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- Hallqvist, Johan, 1950-, et al.
(author)
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Can we disentangle life course processes of accumulation, critical period and social mobility? An analysis of disadvantaged socio-economic positions and myocardial infarction in the Stockholm Heart Epidemiology Program.
- 2004
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In: Social Science and Medicine. - 0277-9536 .- 1873-5347. ; 58:8, s. 1555-62
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Journal article (peer-reviewed)abstract
- The accumulation hypothesis would propose that the longer the duration of exposure to disadvantaged socio-economic position, the greater the risk of myocardial infarction. However there may be a danger of confounding between accumulation and possibly more complex combinations of critical periods of exposure and social mobility. The objective of this paper is to investigate the possibility of distinguishing between these alternatives. We used a population based case-control study (Stockholm Heart Epidemiology Programme) of all incident first events of myocardial infarction among men and women, living in the Stockholm region 1992-94. The analyses were restricted to men 53-70 years, 511 cases and 716 controls. From a full occupational history each subject was categorized as manual worker or non-manual at three stages of the life course, childhood (from parent's occupation), at the ages 25-29 and 51-55, resulting in 8 possible socio-economic trajectories. We found a graded response to the accumulation of disadvantaged socio-economic positions over the life course. However, we also found evidence for effects of critical periods and of social mobility. A conceptual analysis showed that there are, for theoretical reasons, only a limited number of trajectories available, too small to form distinct empirical categories of each hypothesis. The empirical task of disentangling the life course hypotheses of critical period, social mobility and accumulation is therefore comparable to the problem of separating age, period, and cohort effects. Accordingly, the interpretation must depend on prior knowledge of more specific causal mechanisms.
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| 2. |
- Hiyoshi, Ayako, 1972-, et al.
(author)
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A new theory-based social classification in Japan and its validation using historically collected information
- 2013
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In: Social Science and Medicine. - Oxford, United Kingdom : Pergamon-Elsevier Ltd.. - 0277-9536 .- 1873-5347. ; 87, s. 84-92
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Journal article (peer-reviewed)abstract
- Studies of health inequalities in Japan have increased since the millennium. However, there remains a lack of an accepted theory-based classification to measure occupation-related social position for Japan. This study attempts to derive such a classification based on the National Statistics Socio-economic Classification in the UK. Using routinely collected data from the nationally representative Comprehensive Survey of the Living Conditions of People on Health and Welfare, the Japanese Socioeconomic Classification was derived using two variables - occupational group and employment status. Validation analyses were conducted using household income, home ownership, self-rated good or poor health, and Kessler 6 psychological distress (n ≈ 36,000). After adjustment for age, marital status, and area (prefecture), one step lower social class was associated with mean 16% (p < 0.001) lower income, and a risk ratio of 0.93 (p < 0.001) for home ownership. The probability of good health showed a trend in men and women (risk ratio 0.94 and 0.93, respectively, for one step lower social class, p < 0.001). The trend for poor health was significant in women (odds ratio 1.12, p < 0.001) but not in men. Kessler 6 psychological distress showed significant trends in men (risk ratio 1.03, p = 0.044) and in women (1.05, p = 0.004). We propose the Japanese Socioeconomic Classification, derived from basic occupational and employment status information, as a meaningful, theory-based and standard classification system suitable for monitoring occupation-related health inequalities in Japan.
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| 3. |
- Montgomery, Scott M., et al.
(author)
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Sex differences in childhood hearing impairment and adult obesity
- 2010
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In: Longitudinal and Life Course Studies. - 1757-9597. ; 1:4, s. 359-370
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Journal article (peer-reviewed)abstract
- Some adult neurological complications of obesity may have early-life origins. Here, we examine associations of childhood hearing impairment with childhood and adult obesity, among 3288 male and 3527 female members of a longitudinal cohort born in Great Britain in 1970. Height and weight were measured at age 10 years and self-reported at 34 years. Audiometry was conducted at age 10 years. The dependent variable in logistic regression was minor bilateral hearing impairment as a marker of systemic effects, while BMI at age 10 or 34 years were modelled as independent variables with adjustment for potential confounding factors including social class, maternal education and pubertal development at age 10 years. Among females, the adjusted odds ratios (and 95% confidence intervals) for hearing impairment at age 10 years were 2.33 (1.36-3.98) for overweight/obesity; and at age 34 years they were 1.71 (1.00-2.92) for overweight and 2.73 (1.58-4.71) for obesity and the associations were not explained by Childhood BMI at age 10 years. There were no consistent associations among males and interaction testing revealed statistically significant effect modification by sex. The dose-dependent associations among females are consistent with childhood origins for some obesity-associated impaired neurological function and the possible existence of a 'pre-obese syndrome'. The accumulation of risks for poorer health among those who become obese in later life begins in childhood. Childhood exposures associated with bilateral hearing impairment are risks for obesity in later life among females.
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