Multimorbid life expectancy across race, socio-economic status, and sex in South Africa.

Multimorbidity is increasing globally as populations age. However, it is unclear how long individuals live with multimorbidity and how it varies by social and economic factors. We investigate this in South Africa, whose apartheid history further complicates race, socio-economic, and sex inequalities. We introduce the term 'multimorbid life expectancy' (MMLE) to describe the years lived with multimorbidity. Using data from the South African National Income Dynamics Study (2008-17) and incidence-based multistate Markov modelling, we find that females experience higher MMLE than males (17.3 vs 9.8 years), and this disparity is consistent across all race and education groups. MMLE is highest among Asian/Indian people and the post-secondary educated relative to other groups and lowest among African people. These findings suggest there are associations between structural inequalities and MMLE, highlighting the need for health-system and educational policies to be implemented in a way proportional to each group's level of need.

A Dynamic Structural Equation Approach to Modeling Wage Dynamics and Cumulative Advantage across the Lifespan.

Wages and wage dynamics directly affect individuals' and families' daily lives. In this article, we show how major theoretical branches of research on wages and inequality-that is, cumulative advantage (CA), human capital theory, and the lifespan perspective-can be integrated into a coherent statistical framework and analyzed with multilevel dynamic structural equation modeling (DSEM). This opens up a new way to empirically investigate the mechanisms that drive growing inequality over time. We demonstrate the new approach by making use of longitudinal, representative U.S. data (NLSY-79). Analyses revealed fundamental between-person differences in both initial wages and autoregressive wage growth rates across the lifespan. Only 0.5% of the sample experienced a "strict" CA and unbounded wage growth, whereas most individuals revealed logarithmic wage growth over time. Adolescent intelligence and adult educational levels explained substantial heterogeneity in both parameters. We discuss how DSEM may help researchers study CA processes and related developmental dynamics, and we highlight the extensions and limitations of the DSEM framework.

The Matthew effect in science funding.

A classic thesis is that scientific achievement exhibits a "Matthew effect": Scientists who have previously been successful are more likely to succeed again, producing increasing distinction. We investigate to what extent the Matthew effect drives the allocation of research funds. To this end, we assembled a dataset containing all review scores and funding decisions of grant proposals submitted by recent PhDs in a €2 billion granting program. Analyses of review scores reveal that early funding success introduces a growing rift, with winners just above the funding threshold accumulating more than twice as much research funding (€180,000) during the following eight years as nonwinners just below it. We find no evidence that winners' improved funding chances in subsequent competitions are due to achievements enabled by the preceding grant, which suggests that early funding itself is an asset for acquiring later funding. Surprisingly, however, the emergent funding gap is partly created by applicants, who, after failing to win one grant, apply for another grant less often.

Towards a More Realistic Citation Model: The Key Role of Research Team Sizes.

We propose a new citation model which builds on the existing models that explicitly or implicitly include "direct" and "indirect" (learning about a cited paper's existence from references in another paper) citation mechanisms. Our model departs from the usual, unrealistic assumption of uniform probability of direct citation, in which initial differences in citation arise purely randomly. Instead, we demonstrate that a two-mechanism model in which the probability of direct citation is proportional to the number of authors on a paper (team size) is able to reproduce the empirical citation distributions of articles published in the field of astronomy remarkably well, and at different points in time. Interpretation of our model is that the intrinsic citation capacity, and hence the initial visibility of a paper, will be enhanced when more people are intimately familiar with some work, favoring papers from larger teams. While the intrinsic citation capacity cannot depend only on the team size, our model demonstrates that it must be to some degree correlated with it, and distributed in a similar way, i.e., having a power-law tail. Consequently, our team-size model qualitatively explains the existence of a correlation between the number of citations and the number of authors on a paper.

Unobserved Population Heterogeneity and Dynamics of Health Disparities.

BACKGROUND: A growing body of literature has reported widening educational health disparities across birth cohorts or time periods in the United States, but has paid little attention to the implication of mortality selection on the cohort trend in health disparities. OBJECTIVE: This study investigates how changes in the variance of unobserved frailty over time may complicate the interpretation of cohort trends in health disparities and life expectancy. METHODS: We use the microsimulation method to test the effect of mortality selection and further propose a counterfactual simulation procedure to estimate its contribution. Data used in the simulations are based on Panel Studies of Income Dynamics 1968-2013, National Health and Nutrition Examination Survey data 1999-2012, and National Health Interview Survey data 1986-2011. RESULTS: Simulation shows that mortality selection may generate seemingly contradictory trends in health disparities and life expectancy across birth cohorts at the group and individual level. Life expectancy can change even when individual mortality curve is fixed. In the absence of a change in the causal effect of education on mortality at the individual level, an educational life expectancy gap can change across cohorts as a result of the change in frailty variance. Empirical analysis shows that mortality selection accounts for a sizeable amount of contribution to the widening educational life expectancy gap from the 1950s to 1960s birth cohorts in the United States. CONTRIBUTION: We demonstrate mortality selection can complicate the cohort trend in health disparities and life expectancy and propose a counterfactual simulation method to evaluate its contribution.

Older Workers in the Time of COVID-19: The Senior Community Service Employment Program and Implications for Social Work.

It has long been the goal of many gerontological social work scholars to increase the ability and opportunity for people to be engaged in paid and unpaid work throughout the life course. Yet the COVID-19 pandemic is revealing and exacerbating the financial insecurity of many older adults. In this paper, we review information related to older workers and how they might be affected by this pandemic and its aftermath, paying particular attention to the most socioeconomically and physically vulnerable older workers. We also offer first-hand experiences from our careers working with and conducting scholarship on older workers, paying particular attention to recent actions by many in the Senior Community Service Employment Program (SCSEP) network to provide paid sick leave to its low-income, older adult participants. We conclude with implications for social work scholarship and teaching, noting the uptick in technology use among older adults and the disparities that remain, as well as teaching that integrates discussions on the lifelong and cumulative effects of inequalities and marginalization and the need for additional researcher, student, and community collaborations.

Trajectories of perceived neighborhood quality across the life course: Sociodemographic determinants and implications for well-being.

Neighborhoods are an important social context across the life course, with implications for well-being throughout adulthood. However, the capacity to select and/or alter one's neighborhood is dependent in part upon factors such as race, class, and gender. Cumulative advantage/disadvantage and cumulative inequality theory both anticipate growing disparities between the most and least advantaged over time, yet disagree on the a/symmetry of these divergent trajectories. This study analyzes three-wave longitudinal data from the National Study of Midlife Development in the United States (1995-2014) to examine whether trajectories of perceived neighborhood quality differ according to sociodemographic characteristics over a twenty-year period, and whether neighborhood quality influences individual well-being over the same timespan. Results indicate that (1) women, Black and other nonwhite residents, and renters report worse neighborhood quality than their peers; (2) perceived neighborhood quality declines with age for Black and poorly educated residents; (3) perceived neighborhood quality improves with age for highly educated residents; (4) the overall deficit in perceived neighborhood quality among renters is weaker for Black than for White residents, while the overall deficit in perceived neighborhood quality among the poorly educated is contingent upon their having children. Moreover, (5) perceived neighborhood quality predicts both life satisfaction and negative affect over two decades, though its influence on the latter was contingent upon owning or mortgaging one's home rather than renting. Overall, findings offer support for both cumulative advantage/disadvantage and cumulative inequality theory, and suggest implications for theory and future research.

Principles of scientific research team formation and evolution.

Research teams are the fundamental social unit of science, and yet there is currently no model that describes their basic property: size. In most fields, teams have grown significantly in recent decades. We show that this is partly due to the change in the character of team size distribution. We explain these changes with a comprehensive yet straightforward model of how teams of different sizes emerge and grow. This model accurately reproduces the evolution of empirical team size distribution over the period of 50 y. The modeling reveals that there are two modes of knowledge production. The first and more fundamental mode employs relatively small, "core" teams. Core teams form by a Poisson process and produce a Poisson distribution of team sizes in which larger teams are exceedingly rare. The second mode employs "extended" teams, which started as core teams, but subsequently accumulated new members proportional to the past productivity of their members. Given time, this mode gives rise to a power-law tail of large teams (10-1,000 members), which features in many fields today. Based on this model, we construct an analytical functional form that allows the contribution of different modes of authorship to be determined directly from the data and is applicable to any field. The model also offers a solid foundation for studying other social aspects of science, such as productivity and collaboration.

Changes in the labour market and health inequalities during the years of the recent economic downturn in Italy.

There is widespread concern that episodes of unemployment and unstable working conditions adversely affect health. We add to the debate by focusing on the relationship between work trajectory and the self-reported health of Italian men and women during the present economic downturn. Relying on Italian data in the EU-SILC project (from 2007 to 2010), our sample includes all individuals aged 30 to 60 in 2010, and uses multivariate binomial regression models for preliminary analyses and the Structural Equations modelling (SEM) to observe the cumulative effects of health status according to different job trajectories. Our main findings show similar pictures for men and women. Individuals who are unemployed, ejected or in precarious occupational positions have a higher risk of worsening their health status during these years.

Socioeconomic inequalities in health trajectories in Switzerland: are trajectories diverging as people age?

Do socioeconomic differences in health status increase as people age, reflecting cumulative advantage or disadvantage in health trajectories? Life course research hypothesises that cumulative advantage/disadvantage (CAD) is an important underlying social process that shape inequalities as people age. The objective of this study is to examine whether health trajectories are diverging as people age across socioeconomic positions (education, employment status and income). In a random sample of 3,665 respondents living in Switzerland (Swiss Household Panel 2004-2011), trajectories of self-rated health, body mass index, depression and medicated functioning were examined with multilevel regression models. The results showed that employment status and income were associated with diverging health trajectories among men; however, only a few associations supported the CAD hypothesis. Education was rarely associated with diverging health trajectories. In conclusion, little evidence was found to support the CAD model.

Immigration Experience and Cognitive Function Trajectories Among Older Chinese Immigrants.

OBJECTIVES: Although a number of studies have documented cognitive health among older immigrants in the United States, little is known about how the life-course immigration experiences are associated with cognitive trajectories among older Chinese immigrants. We assess patterns of cognitive functioning and change over time and examine whether age at migration, reasons for migration, acculturation, perceived discrimination, and preferred dialects are related to cognitive trajectories. METHODS: The sample comprised 2,075 participants from the Population Study of Chinese Elderly (PINE), who completed a battery of cognitive tests at four time points (2011-2019). Latent class growth analysis and multinomial logistic regression were utilized. RESULTS: Three latent classes of cognitive trajectories were identified: the low functioning with the fastest decline (LCF, 12%), the moderate functioning with a medium decline rate (MCF, 39%), and the high functioning with the slowest decline (HCF, 48%). Perceiving more discrimination reduced, whereas speaking Taishanese increased the odds of being in the LCF and MCF. High acculturation only distinguished MCF from HCF after controlling for the known factors of cognitive health such as age, education, and social engagement. DISCUSSION: This study identifies a group of older Chinese immigrants who are especially vulnerable to cognitive impairment and indicates that the risk of cognitive decline appears to be elevated with lower levels of acculturation and unidentified racial discrimination. More research is needed to fully understand the underlying mechanisms that link the life-course immigration experiences to cognitive health outcomes in later life.

Education and age trajectories of chronic conditions: Are tests of the cumulative advantage and disadvantage hypothesis biased by underreporting?

OBJECTIVE: This study examined the impact of underreporting on tests of the cumulative advantage and disadvantage hypothesis (CAD), which predicts age-related increases in health disparities between individuals with higher and lower education. METHODS: Using the English Longitudinal Study of Ageing (ELSA), we identified underreporting by comparing self-reported hypertension and diabetes with biomedically measured hypertension (systolic blood pressure≥140 mm Hg and/or diastolic blood pressure≥90 mm Hg) and diabetes (fasting glucose level≥7 mmol/l and/or HbA1c≥6.5%). In a sample of 11,859 respondents aged 50 to 85 (54% women, 97% White), we assessed the associations between underreporting and the main analytic constructs in tests of the CAD (education, age, sex, and cohort). RESULTS: The results showed that self-reported measures underestimated the prevalence of hypertension and diabetes. Underreporting showed weak to moderate associations with the main constructs in tests of the CAD, being more pronounced in individuals with lower education, in older age, in more recent cohorts, and among men. When correcting for underreporting using biomedical measures, the overall prevalence of hypertension and diabetes increased substantially, but education differences in age trajectories of both conditions remained similar. CONCLUSIONS: Underreporting affected conclusions about the prevalence of hypertension and diabetes, but it did not affect conclusions about the CAD hypothesis for either condition.

Explaining disparities in cognitive functioning: a test of competing hypotheses.

This study seeks to examine how the trajectories of total cognition scores exhibited by two birth cohorts vary by race/ethnicity, gender and the level of education. The empirical work of this study is be based on the 1998-2014 Health and Retirement Study (HRS) and the HRS Cross-Wave Tracker file. The analysis is limited to individuals with available information on cognitive functioning, sex, race/ethnicity, wave, highest level of education, and the physical comorbidities associated with cognitive functioning (20,985 from the Traditionalist cohort and 11,077 from the Baby Boomer cohort). Growth curve modelling is used to assess the aims of this study. Findings reveal that the cumulative advantage (disadvantage), persistent inequality and age-as-leveller hypotheses explain heterogeneity in total cognition scores for different race/ethnicity-sex groups, race/ethnicity-education and education-sex groups. These findings suggest that the development of an integrated treatment and screening mechanisms for physical comorbidities and cognitive functioning, and for the design of preventive strategies with the purpose of slowing or avoiding cognitive decline and maintaining healthy cognitive function should have a particular focus on females, racial ethnic minorities and those with low education.

Evolution of the income-related gap in health with old age: evidence from 20 countries in European and Chinese panel datasets.

Some studies show that the protective effect of higher income on health weakens with old age (age-as-leveller pattern), whereas others show that it strengthens with old age (cumulative advantage/disadvantage pattern). Many existing studies are limited in that they use single-country and/or single-timepoint designs. To overcome these limitations and better understand how the income-health gradient evolves in older age, we used cross-national and longitudinal data of the Survey of Health, Ageing and Retirement in Europe (2004-2019, N = 73,407) and the China Health and Retirement Longitudinal Study (2011-2018, N = 10,067). We operationalised health using multimorbidity and three alternative indicators (functional disability, mobility disability, and memory). We performed Poisson growth curve modelling to capture the between-participant effects of age and the within-participant effects of aging. We obtained three consistent and robust findings for Europe (patterns were observed in most countries) and China. First, the protective effect of higher income on multimorbidity, functional disability, and mobility disability was weaker for older than for younger adults (between-participant age-as-leveller pattern). Second, only the protective effect of higher income on mobility disability weakened over the later life course (within-participant age-as-leveller pattern). Third, the protective effect of higher income on memory was stronger for older than for younger adults and strengthened over the later life course (between-participant and within-participant cumulative advantage/disadvantage pattern). Longitudinal data, growth curve modelling distinguishing the between-participant from within-participant effect, and adjustments for potential confounders based on the hypothesised causal structure enabled us to better navigate the landscape of causal inference. Findings suggest that the income-related gap in physical health but not in cognitive health narrows in old age for both Europe and China.

Life Course Pathways Into Intergenerational Caregiving.

OBJECTIVES: We develop a framework for the analysis of pathways into intergenerational caregiving to older people provided by family members using life course concepts of key turning events in life, cumulative processes, and linked lives within the family realm. METHODS: Using framework analysis, we analyze semistructured qualitative interviews from a sample of dyads (older cared-for adults and their main family carers comprised of children, children-in-law, and grandchildren) in Austria (N = 24) and Slovenia (N = 52). Data were collected in 2019 through purposive sampling, including dyads from a differentiated socioeconomic background and gender. RESULTS: The analysis reveals 4 nonexclusive pathways into caregiving. One pathway is associated with single turning events occurring in family or work trajectories of carers that expanded the possibilities for caregiving later in life. A second pathway referred to cumulative processes that later influenced transitions into caregiving, such as personal biographies marked by weak labor market attachment. Another cumulative pathway, exclusive to caregiving, is characterized by continued and sustained exchanges of support within families that cement reciprocal ties that underpin caregiving at later stages. In the fourth pathway, life trajectories of siblings, but also family relationships and conflicts, constrained carers into their role. DISCUSSION: Decisions regarding caregiving within families can be best understood as processes, linked to developments in other trajectories in carers' lives, as much as to internal family dynamics and relationships. Becoming a carer may be itself the result of intertwined accumulated vulnerabilities, as well as cumulative exchanges within families.

Dynamics of cumulative advantage and threats to equity in open science: a scoping review.

Open Science holds the promise to make scientific endeavours more inclusive, participatory, understandable, accessible and re-usable for large audiences. However, making processes open will not per se drive wide reuse or participation unless also accompanied by the capacity (in terms of knowledge, skills, financial resources, technological readiness and motivation) to do so. These capacities vary considerably across regions, institutions and demographics. Those advantaged by such factors will remain potentially privileged, putting Open Science's agenda of inclusivity at risk of propagating conditions of 'cumulative advantage'. With this paper, we systematically scope existing research addressing the question: 'What evidence and discourse exists in the literature about the ways in which dynamics and structures of inequality could persist or be exacerbated in the transition to Open Science, across disciplines, regions and demographics?' Aiming to synthesize findings, identify gaps in the literature and inform future research and policy, our results identify threats to equity associated with all aspects of Open Science, including Open Access, Open and FAIR Data, Open Methods, Open Evaluation, Citizen Science, as well as its interfaces with society, industry and policy. Key threats include: stratifications of publishing due to the exclusionary nature of the author-pays model of Open Access; potential widening of the digital divide due to the infrastructure-dependent, highly situated nature of open data practices; risks of diminishing qualitative methodologies as 'reproducibility' becomes synonymous with quality; new risks of bias and exclusion in means of transparent evaluation; and crucial asymmetries in the Open Science relationships with industry and the public, which privileges the former and fails to fully include the latter.

Matthew or compensatory effects? Factors that influence the math literacy of primary-school children in Germany.

BACKGROUND AND AIMS: This study focuses on individual differences in the math competencies of primary-school children in Germany. It considers whether or not there are Matthew or compensatory effects in math literacy and which factors and background characteristics of primary-school children can affect competence development. Despite the abundant research on this topic, the findings are often ambiguous, and studies in the German context are sparse. SAMPLE AND METHODS: We used the Starting Cohort 2 of the German National Educational Panel Study and a weighted multilevel mixed-effects panel regression for our analyses (N = 4,982). RESULTS: Our results revealed compensatory effects for low-achieving students in math literacy. There were also small gender differences, but lower achieving girls can close the gap with boys during primary school. With respect to the educational background of the parents, almost no longitudinal effects were observed. CONCLUSIONS: The results indicated that the joint primary-school period has a compensatory effect on lower performing students. However, higher achieving students retained their lead, implying that social inequalities persist to some extent.

The Death of a Child and Parents' Psychological Distress in Mid to Later Life: Racial/Ethnic Differences in Exposure and Vulnerability.

OBJECTIVES: This study considered whether experiencing the death of a child is associated with subsequent psychological distress in older populations, as well as variation in both exposure and vulnerability to the death of a child among Black, Hispanic, and White older parents. METHODS: We used multilevel models to link the death of a child with subsequent distress for 9,763 non-Hispanic White, 2,496 non-Hispanic Black, 1,014 foreign-born Hispanic, and 712 U.S.-born Hispanic parents from the Health and Retirement Study, 2006-2016. RESULTS: The death of a child is associated with increased psychological distress in mid to later life for Black, White, and Hispanic parents, with greater vulnerability for foreign-born Hispanic parents. Notably, Black and U.S.-born Hispanic parents are disadvantaged because of the additive effects of their greater exposure to bereavement and their higher distress levels regardless of bereavement status. These effects persist net of additional stressors associated with race/ethnicity. DISCUSSION: The death of a child is a traumatic life course event associated with lasting psychological distress for aging parents. Black and U.S.-born Hispanic parents are disadvantaged in that they are more likely than White parents to experience the death of a child, and foreign-born Hispanic parents may be disadvantaged by greater vulnerability to distress following child death.

Addressing challenges faced by underrepresented biomedical investigators and efforts to address them: An NHLBI-PRIDE perspective.

Junior investigators from groups underrepresented in the biomedical workforce confront challenges as they navigate the ranks of academic research careers. Biochemical research needs the participation of these researchers to adequately tackle critical research priorities such as cardiovascular health disparities and health inequities. We explore the inadequate representation of underrepresented minority investigators and the historical role of systemic racism in impacting their poor career progression. We highlight challenges these investigators face, and opportunities to address these barriers are identified. Ensuring adequate recruitment and promotion of underrepresented biomedical researchers fosters inclusive excellence and augments efforts to address health inequities. The Programs to Increase Diversity among Individuals Engaged in Health-Related Research (PRIDE), funded by the National Heart, Lung, and Blood Institute (NHLBI), is a pilot program by the National Institutes of Health (NIH) that aims to address these challenges yet, only a limited number of URM can be accepted to PRIDE programs. Hence the need for additional funding for more PRIDE or PRIDE-like programs. Here we aim to examine the challenges underrepresented minority biomedical investigators face and describe ongoing initiatives to increase URM in biomedical research using the NHLBI-PRIDE program as a focus point.

Health shocks and couples' labor market participation: A turning point or stuck in the trajectory?

A health shock can have lasting consequences for the employment of not only the individuals experiencing it, but also their spouses. In this article, we complement the individual approach to the impact of health shocks with a dyadic perspective and show how employment opportunities and restrictions within couples are interdependent in the face of severe illness. We investigate whether the association between male spouses' health shocks and couples' employment trajectories depends on household specialization and both spouses' education. Multichannel sequence analysis is applied to retrospective life-course data from the Survey for Health, Ageing and Retirement in Europe for couples with health shocks and their matched controls (N = 1022). By identifying typical employment trajectories, we find that health shocks are negatively associated with trajectories where both spouses continue in full-time employment and positively with trajectories where the man retires while the woman continues working and where both spouses retire simultaneously. Couples' trajectories differ according to the spouses' combined education levels. Findings suggest that health shocks may exacerbate economic inequalities within and between couples.