Women?s health in mid-life: life course social roles and agencyas quality

Data from a prospective British birth cohort study showed that women who were childless, lone mothers or full-timehomemakers between the ages of 26 and 54 were more likely to report poor health at age 54 than women who occupiedmultiple roles between these ages. To explain this finding we developed and tested a theory of role quality based on theconcept of agency by drawing on Giddens? theory of structuration and Doyal and Gough?s theory of human needs.According to our theory, the patriarchal structuration (drawing on Giddens? term) of work and family roles provides bothlimitation and opportunity for the expression of agency. Doyal and Gough?s theory of human needs was then used toidentify the restriction of agency as a possible influence on health. This theory of role quality was operationalised using ameasure of work (paid and unpaid) quality at age 36 and a measure of work and family stress between ages 48 and 54. Therelatively poor subjective health in mid-life of lone mothers was explained by work and family stress and adult social class.In contrast, the poor health in mid-life of long-term homemakers and childless women was less easily explained.Homemaker?s excess risk of reporting poor health at age 54 remained strong and significant even after adjusting for rolequality and socioeconomic indicators, and childless women were at an increased risk of reporting poor health despite thesocial advantage inherent in attaining educational qualifications and occupying professional or managerial occupations.This study highlights the need to develop measures of role quality specifically designed to capture agency aspects of socialroles

Work-family life courses and BMI trajectories in three British birth cohorts.

BACKGROUND/OBJECTIVES: Combining work and family responsibilities has previously been associated with improved health in mid-life, yet little is known about how these associations change over time (both biographical and historical) and whether this extends to body mass index (BMI) trajectories for British men and women. The purpose of this study was to investigate relationships between work-family life courses and BMI trajectories across adulthood (16-42 years) for men and women in three British birth cohorts. SUBJECTS/METHODS: Multiply imputed data from three nationally representative British birth cohorts were used-the MRC National Survey of Health and Development (NSHD; 1946 birth cohort, n=3012), the National Child Development Study (NCDS; 1958 birth cohort, n=9614) and the British Cohort Study (BCS; 1970 birth cohort, n=8140). A typology of work-family life course types was developed using multi-channel sequence analysis, linking annual information on work, partnerships and parenthood from 16 to 42 years. Work-family life courses were related to BMI trajectories using multi-level growth models. Analyses adjusted for indicators of prior health, birthweight, child BMI, educational attainment and socioeconomic position across the life course, and were stratified by gender and cohort. RESULTS: Work-family life courses characterised by earlier transitions to parenthood and weaker long-term links to employment were associated with greater increases in BMI across adulthood. Some of these differences, particularly for work-family groups, which are becoming increasingly non-normative, became more pronounced across cohorts (for example, increases in BMI between 16 and 42 years in long-term homemaking women: NSHD: 4.35 kg m-2, 95% confidence interval (CI): 3.44, 5.26; NCDS: 5.53 kg m-2, 95% CI: 5.18, 5.88; BCS: 6.69 kg m-2, 95% CI: 6.36, 7.02). CONCLUSIONS: Becoming a parent earlier and weaker long-term ties to employment are associated with greater increases in BMI across adulthood in British men and women.Rebecca Lacey, Anne McMunn, Amanda Sacker and Meena Kumari received funding from the European Research Council (grant number: ERC-2011-StG_20101124, PI: Anne McMunn). Steven Bell also received funding from the European Research Council (grant number: ERCStG-2012-309337_Alcohol-Lifecourse, PI: Annie Britton) and UK Medical Research Council/Alcohol Research UK (MR/M006638/1). Amanda Sacker, Anne McMunn and Meena Kumari additionally received support from the Economic and Social Research Council’s International Centre for Life Course Studies in Society and Health (grant number: ES/J019119/1). DK is supported by the UK Medical Research Council (MC_UU_12019/1). The MRC National Survey of Health and Development is funded by the UK Medical Research Council. Peggy McDonough and Diana Worts were supported by the Canadian Institutes of Health Research grant MOP 119526 and the Social Sciences and Humanities Research Council grant 43512-1267

Associations between objectively assessed and questionnaire-based sedentary behaviour with body mass index and systolic blood pressure in Kuwaiti adolescents.

OBJECTIVE: Kuwait has one of the highest obesity rates in the world. This study examined the associations between sedentary behaviour (objectively measured and self-reported), adiposity and systolic blood pressure in a sample of adolescents residing in Kuwait. Data was obtained from the Study of Health and Activity among adolescents in Kuwait (2012-2013). The sample included a total of 435 adolescents (201 boys). Outcomes were age- and sex specific body mass index Z-scores and systolic blood pressure. Exposures were total sedentary behaviour measured by accelerometry and time spent in some sedentary behaviours (television viewing, video games, computer use and total screen-time). We used multiple linear regression analyses, adjusted for age, governorate, maternal education and physical activity, to examine associations between sedentary behaviour and adiposity and systolic blood pressure. RESULTS: Only 2 statistically significant associations were found between sedentary behaviour and the study outcomes: body mass in boys was directly associated with higher sedentary time [β (95% CIs) 0.003 (0.00 to 0.06)]; body mass index was inversely associated with videogames in both sexes [girls: β (95% CIs) - 0.17 (- 0.48 to - 0.04); boys: - 0.24 (- 0.57 to - 0.12)]. In this sample of Kuwaiti adolescents, sedentary behaviour showed limited deleterious associations with adiposity and systolic blood pressure

Work-Family Life Courses and Metabolic Markers in the MRC National Survey of Health and Development

The aim was to investigate whether the combined work-family life courses of British men and women were associated with differences in metabolic markers?waist circumference, blood pressure, high density lipoprotein cholesterol, triglycerides, and glycated haemoglobin?in mid-life. We used data from the Medical Research Council?s National Survey of Health and Development?the 1946 British birth cohort. Multi-channel sequence analysis was used to create a typology of eight work-family life course types combining information on work, partnerships and parenthood between ages 16?51. Linear regression tested associations between work-family types and metabolic outcomes at age 53 on multiply imputed data (20 imputations) of >2,400 participants. Compared with men with strong ties to employment and early transitions to family life, men who made later transitions to parenthood and maintained strong ties to paid work had smaller waist circumferences (-2.16cm, 95% CI: -3.73, -0.59), lower triglycerides (9.78% lower, 95% CI: 0.81, 17.94) and lower blood pressure (systolic: -4.03mmHg, 95% CI: -6.93, -1.13; diastolic: -2.34mmHg, 95% CI: -4.15, -0.53). Married men and women who didn?t have children had increased high density lipoprotein cholesterol (7.23% higher, 95% CI: 0.68, 14.21) and lower waist circumferences (-4.67cm, 95% CI: -8.37, -0.97), respectively. For men later transitions to parenthood combined with strong ties to paid work were linked to reduced metabolic risk in mid-life. Fewer differences between work-family types and metabolic markers were seen for women

Work-family life courses and psychological distress: Evidence from three British birth cohort studies

This study uses multi-channel sequence analysis to characterize work-family life course types between the ages of 16 and 42, and multivariable logistic regression to examine their association with psychological distress at age 42/43 for men and women in three nationally-representative British birth cohorts born in 1946 (N = 2,858), 1958 (N = 9,140), and 1970 (N = 7,095). We hypothesised that work-family life courses characterized by weaker links to employment and earlier transitions to partnerships and parenthood would be associated with a greater probability of psychological distress at age 42, and that this association would be become more pronounced across cohorts. Levels of psychological distress were higher amongst men and women with weaker long-term ties to employment, although these were largely explained by early life factors. Teen mothers had higher levels of psychological distress in the two later-born cohorts, and this remained unexplained in adjusted models for the 1970 cohort

Proximal predictors of change in quality of life at older ages

International audienceObjective To investigate whether changes in health, social and economic circumstances predict change in quality of life at older ages. Design Secondary analysis, using multiple regression analyses, of waves 1 and 3 of the English Longitudinal Study of Ageing. Setting England, 2002-2006 Participants Nationally representative sample of non-institutionalised adults aged over 50 living in England with non-missing data for the variables of interest (N=4848). Main outcome measure Quality of life (QoL) in 2006, with reference to QoL in 2002, both measured using CASP-19 score. Results Mean QoL decreased over the four years, with becoming depressed (â -0.12) and developing difficulties with activities of daily living (â -0.08) contributing to this decrease. Improvements in family relationships (â 0.10), the neighbourhood (â 0.08) and perceived financial position (â 0.07) each counteracted the decline in QoL. Initial QoL strongly predicted QoL at follow-up (â 0.46). Regression models explained 59% of variation in QoL, and there were small differences between age and gender groups. Conclusions Maintenance of good QoL in older aged people is enabled by the avoidance of depression, maintenance of physical function, good neighbourhood standards, family relationships and financial circumstances

Fertility History and Physical and Mental Health Changes in European Older Adults

Previous studies have shown that aspects of reproductive history, such as earlier parenthood and high parity, are associated with poorer health in mid and later life. However, it is unclear which dimensions of health are most affected by reproductive history, and whether the pattern of associations varies for measures of physical, psychological and cognitive health. Such variation might provide more insight into possible underlying mechanisms. We use longitudinal data for men and women aged 50–79 years in ten European countries from the Survey of Health, Ageing and Retirement in Europe to analyse associations between completed fertility history and self-reported and observed health indicators measured 2–3 years apart (functional limitations, chronic diseases, grip strength, depression and cognition), adjusting for socio-demographic, and health factors at baseline. Using multiple imputation and pattern mixture modelling, we tested the robustness of estimates to missing data mechanisms. The results are partly consistent with previous studies and show that women who became mothers before age 20 had worse functional health at baseline and were more likely to suffer functional health declines. Parents of 4 or more children had worse physical, psychological and cognitive health at baseline and were more likely to develop circulatory disease over the follow-up period. Men who delayed fatherhood until age 35 or later had better health at baseline but did not experience significantly different health declines. This study improves our understanding of linkages between fertility histories and later life health and possible implications of changes in fertility patterns for population health. However, research ideally using prospective life course data is needed to further elucidate possible mechanisms, considering interactions with partnership histories, health behaviour patterns and socio-economic trajectories

Understanding Older Adults Labour Market Trajectories: A Gendered Life Course Perspective

The recent push to keep older adults in the labour force glosses over who is likely to follow what kind of employment trajectory and why. In this paper, we broaden understandings of later-life labour market involvement by applying a comparative gendered life course perspective. Our data come from the Survey of Health, Ageing and Retirement in Europe and the Health and Retirement Study (US), two representative panel studies of individuals aged 50-plus. Using a unique modeling strategy, we examine employment biographies for older women and men from four nations with diverse policy regimes (Germany, Italy, Sweden, and the US), along with their links to family experiences and earlier attachment to the labour force. We find that, in every nation, women prevail in groups representing a weak(er) attachment to the labour market and men in groups signifying a strong(er) attachment. However, this pattern is much stronger for Germany and Italy than for Sweden and the US. Similarly, both family experiences and prior employment matter more for later-life labour market involvement in Germany and Italy. Our findings demonstrate that older adults’ employment trajectories are gendered; moreover, there is evidence that they are influenced by policies related not only to paid work but also to caregiving, and by those affecting not only current decisions but also those made earlier in the life course

Changes in cognition during retirement transition: the Whitehall II Cohort study

We tested the ‘use it or lose it’ hypothesis in a cohort of 3,433 civil servants who participated in the Whitehall II Study, including repeated measurements of cognitive functioning up to 14 years before and 14 years after retirement. Piecewise models, centred at the year of retirement, were used to compare trajectories of verbal memory, abstract reasoning, phonemic verbal fluency, and semantic verbal fluency before and after retirement. We found that all domains of cognition declined over time. Declines in verbal memory were 38% faster after retirement compared to before, after taking account of age-related decline. Higher employment grade was protective against verbal memory decline while people were still working, but this ‘protective effect’ was lost when individuals retired, resulting in a similar rate of decline post-retirement across employment grades. We did not find a significant impact of retirement on the other cognitive domains