Sexual orientation health inequality: Evidence from Understanding Society , the UK Longitudinal Household Study

Few studies from the United Kingdom have fully investigated inequalities between members of different sexual minority groups and heterosexuals over range of health outcomes. Using data from over 40,000 individuals, this study explores the health inequalities of sexual minority UK adults. We include respondents who identify as other and those who prefer not to say (PNS). Data come from wave three (2011–2012) of the nationally-representative Understanding Society, the UK Household Longitudinal Study. Sexual orientation was asked in the self-completion portion of the study. Markers of health include physical and mental functioning, minor psychological distress, self-rated health, substance use and disability. Multiple linear and logistic regression analyses tested for differences in markers of health between sexual orientation groups. Overall, heterosexual respondents had the best health while bisexual respondents had the worst. Gay and lesbian respondents reported poorer health than heterosexuals, specifically with regards to mental functioning, distress and illness status. The other and PNS respondents were most similar to each other and generally experienced fewer health inequalities than gay and lesbian respondents; they were less likely to use tobacco or alcohol. In sum, sexual minorities experience health inequality. The inclusion of other and PNS respondents has not been done in other studies and shows that while they may be healthier than gay/lesbian and bisexual respondents they still experiences poorer health than heterosexuals. Health promotion interventions are needed for these other and PNS individuals, who might not participate in interventions targeted toward known sexual minority groups

Allostatic load and chronic pain: a prospective finding from the national survey of midlife development in the United States, 2004-2014.

Background Previous research has demonstrated a correlation between chronic stress and chronic pain (CP). However, there have been few studies examining the prospective association of allostatic load (AL)-the biological processes related to stress-with CP. Methods We firstly conducted latent class analysis to identify phenotypes of AL using a community-dwelling sample, the Midlife in the United States. Multinomial logistic regression models were used to examine the prospective association between phenotypes of AL at MIDUS 2 biomarker project and the presence of CP, CP interference and the number of CP sites at MIDUS 3. Results Three phenotypes of AL, low biological dysregulation, parasympathetic dysregulation and metabolic dysregulation, were identified. Compared to low biological dysregulation group, participants experiencing metabolic dysregulation phenotype of AL at MIDUS 2 had higher risks of having high-interference CP (RRR = 2.00, 95% CI: 1.06, 3.79, P < 0.05) and 3 or more CP sites (RRR = 2.03, 95% CI: 1.08, 3.83, P < 0.05) at MIDUS 3. Conclusion The findings indicate that focusing on mitigating the metabolic dysfunction phenotype of AL has the potential to be an efficacious strategy for alleviating future CP bodily widespreadness and high CP interference

Sexual Orientation and the Incidence of COVID-19: Evidence from Understanding Society in the UK Longitudinal Household Study

COVID-19 infection rates and severity are worse in marginalised groups, although, for sexual and gender minorities, there are no data on infections, hospitalisations or deaths, but there may be worse rates. This study uses information from Understanding Society: The UK Household Longitudinal Study (UKHLS) to derive COVID-19 symptoms and positive tests by sexual orientation. Data came from all seven UKHLS COVID-19 survey waves in 2020 and 2021, and sexual orientation in main UKHLS waves 3 and 9. Numbers ranged from 17,800 to 12,000. Covariates in the regression models were gender, age, highest educational qualification, ethnicity, diagnosed medical condition, and key worker status. Compared to heterosexual individuals, more sexual minorities experienced symptoms, and bisexual individuals reported a greater number of symptoms. Gays and lesbians were no more or less likely to have been tested, but a larger proportion of bisexual individuals were tested. Regression models showed that differences mostly disappeared when other characteristics were considered. A small sample size means that principal questions remain, so health inequalities have been largely unnoticed and therefore not addressed. Suitable action should be taken to minimise their future risks. Why sexual and gender minorities have been omitted needs to be explored, and action needs to be taken to ensure this does not happen again

Social Media Use and Adolescent Mental Health: Findings From the UK Millennium Cohort Study

Background Evidence suggests social media use is associated with mental health in young people but underlying processes are not well understood. This paper i) assesses whether social media use is associated with adolescents' depressive symptoms, and ii) investigates multiple potential explanatory pathways via online harassment, sleep, self-esteem and body image. Methods We used population based data from the UK Millennium Cohort Study on 10,904 14 year olds. Multivariate regression and path models were used to examine associations between social media use and depressive symptoms. Findings The magnitude of association between social media use and depressive symptoms was larger for girls than for boys. Compared with 1–3 h of daily use: 3 to < 5 h 26% increase in scores vs 21%; ≥ 5 h 50% vs 35% for girls and boys respectively. Greater social media use related to online harassment, poor sleep, low self-esteem and poor body image; in turn these related to higher depressive symptom scores. Multiple potential intervening pathways were apparent, for example: greater hours social media use related to body weight dissatisfaction (≥ 5 h 31% more likely to be dissatisfied), which in turn linked to depressive symptom scores directly (body dissatisfaction 15% higher depressive symptom scores) and indirectly via self-esteem. Interpretation Our findings highlight the potential pitfalls of lengthy social media use for young people's mental health. Findings are highly relevant for the development of guidelines for the safe use of social media and calls on industry to more tightly regulate hours of social media use

The mental health impact of COVID-19 and lockdown-related stressors among adults in the UK.

Background The COVID-19 pandemic in the UK and subsequent lockdown may have affected the mental health of the population. This study examines whether there was an increase in the prevalence and incidence of common mental disorders (CMD) in the UK adult population during the first months of lockdown and whether changes in CMD were associated with stressors related to the pandemic and lockdown. Methods Longitudinal data from the UK Household Longitudinal Study waves 10-11: 2019-2020 and waves 1-4 of the COVID-19 monthly surveys in April (n = 17 761) to July 2020 (n = 13 754), a representative sample of UK adult population, were analysed. CMD was measured using the 12-item General Health Questionnaire (GHQ-12) (cut-off >2). Changes in CMD were analysed in relation to COVID-19 and social stressors. Results Around 29% of adults without CMD less than a year earlier had a CMD in April 2020. However, by July 2020, monthly incidence of CMD had reduced to 9%. Most employment, financial and psychological 'shocks' were at their highest levels in April and reduced steadily in later months. Despite the lifting of some lockdown conditions by July, stressors related to loneliness, unemployment, financial problems and domestic work continued to influence CMD. Conclusion Some COVID-19 policy responses such as furloughing may have been effective in mitigating the increase in CMD for some groups of employees. Despite some reduction in levels of pandemic and lockdown-related stressors by the middle of 2020, loneliness and financial stressors remained key determinants of incidence in CMD among the UK adult population

De-standardization and gender convergence in work–family life courses in Great Britain: A multi-channel sequence analysis

This study addresses the question of de-standardized life courses from a gender perspective. Multi-channel sequence analysis is used to characterise the domains of work, partnership and parenthood in combination across the adult life courses of three birth cohorts of British men and women between the ages of 16 and 42. Three research questions are addressed. First, we examine whether there is evidence of increasing between-person de-standardization (diversity) and within-person differentiation (complexity) in work and family life courses across cohorts during the main childrearing years. Second, we investigate whether men's and women's work–family life courses are converging over time. Finally, we assess the link between educational attainment and work–family life courses across cohorts. Data are from the MRC National Survey of Health and Development 1946 birth cohort (n = 3012), the National Child Development Study 1958 birth cohort (n = 9616), and the British Cohort Study 1970 birth cohort (n = 8158). We apply multi-channel sequence analysis to group individuals into twelve conceptually-based work–family life course types. We find evidence of growing between-person diversity, across cohorts, for both women and men. In addition, partnership trajectories are growing more complex for both genders, while parental biographies and women's work histories are becoming less so. Women's and men's work–family life courses are becoming increasingly similar as more women engage in continuous full-time employment; however, life courses involving part-time employment or a career break remain common for women in the most recent cohort. Continuous, full-time employment combined with minimal family ties up to age 42 emerged as the most common pattern for women and the second most common for men in the 1970 cohort

Are Flexible Work Arrangements Associated with Lower Levels of Chronic Stress-Related Biomarkers? A Study of 6025 Employees in the UK Household Longitudinal Study

Debates around the benefits of flexible work arrangements for employee well-being are limited by a lack of empirical analyses on whether flexible working enables employees with work or family stressors to cope with their levels of stress. This study examines whether the availability and use of different flexible work arrangements are associated with lower allostatic load (an index of chronic stress-related biomarkers) in a large representative study of UK adults. Male and female employees who made use of reduced hours working arrangements had lower levels of allostatic load. Among women caring for two or more children aged under 15, there was a difference of almost one unit of the allostatic load index (an additional biomarker risk) between women who used reduced hours flexible work and those without such arrangements. Reduced hours flexible work arrangements could enable women who combine work and family roles to reduce their levels of chronic stress

Gender differences in the associations between age trends of social media interaction and well-being among 10-15 year olds in the UK

Background Adolescents are among the highest consumers of social media while research has shown that their well-being decreases with age. The temporal relationship between social media interaction and well-being is not well established. The aim of this study was to examine whether the changes in social media interaction and two well-being measures are related across ages using parallel growth models. Methods Data come from five waves of the youth questionnaire, 10-15 years, of the Understanding Society, the UK Household Longitudinal Study (pooled n =9859). Social media interaction was assessed through daily frequency of chatting on social websites. Well-being was measured by happiness with six domains of life and the Strengths and Difficulties Questionnaire. Results Findings suggest gender differences in the relationship between interacting on social media and well-being. There were significant correlations between interacting on social media and well-being intercepts and between social media interaction and well-being slopes among females. Additionally higher social media interaction at age 10 was associated with declines in well-being thereafter for females, but not for males. Results were similar for both measures of well-being. Conclusions High levels of social media interaction in early adolescence have implications for well-being in later adolescence, particularly for females. The lack of an association among males suggests other factors might be associated with their reduction in well-being with age. These findings contribute to the debate on causality and may inform future policy and interventions

Work-family life courses and markers of stress and inflammation in mid-life: evidence from the National Child Development Study.

Background This study investigated associations between work-family life courses and biomarkers of inflammation and stress in mid-life among British men and women. Gender differences in these associations were also explored. Methods A novel statistical method-multi-channel sequence analysis-defined work-family life courses between the ages of 16 and 42 years, combining annual information on work, partnership and parenthood. Associations between work-family life courses and inflammation [C-reactive protein (CRP), fibrinogen and von Willebrand factor] and cortisol at age 44/45 years were tested using multivariate linear regression using multiply-imputed data on almost 6500 participants from the National Child Development Study 1958 British birth cohort. Results Compared with those who combined strong ties to paid work with later transitions to stable family lives ('Work, later family' group), 'Teen parents' had higher CRP [40.6% higher, 95% confidence interval (CI): 5.6, 87.0] and fibrinogen (7.8% higher, 95% CI: 2.3, 13.5) levels, and homemakers ('No paid work, early family') had raised fibrinogen levels (4.7% higher, 95% CI: 0.7, 9.0), independent of childhood health and socioeconomic position, adult socioeconomic position, health behaviours and body mass index (BMI). Those who combined later transitions to stable family ties with a career break for childrearing had higher post-waking cortisol than the 'Work, later family' group; however, no associations were seen for other work-family types, therefore suggesting a null finding with cortisol. No statistically significant gender interactions in associations between work-family types and inflammatory or cortisol outcomes were found. Conclusions Work-family life courses characterised by early parenthood or weak work ties were associated with a raised risk profile in relation to chronic inflammation

Cumulative disadvantage, employment–marriage, and health inequalities among American and British mothers

This paper illuminates processes of cumulative disadvantage and the generation of health inequalities among mothers. It asks whether adverse circumstances early in the life course cumulate as health-harming biographical patterns across the prime working and family caregiving years. It also explores whether broader institutional contexts may moderate the cumulative effects of micro-level processes. An analysis of data from the British National Child Development Study and the US National Longitudinal Survey of Youth reveals several expected social inequalities in health. In addition, the study uncovers new evidence of cumulative disadvantage: Adversities in early life selected women into long-term employment and marriage biographies that then intensified existing health disparities in mid-life. The analysis also shows that this accumulation of disadvantage was more prominent in the US than in Britain