Hazardous alcohol consumption in slow- and fast-privatized Russian industrial towns.

Hazardous drinking, defined as the consumption of homemade, unofficially made alcohol and non-beverages, is prevalent and accounts for a high proportion of alcohol-related deaths in Russia. Individual-level characteristics are important explanations of hazardous drinking, but they are unlikely to explain spatial variation in this type of alcohol consumption. Areas that attracted insufficient attention in the research of hazardous drinking are the legacy of industrialization and the speed of economic reforms, mainly through the privatization policy of major enterprises in the 1990s. Applying mixed-effects logistic regressions to a unique dataset from 30 industrial towns in the European part of Russia, we find that in addition to individual-level characteristics such as gender, age, marital status, education, social isolation, labor market status, and material deprivation, the types of towns where informants' relatives resided such as industrial structure and speed of privatization also accounted for the variance in hazardous alcohol consumption among both male and female populations of the analyzed towns.

The heterogeneous well-being effects of intergenerational mobility perceptions.

Individuals make comparisons with their parents which determine their intergenerational mobility perceptions, yet very little is known about the areas used for intergenerational comparison and whether these matter for individuals' well-being. In 2021 we commissioned a nationally representative survey in Georgia in which we explicitly asked 1159 individuals an open-ended question on the most important areas in their intergenerational comparisons. More than 170 types of answers were provided by respondents and many of these responses went beyond the standard indicators of intergenerational mobility. We show that the areas of intergenerational comparison significantly differ between those who perceive themselves as being downwardly and upwardly mobile or immobile using the measure of mobility previously validated in cross-national research. Using, among other statistical approaches, treatment effects estimators, we demonstrate that some areas of intergenerational comparison, particularly in terms of income attainment, are significantly and consistently associated with internationally validated measures of well-being.

A longitudinal study of perceived social position and health-related quality of life.

BACKGROUND: A large body of evidence suggests that there is a social gradient in the association between perceived social position and various health outcomes. Yet only a fraction of this research uses longitudinal data, and these studies usually rely on two data points in time, consider a single health outcome measure, overlook non-linear effects of perceived social position, and come almost exclusively from the Western welfare democracies. METHODS: Using data for 1921 individuals from three waves (2008, 2013, 2018) of the Polish Panel Survey (POLPAN), we fit between- and within-individuals hybrid-effects models with cluster-robust standard errors to investigate the association between one's perceived social position (self-placement on a socioeconomic hierarchy scale varying 1 to 10) and subsequent health-related quality of life (HRQoL) measured using the Nottingham Health Profile (NHP) and its six components. RESULTS: We find that the association between perceived social position and health-related quality of life is larger when estimated between individuals than within individuals, yet in fixed- and hybrid-effects models perceived social position remains significantly and negatively linked with both the aggregated NHP measure as well as with its components such as emotional reaction, physical abilities, sleep, and social isolation. We also identify that starting to perceive oneself at the lower end of the social hierarchy is associated with a deteriorating health-related quality of life but a change at the top of the perceived social hierarchy is not linked with an improvement in NHP scores. CONCLUSIONS: We provide new evidence on the significant and non-linear links between perceived social position and health-related quality of life and highlight possible pathways linking these two aspects of individuals' lives.

Early-life impairments, chronic health conditions, and income mobility.

Individuals who have congenital conditions or become disabled early in life tend to have poorer educational and occupational outcomes than non-disabled individuals. Disability is known to be a complex entity with multiple causations, involving, inter alia, physiological, social, economic, and cultural factors. It is established that social factors can influence educational and occupational attainment for disabled people, and current disability policy in many countries, particularly in the Global North, stress the importance of equality of opportunity. However, there is a scarcity of research that explores the specific degrees to which advanced welfare states contribute to the equalization of life chances for individuals with early-life impairments and chronic health conditions. In this study, we use a Norwegian sample of high-quality register data on individuals with vision loss, hearing loss, physical impairment, type 1 diabetes, asthma, and Down syndrome diagnosed early in life and compare their intergenerational income mobility trajectories with a random sample drawn from the country's entire population. We find that individuals' early-life diagnoses are linked to significantly worse income outcomes in adulthood than what is observed among the general population. We conclude that even in one of the most advanced egalitarian welfare states, such as Norway, much remains to be done to equalize life chances for individuals with early-life impairments and chronic health conditions.

No evidence that social-democratic welfare states equalize valued outcomes for individuals with disabilities.

It is acknowledged that generous welfare states can provide better outcomes to their populations in terms of objective and subjective indicators of well-being, yet there is little comparative evidence of the role that the welfare state regime plays in lessening disability-based inequalities. Using a large comparative data set of most European societies, Tukey's honestly significant difference and generalized Hausman tests for six welfare state regimes, we examine the assumption that social-democratic countries perform better in mitigating disability-based inequalities than conservative, liberal, Southern, Eastern European, and the former Soviet Union welfare state regimes. We compare the valued outcomes for individuals with and without disabilities regarding their education, labour market participation, material well-being, and life satisfaction. The main finding of this study is that the most generous welfare states in Europe do not perform better, and in some cases, perform worse, than other less comprehensive welfare state regimes in closing the gap in valued outcomes between individuals with disabilities and the rest of the population. We discuss potential explanations of these inequalities such as the nature of expectations and changing characteristics of welfare state regimes, and difficulties related to measuring disabilities across European societies.

A counterexample to secularization theory? Assessing the Georgian religious revival.

Secularization theory allows for transitory religious revivals under certain conditions, such as extreme societal crises or state weakness. The country of Georgia has witnessed the largest religious revival of Orthodox countries and one of the most striking religious resurgences worldwide. This paper gives both a statistical and historical description of this revival and asks whether it is a counterexample to secularization theory. We show that the main thrust of the religious revival in Georgia lasted 25 years and seized the entire society in what was mainly a period effect. The most significant cause for the revival was a major societal and economic crisis starting in 1985 combined with a very weak state, creating massive individual insecurity. In these circumstances, the Georgian Orthodox Church was able to provide identity for individuals and legitimacy for governments. Other possible causes of the revival-state funding, too rapid modernization, or emigration-can be excluded as primary drivers of the process. The Georgian case shows a situation in which secularization theory expects transitory revivals and is thus not a counterexample.

Physical attractiveness and cardiometabolic risk.

OBJECTIVES: There is only limited evidence suggesting that physical attractiveness and individuals' actual health are causally linked. Past studies demonstrate that characteristics related to physical attractiveness are more likely to be present in healthy individuals, including those with better cardiovascular and metabolic health, yet many of these studies do not account for individuals' initial health and socioeconomic characteristics, which are related to both physical attractiveness and later life health. METHODS: We use panel survey data from the National Longitudinal Study of Adolescent to Adult Health in the United States to examine the relationship between interviewer-rated in-person physical attractiveness and actual cardiometabolic risk (CMR) based on a set of relevant biomarkers: LDL cholesterol, glucose mg/dL, C-reactive protein, systolic and diastolic blood pressure, and resting heart rate. RESULTS: We identify a robust relationship between individuals' physical attractiveness and 10-year follow up actual health measured by the levels of CMR. Individuals of above-average attractiveness appear to be noticeably healthier than those who are described as having average attractiveness. We find that individuals' gender and race/ethnicity do not have a major effect on the described relationship. The link between physical attractiveness and health is affected by interviewers' main demographic characteristics. We carefully address the possibility of confounders affecting our results including sociodemographic and socioeconomic characteristics, cognitive and personality traits, initial health problems and BMI. CONCLUSION: Our findings are largely in line with the evolutionary perspective which assumes that physical attractiveness is linked to individuals' biological health. Being perceived as physically attractive might also imply, among other aspects, high levels of satisfaction with life, self-confidence and ease of finding intimate partners, all of which can positively affect individuals' health.

Information About Inequality of Opportunity Increases Downward Mobility Perceptions: A Population-Wide Randomized Survey Experiment.

Existing evidence which is primarily based on cross-sectional and observational data suggests that perceptions of doing worse or better than parents might be more important for various life outcomes than the conventional measures of mobility based on the objective indicators of socioeconomic position. In 2021, we commissioned a nationally representative survey in Georgia which included a population-wide randomized survey experiment. We confirmed the association between, on the one hand, perceived social mobility and, on the other hand, physical and mental health, satisfaction with life, and the perceived state of affairs in the country. More importantly, the experimental design allowed us to conclude that the perception of being downwardly mobile was causally determined by a short message shared with individuals that equality of opportunity in their country was low. Those who were given information that children's socioeconomic position was strongly linked to their parents' socioeconomic position were seven percentage points more likely than individuals in the control group to perceive themselves as being downwardly mobile. We extrapolate these findings to the broader context and argue that the messages about (in)equality of opportunity which individuals receive in their everyday lives might also shape their perceptions of social mobility in other countries.

Does perceived social mobility affect health? Evidence from a fixed effects approach.

RATIONALE: The question as to whether changing one's socioeconomic position over the life course affects health has not been answered in a conclusive manner. At the same time, it has been established that individuals who think of themselves that they are higher in the social hierarchy are healthier than those who think otherwise. OBJECTIVE: In this study, we focus on perceived social mobility to shed new light on the issue of how social mobility affects health. We examine whether perceived social mobility, i.e., an individual's appraisal of doing better or worse than their parents, affects health by analyzing longitudinal data from Poland. METHODS: Using a fixed effects approach to account for all time-invariant and important time-varying confounders, we analyze the Polish Panel Survey which has been collecting data on participants' social mobility perceptions along with information on their self-reported physical health and psychological wellbeing. RESULTS: We find that perceived social mobility is a significant predictor of self-reported physical health and psychological wellbeing, even in models that adjust for a host of theoretically relevant control variables. The results demonstrate that upward subjective mobility has a consistent and strong positive effect on health outcomes. The effect of perceived social mobility is stronger for males and for those with less advantageous social origins. CONCLUSIONS: Our findings are in line with the "from rags to riches" theoretical perspective, emphasizing the positive implications of upward social mobility on health through various psychological mechanisms. Based on our findings, we call for greater scholarly attention to subjective aspects of social mobility in research on health outcomes.

Population health, not individual health, drives support for populist parties.

Recent electoral shifts toward populist parties may have been partly driven by deteriorating health, although empirical evidence on this link is primarily confined to ecological designs. We performed both ecological- and individual-level analyses to investigate whether changes in health are associated with changes in the support for populist parties. Data were used on the strategic Dutch case, the only liberal democracy featuring leftist and rightist populist politicians in parliament for over a decade. We used: (a) fixed effects models to examine whether changes in the standardized mortality ratios and self-assessed health (SAH) in municipalities were associated with changes in the populist vote share in four parliamentary elections (2006/2010/2012/2017); and (b) 10 waves of panel data collected in 2008 to 2018 to investigate if changes in individual-level SAH were linked to movement in the sympathy, intention to vote, and actual voting for populist parties. The ecological analyses showed that: changes in municipality mortality ratios were positively linked to changes in the vote share of right-wing populist parties, while changes in the prevalence of less-than-good SAH were negatively associated with changes in the vote share for left-wing populist parties. The individual-level analyses identified no such associations. Our findings imply that support for populist parties may be driven by health concerns at the ecological, but not the individual, level. This suggests that sociotropic (e.g. perceiving population health issues as a social problem), but not egotropic (e.g. relating to personal health issues like experienced stigma), concerns may underlie rising support for populist parties.

The COVID-19 pandemic and war.

Could there be a symbiotic relationship between COVID-19 and conflict? On the one hand, circumstances associated with armed conflicts may give rise to greater spread of the virus, while, on the other hand, the COVID-19 pandemic may create conditions for violence through heightened xenophobia and nationalism or may change the dynamics of existing conflicts. We illustrate this with the example of war in the South Caucasus, one of the hot spots of the pandemic. Elsewhere, COVID-19 may have reduced the intensity of conflicts in some places, but it also may have contributed to anti-government protests and communal violence. We call for greater emphasis on traditional public health measures in unstable settings coupled with actions to hasten the peaceful resolution of ongoing conflicts.

BMI and dissatisfaction with life: contextual factors and socioemotional costs of obesity.

PURPOSE: In this study, we investigate whether individuals' BMI categories are associated with being dissatisfied with one's life, how this association is affected by the social comparison that individuals make, and what the role of the overall BMI levels in this process is. METHODS: We use data for 21,577 men and 27,415 women, collected in 2016 by the European Bank for Reconstruction and Development, from 34 countries in Europe, the Middle East, and Central Asia. To understand the moderating effect of contextual environment, we use multilevel mixed effect logistic regression models and data for national, regional, and cohort-specific BMI levels. RESULT: We find that the association of BMI and dissatisfaction with life differs by gender, with overweight men being less likely to be dissatisfied with life than men with normal weight and obese women being more likely to be dissatisfied with life compared to women with normal weight. For contextual effects, we find that obese women in regions with low BMI levels are more likely to be dissatisfied with life. The effect of obesity on female life dissatisfaction is not observed in regions with high BMI levels. As for men, regional BMI levels affect the levels of life dissatisfaction but only for underweight men. CONCLUSIONS: Our study adds additional nuance to the quality-of-life research by showing that the association between BMI and decreased life satisfaction is, at least partially, moderated by the contextual environment, and that the character of these effects differs by gender.

Downward income mobility among individuals with poor initial health is linked with higher cardiometabolic risk.

The effects of socioeconomic position (SEP) across life course accumulate and produce visible health inequalities between different socioeconomic groups. Yet, it is not well-understood how the experience of intergenerational income mobility between origin and destination SEP, per se, affects health outcomes. We use data from the National Longitudinal Study of Adolescent to Adult Health collected in the United States with the outcome measure of cardiometabolic risk (CMR) constructed from data on LDL Cholesterol, Glucose MG/DL, C-reactive protein, systolic and diastolic blood pressure, and resting heart rate. Intergenerational income mobility is estimated as the difference between Waves 1 and 5 income quintiles. Diagonal reference models are used to test if intergenerational income mobility, net of origin and destination income quintile effects, is associated with CMR. We find that individuals in the lowest and the highest income quintiles have, respectively, the highest and the lowest CMR; both origin and destination income quintiles are equally important; there are no significant overall income mobility effects for different gender and race/ethnicity groups, but downward income mobility has negative health implications for individuals with poor initial health. We conclude that downward income mobility can increase inequalities in CMR in the United States by worsening the health of those who had poor health before their mobility experiences.

Social Mobility, Health and Wellbeing in Poland.

Recently there has been a surge of interest in the consequences of intergenerational social mobility on individuals' health and wellbeing outcomes. However, studies on the effects of social mobility on health, using high-quality panel survey data, have almost exclusively been conducted in Western welfare democracies. To account for this gap, and using empirical data from one of the largest and most eventful post-communist countries, Poland, in this study we investigate how individuals' origin and destination socio-economic position and social mobility are linked to self-rated health and reported psychological wellbeing. We use the Polish Panel Survey (POLPAN) data to construct self-rated health and psychological wellbeing measures, origin, destination and occupational class mobility variables, and account for an extensive set of sociodemographic determinants of health. We employ diagonal reference models to distinguish social mobility effects from origin and destination effects, and account for possible health selection mechanisms. Our results suggest that there is an occupational class gradient in health in Poland and that both parental and own occupational class matter for individual health outcomes. We also find a positive reported psychological wellbeing effect for upward social mobility from the working to the professional class.

Equality of opportunity and health in post-COVID world.

Links between equality of opportunity and health in post-COVID world must be an issue of general interest to academic, health, and policy audiences in the developed countries and other parts of the world. We already know that COVID-19 disproportionally affects most vulnerable and marginalised groups, while their positions in social hierarchy are strongly shaped by intergenerational transmission of advantages and disadvantages. Further, recent evidence from the United States and Europe also suggests that inequality of opportunity has significant negative consequences for health. This correspondence end with a call that decision makers, while rebuilding the post-COVID social model, should remember that equality of opportunity is not only fair but it is also good for health.

Socioeconomic position, social mobility, and health selection effects on allostatic load in the United States.

The contemporaneous association between higher socioeconomic position and better health is well established. Life course research has also demonstrated a lasting effect of childhood socioeconomic conditions on adult health and well-being. Yet, little is known about the separate health effects of intergenerational mobility-moving into a different socioeconomic position than one's parents-among early adults in the United States. Most studies on the health implications of mobility rely on cross-sectional datasets, which makes it impossible to differentiate between health selection and social causation effects. In addition, understanding the effects of social mobility on health at a relatively young age has been hampered by the paucity of health measures that reliably predict disease onset. Analysing 4,713 respondents aged 25 to 32 from the National Longitudinal Study of Adolescent Health's Waves I and IV, we use diagonal reference models to separately identify the effects of socioeconomic origin and destination, as well as social mobility on allostatic load among individuals in the United States. Using a combined measure of educational and occupational attainment, and accounting for individuals' initial health, we demonstrate that in addition to health gradient among the socially immobile, individuals' socioeconomic origin and destination are equally important for multi-system physiological dysregulation. Short-range upward mobility also has a positive and significant association with health. After mitigating health selection concerns in our observational data, this effect is observed only among those reporting poor health before experiencing social mobility. Our findings move towards the reconciliation of two theoretical perspectives, confirming the positive effect of upward mobility as predicted by the "rags to riches" perspective, while not contradicting potential costs associated with more extensive upward mobility experiences as predicted by the dissociative thesis.

How democracy alters our view of inequality - and what it means for our health.

BACKGROUND: Income inequality is associated with poor health when economic disparities are especially salient. Yet, political institutions may alter this relationship because democracies (as opposed to autocracies) may be more inclined to frame inequalities in negative rather than positive ways. Living in a particular political system potentially alters the messages individuals receive about whether inequality is large or small, good or bad, and this, in turn, might affect whether beliefs about inequality influence health. Further, media coverage of economic inequality may negatively affect health if it contributes toward the general perception that the gap between rich and poor has gone up, even if there has been no change in income differentials. METHODS: In this study, we explore the relationship between democracy, perceptions of inequality, and self-rated health across 28 post-communist countries using survey and macro-level data, multilevel regression models, and inverse probability weighting to estimate the average treatment effect on the treated. RESULTS: We find that self-rated health is higher in more democratic countries and lower among people who believe that inequality has risen in the last few years. Moreover, we observe that people in democracies are more likely to learn about rising inequality through watching television and that when they do it has a more harmful effect on their health than when people in autocracies learn about rising inequality through the same channel, suggesting that in countries where there is less trust in the television media learning about rising inequality is not as harmful for health. CONCLUSIONS: Our results indicate that while democracies are generally good for well-being, they may not be unambiguously positive for health. This does not mean, of course, that inequality is good for health nor that, on average, autocracies have better health than democracies; but rather that being more aware of inequality can negatively affect self-rated health.

The Polish Panel Survey (POLPAN) dataset: Capturing the impact of socio-economic change on population health and well-being in Poland, 1988-2018.

The Polish Panel Survey, POLPAN, one of the longest continuously run panel studies in Europe, is designed to facilitate research on the socio-economic structure, inequalities and the individual life course under conditions of social change in Poland. POLPAN is well suited for studying how women's and men's health and wellbeing are influenced by their life conditions, such as financial and social resources, that Poland's post-1989 profound socio-economic transformations impacted, and how health outcomes further shape individuals' attitudes and behaviours. Initiated in 1987-88, POLPAN has been fielded in five-year intervals, most recently in 2018, with wave-specific samples representative of the Polish adult population and response rates for full panelists consistently above 70%. In POLPAN, health assessment measures are collected in all waves, as part of respondents' multi-dimensional and life course inequality profile. Data on self-rated physical and psychological health, collected since 1998 (Wave Three), are complemented with respondents' Nottingham Health Profile and core anthropometric information about personal weight and height (Wave Five onwards); health and wellbeing related reasons for work interruptions (since Wave Four); information on extensive hospital stays (Wave Six onwards) and respondents' chronic or protracted illnesses (in Wave Six), respondents' disability status (all waves). The newly released integrated 1988-2018 POLPAN dataset is available on Harvard Dataverse, or upon request, via e-mail: polpan@ifispan.waw.pl.

Intergenerational social mobility and health in Russia: Mind over matter?

The consequences of changing one's socio-economic status over the life course-i.e. social mobility-for individual health are not well understood. Theories of the health implications of social mobility draw on the human perception of one's changing conditions, but empirical studies mostly examine the health implications of moving from objectively defined indicators of parental socio-economic position such as education, occupation, or income, to own socio-economic position in adult life. Little is known about the consequences of individuals' own assessment of changes in socio-economic position for health outcomes. In this study, we examine the association of social mobility and health in a unique sample of the Russian population after the transition to a market society. We take a broad perspective on social mobility, putting emphasis on subjectively perceived social mobility. Results show that individuals' objective characteristics only partially explain the variation in their subjective perceptions of intergenerational mobility. Net of social origin and destination variables, subjective social mobility is associated with individuals' health outcomes, as measured by the 12-Item Short Form Health Survey. Those who perceive being upwardly mobile report better health, and downward mobility is associated with poorer health. The association holds for mental and physical health, for perceived downward and upward social mobility, and for a general subjective measure of mobility and a subjective measure prompting respondents to only think of mobility in terms of occupation. These findings are robust to controlling for a rich set of socio-demographic predictors on childhood adversity, contemporaneous material wellbeing, and family-related circumstances. We conclude that a conventional focus on single socio-economic status dimensions such as occupation might be too narrow to capture the health consequences of social mobility.

Are Populist Leaders Creating the Conditions for the Spread of COVID-19? Comment on "A Scoping Review of Populist Radical Right Parties' Influence on Welfare Policy and its Implications for Population Health in Europe".

Do populist leaders contribute to the spread of coronavirus disease 2019 (COVID-19)? While all governments have struggled to respond to the pandemic, it is now becoming clear that some political leaders have performed much better than others. Among the worst performing are those that have risen to power on populist agendas, such as in the United States, Brazil, Russia, India, and the United Kingdom. Populist leaders have tended to: blame "others" for the pandemic, such as immigrants and the Chinese government; deny evidence and show contempt for institutions that generate it; and portray themselves as the voice of the common people against an out-of-touch 'elite.' In our short commentary, focusing on those countries with the most cases, we find that populist leaders appear to be undermining an effective response to COVID-19. Perversely, they may also gain politically from doing so, as historically populist leaders benefit from suffering and ill health. Clearly more research is needed on the curious correlation of populism and public health. Notwithstanding gaps in the evidence, health professionals have a duty to speak out against these practices to prevent avoidable loss of life.