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1.
Proc Natl Acad Sci U S A ; 121(4): e2305564121, 2024 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-38236732

RESUMO

Data from the distant past are fertile ground for testing social science theories of education and social mobility. In this study, we construct a dataset from 3,640 tomb epitaphs of males in China's Tang Dynasty (618-907 CE), which contain granular and extensive information about the ancestral origins, family background, and career histories of the deceased elites. Our statistical analysis of the complete profiles yields evidence of the transition away from an aristocratic society in three key trends: 1) family pedigree (i.e., aristocracy) mattered less for career achievement over time, 2) passing the Imperial Examination (Keju) became an increasingly important predictor of one's career achievement, and 3) father's position always mattered throughout the Tang, especially for men who did not pass the Keju. The twilight of medieval Chinese aristocracy, according to the data, began in as early as the mid-seventh century CE.


Assuntos
Mobilidade Social , Ciências Sociais , Masculino , Humanos , Linhagem , Escolaridade , China
2.
Sci Rep ; 14(1): 1165, 2024 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-38216716

RESUMO

The COVID-19 pandemic demonstrated the importance of social distancing practices to stem the spread of the virus. However, compliance with public health guidelines was mixed. Understanding what factors are associated with differences in compliance can improve public health messaging since messages could be targeted and tailored to different population segments. We utilize Twitter data on social mobility during COVID-19 to reveal which populations practiced social distancing and what factors correlated with this practice. We analyze correlations between demographic and political affiliation with reductions in physical mobility measured by public geolocation tweets. We find significant differences in mobility reduction between these groups in the United States. We observe that males, Asian and Latinx individuals, older individuals, Democrats, and people from higher population density states exhibited larger reductions in movement. Furthermore, our study also unveils meaningful insights into the interactions between different groups. We hope these findings will provide evidence to support public health policy-making.


Assuntos
COVID-19 , Mídias Sociais , Masculino , Humanos , Estados Unidos/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Distanciamento Físico , SARS-CoV-2 , Pandemias/prevenção & controle , Mobilidade Social , Demografia
3.
Br J Sociol ; 75(1): 56-64, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37955958

RESUMO

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.


Assuntos
Pessoas com Deficiência , Humanos , Mobilidade Social , Renda , Escolaridade , Seguridade Social
4.
J Appl Gerontol ; 43(4): 446-453, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38016111

RESUMO

The purpose of this study is to investigate the association between social mobility and cognitive impairment among older adults in Korea. The study sample is drawn from nationally representative data, which comes from the 2016 Korean Longitudinal Study of Ageing (KLoSA). The final sample consists of 4264 KLoSA respondents aged 65 or older. Gender-specific logistic regression models are used to examine the association between social mobility and cognitive impairment. The results show that, when compared to the reference group (stable low social mobility), women in the downward and the stable high social mobility groups were less likely to have cognitive impairment. In contrast, upward social mobility was a protective factor for cognitive impairment only among men. Gender-specific interventions may be needed to enhance cognitive health among older Koreans. Further research is needed to examine the causal relations between social mobility and cognitive health between the genders.


Assuntos
Disfunção Cognitiva , Mobilidade Social , Humanos , Masculino , Feminino , Idoso , Estudos Longitudinais , Disfunção Cognitiva/epidemiologia , Envelhecimento/psicologia , República da Coreia/epidemiologia
5.
Soc Sci Med ; 340: 116340, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38006845

RESUMO

Socioeconomic status (SES) is a robust correlate of mental health, and emerging research indicates that life course trajectories of SES (i.e., social mobility) may be more predictive for health outcomes than point-in-time SES assessments. This paper presents five primary meta-analyses to determine how mental health differs between social mobility groups. We conducted a systematic review of PsycINFO, Web of Science, and PubMed for studies of social mobility and mental health. We used random-effects multilevel meta-analyses to compare mental health problems between individuals who experienced upward mobility, downward mobility, stable high SES, and stable low SES. We included data from 21 studies and 157,763 unique participants yielding 105 effect sizes. Upwardly mobile participants experienced more mental health problems than stable high SES participants (d = 0.11), fewer mental health problems than stable low SES participants (d = -0.24), and fewer mental health problems than downwardly mobile participants (d = -0.17). Downwardly mobile individuals experienced more mental health problems than stable high SES participants (d = 0.26) and fewer mental health problems than stable low SES participants (d = -0.10). Subgroup analyses revealed that the magnitude of effects did not differ by continent of study, type of generational mobility (intergenerational vs. intragenerational), or SES indicator. Meta-regressions with continuous moderators (age, gender, race, study quality) were also non-significant. Taken together, these results indicate that both upwardly and downwardly mobile individuals experience more mental health problems than those who are persistently advantaged, and they both experience fewer mental health problems than those who are persistently disadvantaged. Our findings suggest that while current SES has a stronger association with adult mental health than childhood SES, it is important to also consider the impact of early life and prior generation SES to account for lingering effects of early disadvantage.


Assuntos
Saúde Mental , Mobilidade Social , Adulto , Humanos , Criança , Classe Social , Fatores Socioeconômicos
6.
J Interpers Violence ; 39(7-8): 1676-1703, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37937750

RESUMO

Previous studies exploring the influential factors associated with attitudinal acceptance of wife abuse (AAWA) did not widely focus on the relation between women's social mobility (WSM) and different dimensions of AAWA in rural Bangladesh. This current study examined the association between WSM and different dimensions of AAWA in the context of socio-cultural differences among the Bengali, the Santal, and the Garo ethnic communities in rural Bangladesh. Adopting a cross-sectional design, 1,929 married men and women were randomly included in the study from 8 Bengali, 8 Santal, and 8 Garo villages where 50.2% were women and 49.8% were men. Of the sample, 33.2% Garo, 33.2% Santal, and 33.6% Bengali participants were included in this study. Data revealed that 45.5% of women had low social mobility and the prevalence of different dimensions of AAWA was high and varied among the study communities. We used descriptive statistics, chi-square, and binary logistic regression analysis to estimate the association. The multivariate binary logistic regression analysis results revealed that the likelihood of attitudinal acceptance of overall abuse, psychological abuse, physical abuse, abuse on disobeying family obligation, and abuse on challenging male authority were significantly lower for the respondents who belonged to families where women enjoyed high mobility compared to those who belonged to families where WSM was low. This study also showed that the Bengali and the Santal participants were more likely to accept different dimensions of AAWA compared to the Garos. This study suggests that WSM should be considered in policy-making and implementing interventions to reduce the different dimensions of AAWA in rural Bangladesh.


Assuntos
Maus-Tratos Conjugais , Humanos , Masculino , Feminino , Maus-Tratos Conjugais/psicologia , Estudos Transversais , Bangladesh/epidemiologia , Mobilidade Social , Análise Multivariada , População Rural , Fatores Socioeconômicos
7.
Can J Public Health ; 115(1): 148-156, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37801229

RESUMO

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.


Assuntos
Saúde Mental , Mobilidade Social , Adulto , Masculino , Humanos , Feminino , Estados Unidos , Escolaridade , Estudos Longitudinais , Canadá/epidemiologia , Estresse Psicológico/epidemiologia
8.
J Health Psychol ; 29(2): 99-112, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37466150

RESUMO

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.


Assuntos
Pais , Mobilidade Social , Humanos , Renda , Georgia
9.
Econ Hum Biol ; 52: 101336, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38104358

RESUMO

The distribution of obesity tends to shift from rich to poor individuals as countries develop, in a process of shifting sociodemographic patterns of obesity that has been called the 'obesity transition'. This change tends to happen with economic development, but little is known about the specific mechanisms that drive the change. We propose that improvements in childhood circumstances with economic development may be one of the drivers of the obesity transition. We explore whether the social gradient in body weight differs by childhood socioeconomic status (SES), proxied by the respondent's mother having Grade 12, using South Africa's nationally representative panel National Income Dynamics Study. In support of our hypothesis, we find that the social gradient in body weight is less positive for adults who had a high childhood SES, and already appears to have reversed among high-SES women who also had a high childhood SES. Upward social mobility over an individual's life course or across a single generation is associated with higher body weight compared to a stable high SES. But a high SES sustained in childhood and adulthood - or across more than one generation - may decrease adult obesity risk, and result in a reversal of the social gradient in body weight. Random effects within-between models show that the social gradient in body weight and its interaction with childhood SES are driven more by differences in income between individuals than by short-run changes in income within individuals, again suggesting that the obesity transition is driven by long-run changes rather than by very short-run changes. Our results are broadly robust to using several alternative measures of body weight, childhood SES and adult SES. Our results are consistent with the hypothesis that widespread improvements in childhood circumstances and nutrition with economic development may contribute to the shift to later stages of the obesity transition.


Assuntos
Obesidade , Mobilidade Social , Adulto , Humanos , Feminino , África do Sul/epidemiologia , Obesidade/epidemiologia , Classe Social , Peso Corporal , Fatores Socioeconômicos
10.
Adv Life Course Res ; 58: 100565, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-38054866

RESUMO

In this study, we explore the dynamics of the intragenerational mobility of the top income earners during financial crises. We analyze panel data on the income levels of a cohort consisting of 22,601 individuals in Israel born between 1963 and 1973, for the period between 1995 and 2013. Studying a specific cohort allows us to focus on the changes caused by period effects, rather than cohort replacement distortions. We use common intragenerational mobility measurements before, during, and after two major recessions- the Dot.com crisis and the Global Financial Crisis of 2008- which occurred during the analyzed period. However, since these are usually descriptive, we adopt a methodology that enables us to calculate confidence intervals of these measurements and thus test for changes over time. Our results show if the two crises had any effect on the intragenerational mobility of the top income earners of the analyzed cohort, it was a minor and transitory effect.


Assuntos
Renda , Parto , Humanos , Gravidez , Feminino , Israel , Reimplante , Mobilidade Social
11.
Adv Life Course Res ; 56: 100546, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-38054890

RESUMO

BACKGROUND: Optimizing cognitive development through early adulthood has implications for population health. This study aims to understand how socioeconomic position (SEP) across development relates to executive functioning. We evaluate three frameworks in life-course epidemiology - the sensitive period, accumulation, and social mobility hypotheses. METHODS: Participants were young adults from Santiago, Chile who were studied from 6 months to 21 years. Family SEP was measured at ages 1 y, 10 y, and 16 y with the modified Graffar Index. Executive functioning was assessed at ages 16 y and 21 y by the Trail Making Test Part B (Trails B). Analyses estimating 16 y and 21 y executive function involved 581 and 469 participants, respectively. Trails B scores were modeled as a function of SEP at 1 y, 10 y, and 16 y, as the total accumulation of disadvantage, and as change in SEP between 1 y and 10 y and between 10 y and 16 y. RESULTS: Participants were low- to middle-income in infancy and, on average, experienced upwards mobility across childhood. Half of participants (58%) improved Trails B scores from 16 y and 21 y. Most (68%) experienced upward social mobility between infancy and 16 y. When examined independently, worse SEP measured at 10 y and 16 y related to worse (longer time to complete) Trails B scores at Age 21 but did not relate to the other outcomes. After mutual adjustment as a test of the sensitivity hypothesis, no SEP measure was independently related to any outcome. Testing the accumulation hypothesis, cumulative low SEP was associated with worse cognitive performance at 21 y (ß = 3.6, p = 0.04). Results for the social mobility hypothesis showed no relation to cognitive scores or to change in cognitive scores. Comparing all hypotheses, SEP at 16 y explained the most variability in executive functioning at 21 y, providing support for the sensitive period hypothesis. CONCLUSIONS: Results indicate that experiencing cumulatively low socioeconomic position from infancy to adolescence can have a negative impact on cognitive functioning in young adulthood. Findings also provide evidence in support of adolescence as a key developmental period during which SEP can most strongly impact cognitive functioning.


Assuntos
Cognição , Função Executiva , Criança , Adolescente , Adulto Jovem , Humanos , Adulto , Chile , Renda , Mobilidade Social
12.
PLoS One ; 18(12): e0294676, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38051711

RESUMO

Recent works in the field of Social Psychology have shown the importance of studying subjective social mobility from different perspectives. In the literature about subjective societal mobility, most of the research is focused on the mobility-immobility framing. However, several authors suggested studying social mobility beliefs effects differentiating according to mobility's trajectory, that is, upward (i.e., improving status over time) and downward (i.e., getting worse in status over time). The present research was motivated by the lack of measures that discriminate between beliefs in upward and downward societal mobility. Across two studies using different samples of the Spanish adult population, we examined both dimensions of social mobility beliefs and tested their predictive validity on other related constructs. In Study 1 (N = 164), with an EFA, we corroborated the independence between the two types of mobility. The internal structure was confirmed by a CFA in Study 2 (N = 400). Furthermore, it was shown that upward and downward mobility beliefs are differently related to other related constructs. The results from Studies 1-2 showed good convergent validity. In all correlations with the different constructs (attitudes towards inequality, meritocratic beliefs, justification of the economic system, and status anxiety) we found opposite direction effects for both types of societal mobility (upward and downward). The development of this new instrument can help to deepen our understanding of the psychosocial consequences of subjective social mobility, as well as to differentiate two processes that may have different consequences.


Assuntos
Atitude , Mobilidade Social , Psicologia Social , Ansiedade
16.
Can Rev Sociol ; 60(4): 567-593, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37671607

RESUMO

The civil service examination system emerged to strengthen the emperor's power by recruiting political elites through open examinations. Did it, during the early- and mid-Ming dynasty, facilitate intergenerational mobility? Rather than oversimplifying it as a single-stage system of meritocracy, we propose a two-stage evaluation framework. In the first stage, the Metropolitan Exam featured merit-based evaluations and generated credentials necessary for becoming political elites. The subsequent non-eliminating Palace Exam then functioned to assess the students' organizational fit in line with an emperor's political calculations. In particular, those whose families served in the bureaucracy were favored, while those from affluent families were discriminated against. We test this two-stage framework using the records of 12,427 students who passed 46 exams between 1400 and 1580, a period characterizing the heyday of this system. Our empirical findings from the mixed-effect regression models confirm this argument and suggest promising directions for future research.


Le système d'examen de la fonction publique est apparu pour renforcer le pouvoir de l'empereur en recrutant des élites politiques par le biais d'examens ouverts. A-t-il, au début et au milieu de la dynastie Ming, facilité la mobilité intergénérationnelle ? Plutôt que de le simplifier à l'extrême comme un système de méritocratie à une seule étape, nous proposons un cadre d'évaluation en deux étapes. Au premier stade, l'examen métropolitain comportait une évaluation fondée sur le mérite et permettait d'obtenir les qualifications nécessaires pour devenir des élites politiques. L'examen du palais, non éliminatoire, permettait ensuite d'évaluer l'aptitude organisationnelle des étudiants en fonction des calculs politiques de l'empereur. En particulier, ceux dont les familles travaillaient dans la bureaucratie étaient favorisés, tandis que ceux issus de familles aisées étaient discriminés. Nous testons ce cadre en deux étapes en utilisant les dossiers de 12 427 étudiants qui ont passé 46 examens entre 1400 et 1580, une période qui caractérise l'apogée de ce système. Les résultats empiriques de nos modèles de régression à effets mixtes confirment cet argument et suggèrent des directions prometteuses pour la recherche future.


Assuntos
Credenciamento , Mobilidade Social , Humanos , Estudantes
17.
Front Public Health ; 11: 1228920, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37744505

RESUMO

Introduction: Older age is associated with the deterioration of physical functioning (PF), and low PF is strongly related to poor quality of life among older people. We conducted a study to examine the trajectories of PF between middle and old age, considering sex differences as well as the association between socioeconomic status (SES) at different life stages and changes in PF. Methods: We analyzed data from the Polish arm of the HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe) study, including 1,116 men and 1,178 women aged 45-64 years at baseline. Adult and childhood SES and social mobility were assessed using a retrospectively focused questionnaire. PF was assessed using the 10-question SF-36 scale at baseline examination, face-to-face re-examination, and three postal surveys, covering up to 20 years (on average, 18 years). We employed Generalized Estimating Equations models to assess changes in PF scores over time and compare PF trajectories across different SES categories. Results: After adjusting for age and other covariates, we found that, in both sexes, participants with always middle or high SES, as well as those who reported upward mobility, had higher PF scores at baseline compared to those with always low SES. A decline in PF between middle and old age was observed in all SES groups; however, the decline was slower in participants with always middle or high SES compared to those with always low SES. Conclusion: This cohort study revealed that lower SES and downward social mobility were cross-sectionally associated with poorer PF, while upward social mobility seemed to largely reverse the effect of low childhood SES. In addition to the cross-sectional associations observed at baseline, advantaged SES was also significantly associated with a slower decline in PF over an 18-year follow-up period.


Assuntos
Qualidade de Vida , Mobilidade Social , Criança , Adulto , Feminino , Humanos , Masculino , Idoso , Estudos de Coortes , Estudos Transversais , Estudos Retrospectivos , Classe Social
18.
Soc Sci Res ; 114: 102912, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37597932

RESUMO

With more countries entering an era of low fertility, factors that may shape individuals' childbearing desires have been extensively explored. One's intergenerational social mobility experience, however, remains under-discussed. This paper examines this issue against the backdrop of China, in which the total fertility rate has rapidly declined to the lowest-low level in recent decades. Using pooled five-wave data from the Chinese General Social Survey from 2010 to 2017, we found a checkmark-shaped relationship between social class and fertility desire. Chinese farmers have the greatest desired number of children, manual workers have the lowest, and the two upper classes lie in the middle. In general, one's origin class and destination class play a similar role in shaping fertility desire, demonstrating the coexistence of socialization and acculturation processes. The gender-specific examination further suggests that, compared to women, men are more reluctant to change the fertility attitude learned from the origin class. Based on these findings, our study proposes a novel explanation of the decline in fertility desire in China and contributes to the literature on how social mobility experiences and gender ideology jointly construct fertility desire.


Assuntos
Características da Família , Classe Social , Mobilidade Social , Feminino , Humanos , Masculino , Aculturação , Povo Asiático , China
19.
Artigo em Inglês | MEDLINE | ID: mdl-37444097

RESUMO

OBJECTIVES: This review aimed to identify and synthesize the existing literature on the effects of socioeconomic status (SES) changes on health. METHODS: A review was conducted using Medline, Cochrane library, and CINAHL (Cumulative Index to Nursing and Allied Health Literature). All longitudinal or cross-sectional studies that examined links between changes to SES across different time periods and measured health outcomes were included. Screening was conducted using select inclusion and exclusion criteria in order of title, abstract, and full text. Two independent reviewers assessed the quality of the full text articles using the Downs and Black checklist. RESULTS: Our literature search led to 2719 peer reviewed articles, 2639 of which were title screened after duplicates were removed. A total of 117 abstracts and 12 full text articles were screened. Overall, findings from 11 articles form the basis of this review. Eight different types of measures of changes to SES were identified. These include education, occupation, economic security, income sufficiency, home ownership, car ownership, health insurance, and marital status. Assessed outcomes included measures related to physical health, cardiovascular disease, mental health, and oral health. A large proportion of studies found that an SES change impacts health. Evidence suggests that those with consistently high SES have the best health outcomes, followed by those who report their SES change from low to high (upward social mobility). Evidence on the relative health effects for those who report their SES change from high to low (downward social mobility) compared to those who report consistently low SES is inconsistent. CONCLUSION: Current evidence suggests that an SES change has an impact on an individual's health. More research on the effects of SES changes on health outcomes in adulthood is needed and can inform various areas of health research including health resiliency and development. Future studies should focus on individual SES indicators and their effects on health outcomes at multiple points throughout life.


Assuntos
Ocupações , Mobilidade Social , Estudos Transversais , Renda
20.
JAMA Netw Open ; 6(7): e2323030, 2023 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-37436752

RESUMO

Importance: Increasing mortality from suicide, drug overdose, and alcohol-related liver disease (collectively referred to as deaths of despair) is a critical public health crisis. Income inequality and social mobility have been separately associated with all-cause mortality; however, no studies have examined their interaction with these preventable deaths. Objective: To assess the interaction between income inequality and social mobility with deaths of despair among working-age Hispanic, non-Hispanic Black, and non-Hispanic White populations. Design, Setting, and Participants: This cross-sectional study analyzed data from the Centers for Disease Control and Prevention WONDER (Wide-Ranging Online Data for Epidemiologic Research) database on county-level deaths of despair from 2000 to 2019 across racial and ethnic groups. Statistical analysis was performed from January 8 to May 20, 2023. Exposures: The primary exposure of interest was county-level income inequality, measured by the Gini coefficient. Another exposure was race- and ethnicity-specific absolute social mobility. Tertiles for the Gini coefficient and social mobility were created to evaluate the dose-response association. Main Outcomes and Measures: The main outcomes were adjusted risk ratios (RRs) of deaths from suicide, drug overdose, and alcoholic liver disease. The interaction between income inequality and social mobility was formally tested on both the additive and multiplicative scales. Results: The sample included 788 counties for Hispanic populations, 1050 counties for non-Hispanic Black populations, and 2942 counties for non-Hispanic White populations. Over the study period, 152 350, 149 589, and 1 250 156 deaths of despair were recorded for working-age Hispanic, non-Hispanic Black, and non-Hispanic White populations, respectively. Compared with the reference group (counties with low income inequality and high social mobility), counties with greater income inequality (high inequality: RR, 1.26 [95% CI, 1.24-1.29] for Hispanic populations; RR, 1.18 [95% CI, 1.15-1.20] for non-Hispanic Black populations; and RR, 1.22 [95% CI, 1.21-1.23] for non-Hispanic White populations) or less social mobility (low mobility: RR, 1.79 [95% CI, 1.76-1.82] for Hispanic populations; RR, 1.64 [95% CI, 1.61-1.67] for non-Hispanic Black populations; and RR, 1.38 [95% CI, 1.38-1.39] for non-Hispanic White populations) had higher RRs for deaths of despair. In counties with high income inequality and low social mobility, positive interactions were observed on the additive scale for Hispanic populations (relative excess risk due to interaction [RERI], 0.27 [95% CI, 0.17-0.37]), non-Hispanic Black populations (RERI, 0.36 [95% CI, 0.30-0.42]), and non-Hispanic White populations (RERI, 0.10 [95% CI, 0.09-0.12]). In contrast, positive interactions on the multiplicative scale were found only for non-Hispanic Black populations (ratio of RRs, 1.24 [95% CI, 1.18-1.31]) and non-Hispanic White populations (ratio of RRs, 1.03 [95% CI, 1.02-1.05]), but not for Hispanic populations (ratio of RRs, 0.98 [95% CI, 0.93-1.04]). In the sensitivity analyses using continuous Gini coefficient and social mobility, a positive interaction was observed between higher income inequality and lower social mobility with deaths of despair on both the additive and multiplicative scales for all 3 racial and ethnic groups. Conclusions and Relevance: This cross-sectional study found that the joint exposure of unequal income distribution and lack of social mobility was associated with additional risks for deaths of despair, suggesting that addressing the underlying social and economic conditions is crucial in responding to the epidemic of deaths of despair.


Assuntos
Morte , Renda , Mobilidade Social , Estudos Transversais , Fatores Socioeconômicos , Hispânico ou Latino , Negro ou Afro-Americano , Estados Unidos
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