and body mass index did little to explain these associations. The three-way interaction between racial identity, gender and immigrant status approached statistical significance for hypertension but not for self-rated health and asthma. CONCLUSION: Our findings provide modest support for the intersectionally inspired principle that combinations of identities derived from race, gender and nationality constitute sui generis categories in the manifestation of health outcomes.
Asunto(s)
Pueblo Asiatico/estadística & datos numéricos , Enfermedad Crónica/etnología , Emigrantes e Inmigrantes/estadística & datos numéricos , Disparidades en el Estado de Salud , Adulto , Anciano , Asia Sudoriental/etnología , Asma/etnología , Canadá , Diabetes Mellitus/etnología , Femenino , Encuestas Epidemiológicas , Humanos , Hipertensión/etnología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Distribución por SexoRESUMEN
The Ottawa Charter for Health Promotion exhibits a substantialist approach to the agency-structure dichotomy. From a substantialist point of view, both individual agency and social structure come preformed and subsequently relate to and influence one another, starkly positioning the choices made by individuals against the structured sets of opportunities and constraints in reference to which choices are made. From a relational perspective, however, relations between elements, not the elements themselves, are the primary ontological focus. We advocate for a relational approach to the structure-agency dichotomy, one that locates both agency and structure in social relations and thereby dissolves the stark distinction between them, suggesting that relational theories can provide useful insights into how and why people 'choose' to engage in health-related behaviours. Pierre Bourdieu's theory of practice, predicated upon the notions of field, capital and habitus, is exemplary in this regard.
Asunto(s)
Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Salud Pública , Canadá , HumanosRESUMEN
INTRODUCTION: We apply capital interplay theory to health inequalities in Switzerland by investigating the interconnected effects of parental cultural, economic and social capitals and personal educational stream on the self-rated health of young Swiss men who live with their parents. METHODS: We apply logistic regression modelling to self-rated health in original cross-sectional survey data collected during mandatory conscription of Swiss male citizens in 2010 and 2011 (n = 23,975). RESULTS: In comparison with sons whose parents completed mandatory schooling only, sons with parents who completed technical college or university were significantly more likely to report very good or excellent self-rated health. Parental economic capital was an important mediating factor in this regard. Number of books in the home (parental cultural capital), family economic circumstances (parental economic capital) and parental ties to influential people (parental social capital) were also independently associated with the self-rated health of the sons. Although sons in the highest educational stream tended to report better health than those in the lowest, we found little evidence for a health-producing intergenerational transmission of capitals via the education stream of the sons. Finally, the positive association between personal education and self-rated health was stronger among sons with relatively poorly educated parents and stronger among sons with parents who were relatively low in social capital. CONCLUSIONS: Our study provides empirical support for the role of capital interplays, social processes in which capitals interpenetrate or co-constitute one another, in the intergenerational production of the health of young men in Switzerland.
Asunto(s)
Autoevaluación Diagnóstica , Estado de Salud , Capital Social , Clase Social , Adolescente , Adulto , Estudios Transversales , Escolaridad , Composición Familiar , Disparidades en el Estado de Salud , Humanos , Modelos Logísticos , Masculino , Modelos Teóricos , Autoinforme , Suiza , Adulto JovenRESUMEN
OBJECTIVE: To examine associations between students' socio-economic status (SES) and school-day dietary intake, and the roles of parents and peers in shaping these associations. DESIGN: A cross-sectional survey measured school-day intake of vegetables, whole grains, low-fat milk, packaged snack foods and sugar-sweetened beverages. Logistic regression models examined associations between SES (parental education and food insecurity status) and dietary outcomes during or en route to or from school, and examined whether peer modelling or parental norms potentially mediated the associations between SES and dietary outcomes. SETTING: Twenty-six public schools in Vancouver, Canada in 2012. SUBJECTS: Nine hundred and fifty students in grades 5-8. RESULTS: Students whose parents completed some college, compared with those completing high school or less, were significantly more likely to consume vegetables daily (unadjusted OR = 1.85; 95 % CI 1.06, 3.22) and students whose parents completed college or university were significantly less likely to consume sugar-sweetened beverages daily (unadjusted OR = 0.67; 95 % CI 0.47, 0.94). Food secure students were also significantly less likely to consume sugar-sweetened beverages daily compared with food insecure students (unadjusted OR = 0.52; 95 % CI 0.29, 0.92). Parental norms, but not peer modelling, emerged as a potential mediator of the association between SES and vegetable intake. SES was not significantly associated with the remaining dietary outcomes. CONCLUSIONS: Higher SES was significantly associated with two of five school-day dietary outcomes and predicted higher likelihood of daily nutritious food choices at school. The present study suggests that there is room for improvement in school-day dietary quality for students from all SES backgrounds in Vancouver.
Asunto(s)
Fenómenos Fisiológicos Nutricionales de los Adolescentes , Fenómenos Fisiológicos Nutricionales Infantiles , Dieta/efectos adversos , Política Nutricional , Relaciones Padres-Hijo , Cooperación del Paciente , Influencia de los Compañeros , Adolescente , Colombia Británica , Niño , Estudios Transversales , Dieta/economía , Escolaridad , Femenino , Humanos , Masculino , Encuestas Nutricionales , Padres/educación , Instituciones Académicas , Factores Socioeconómicos , Transportes , Salud UrbanaRESUMEN
Many health scholars find that Pierre Bourdieu's theory of practice leaves too little room for individual agency. We contend that, by virtue of its relational, field-theoretic underpinnings, the idea of leaving room for agency in Bourdieu's theory of practice is misguided. With agency manifested in interactions and social structures consisting of relations built upon relations, the stark distinction between agency and structure inherent to substantialist thinking is undermined, even dissolved, in a relational field-theoretic context. We also contend that, when treated as relationally bound phenomena, Bourdieu's notions of habitus, doxa, capital and field illuminate creative, adaptive and future-looking practices. We conclude by discussing difficulties inherent to implementing a relational theory of practice in health promotion and public health.
Asunto(s)
Práctica de Salud Pública , Atención a la Salud/métodos , Atención a la Salud/organización & administración , Promoción de la Salud/organización & administración , Humanos , Modelos Teóricos , Salud Pública/métodosRESUMEN
Physical and mental health disparities by socioeconomic status in China are well documented but the effects of the intergenerational reproduction in socioeconomic status on adult mental health have received little attention to date. We utilized cross-sectional data from the 2017 Chinese General Social Survey to examine the significance of intergenerational socioeconomic reproduction for differences in self-assessed mental health in a national sample of Chinese adults between the ages of 23 and 65. We documented substantial elasticities between the socioeconomic status of the survey respondents and their parents: father's education, mother's education and childhood social class were all associated with both respondent education and respondent household income. We also found that associations between parental socioeconomic status and their adult children's self-assessed mental health were partly explained by the children's own socioeconomic status. However, these pathways were noticeably moderated by age cohort. Among younger people, associations between parental socioeconomic status and mental health were mostly explained by educational attainment whereas among older people associations between parental socioeconomic status and mental health were mostly explained by household income. In general, parental socioeconomic status appear to have a greater influence on the mental health of people who grew up after the Chinese economic reform of the 1970s.
RESUMEN
OBJECTIVES: To investigate whether intergenerational mobility in education and income are associated with levels of psychological distress in Canada, a context in which rates of intergenerational mobility are higher than those of the United States but lower than those of Nordic countries. METHODS: The data came from the Longitudinal and International Study of Adults (LISA) linked to tax records from the Canada Revenue Agency (N = 4100). Diagonal reference models were used to investigate whether educational mobility and income mobility were associated with levels of psychological distress in adulthood as assessed by the Kessler (K-10) scale. The models controlled for sociodemographic characteristics and were stratified by gender. RESULTS: Although we did not find that mobility in general was associated with greater levels of psychological distress, we found that downward educational mobility in particular corresponded to higher levels of psychological distress (b = 0.15 with 95% CI = 0.00, 0.31) among men. CONCLUSION: Overall, we found no strong evidence that social mobility in general is impactful for levels of psychological distress, but downward educational mobility in particular may have negative consequences for the mental health of men. In addition, a notable gradient between income and psychological distress in adulthood was observed for both women and men.
RéSUMé: OBJECTIFS: Étudier dans quelle(s) mesure(s) la mobilité intergénérationnelle en matière d'éducation et de revenu est associée aux niveaux de détresse psychologique au Canada, dans un contexte où les taux de mobilité intergénérationnelle sont plus élevés qu'aux États-Unis, mais plus faibles que dans les pays nordiques. MéTHODES: Les données proviennent de l'Étude longitudinale et internationale des adultes (ELIA) reliée aux dossiers fiscaux de l'Agence du revenu du Canada (N = 4 100). Des modèles de référence diagonaux ont été utilisés pour déterminer si la mobilité éducationnelle et la mobilité des revenus étaient associées aux niveaux de détresse psychologique à l'âge adulte, tels qu'évalués par l'échelle de Kessler (K-10). Les modèles ont tenu compte des caractéristiques sociodémographiques et ont été stratifiés en fonction du genre. RéSULTATS: Bien que nous n'ayons pas trouvé que la mobilité en général était associée à des niveaux plus élevés de détresse psychologique, nous avons trouvé que la mobilité éducationnelle descendante correspondait à des niveaux plus élevés de détresse psychologique (b = 0,15 avec IC 95% = 0,00, 0,31) chez les hommes. CONCLUSION: Dans l'ensemble, nous n'avons pas trouvé de preuves solides que la mobilité sociale en général a un impact sur les niveaux de détresse psychologique, mais la mobilité éducationnelle descendante en particulier peut avoir des conséquences négatives sur la santé mentale des hommes. En outre, un gradient notable entre le revenu et la détresse psychologique à l'âge adulte a été observé tant chez les femmes que chez les hommes.
Asunto(s)
Salud Mental , Movilidad Social , Adulto , Masculino , Humanos , Femenino , Estados Unidos , Escolaridad , Estudios Longitudinales , Canadá/epidemiología , Estrés Psicológico/epidemiologíaRESUMEN
BACKGROUND: Social relationships impact health and may affect proximal determinants such as obesity. Our review examined empirical evidence of the impact of changes in social relationships on risk of obesity in aging adults, with attention to gender. METHODS: We systematically searched Medline, EMBASE, Scopus, CINAHL, and ProQuest Dissertations and reference lists of relevant reviews and papers published up to November 2022. Longitudinal studies examining changes in marital status, living arrangement, social participation, and social networks and anthropometric changes or incident obesity were deemed eligible. Relevant data were extracted and synthesized narratively. RESULTS: We identified 41,910 eligible titles, resulting in 252 full texts and 7 included studies. All studies were conducted in the United States and assessed marital transitions only; 3 studies included both women and men. Overall, compared with people who remain non-married, entering marriage leads to a significant increase in body mass index (BMI) for both genders. Conversely, transitioning out of marriage through widowhood or divorce leads to a decrease in weight (kg/lbs), waist circumference, and BMI for both genders. All seven studies were deemed to be of medium quality. CONCLUSIONS: Our review revealed a paucity of prospective evidence on social connections as determinants of obesity among aging adults. There is limited evidence that marital transitions are associated with changes in anthropometric measurements in aging individuals, but no evidence on the effects of changes in living arrangements, social participation, and social networks on anthropometric measurements. More research attention to the social determinants of obesity is warranted.
RESUMEN
INTRODUCTION: Canadian research on racial health inequalities that foregrounds socially constructed racial identities and social factors which can explain consequent racial health inequalities is rare. This paper adopts a social typology of salient racial identities in contemporary Canada, empirically documents consequent racial inequalities in hypertension in an original survey dataset from Toronto and Vancouver, Canada, and then attempts to explain the inequalities in hypertension with information on socioeconomic status, perceived experiences with institutionalized and interpersonal discrimination, and psychosocial stress. METHODS: Telephone interviews were conducted in 2009 with 706 randomly selected adults living in the City of Toronto and 838 randomly selected adults living in the Vancouver Census Metropolitan Area. Bivariate analyses and logistic regression modeling were used to examine relationships between racial identity, hypertension, socio-demographic factors, socioeconomic status, perceived discrimination and psychosocial stress. RESULTS: The Black Canadians in the sample were the most likely to report major and routine discriminatory experiences and were the least educated and the poorest. Black respondents were significantly more likely than Asian, South Asian and White respondents to report hypertension controlling for age, immigrant status and city of residence. Of the explanatory factors examined in this study, only educational attainment explained some of the relative risk of hypertension for Black respondents. Most of the risk remained unexplained in the models. CONCLUSIONS: Consistent with previous Canadian research, socioeconomic status explained a small portion of the relatively high risk of hypertension documented for the Black respondents. Perceived experiences of discrimination both major and routine and self-reported psychosocial stress did not explain these racial inequalities in hypertension. Conducting subgroup analyses by gender, discerning between real and perceived experiences of discrimination and considering potentially moderating factors such as coping strategy and internalization of racial stereotypes are important issues to address in future Canadian racial inequalities research of this kind.