Income-related inequalities in physical and cognitive health domains over the later life course: Longitudinal evidence from the U.S. (1992–2016)

<jats:p> This study aims to investigate changes in the income–health gradient over the later life course. We test the age-as-leveler, the cumulative advantage/disadvantage, and the persistent inequality pattern for physical and cognitive health domains, and analyze whether these patterns are gendered. We used HRS data (1992–2016) and Poisson growth curve models to predict multimorbidity (33,860 participants) as an indicator of physical health and memory (25,291 participants) as an indicator of cognitive health. We disentangled the within-participant from the between-participant effects. For multimorbidity, the income–health gradient weakened as individuals aged; whereas for memory, the income–health gradient strengthened as individuals aged. The cumulative advantage/disadvantage of higher/lower income on memory may be more pronounced among women than men. Findings were confirmed by sensitivity analyses. Findings suggest that the support for the age-as-leveler or cumulative advantage/disadvantage pattern may depend on health domains and the effect strength may depend on gender. </jats:p&gt

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

<jats:title>Abstract</jats:title><jats:p>Some studies show that the protective effect of higher income on health <jats:italic>weakens</jats:italic> with old age (age-as-leveller pattern), whereas others show that it <jats:italic>strengthens</jats:italic> 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, <jats:italic>N</jats:italic> = 73,407) and the China Health and Retirement Longitudinal Study (2011–2018, <jats:italic>N</jats:italic> = 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.</jats:p&gt

Exposure to the 1959–1961 Chinese famine and risk of non-communicable diseases in later life: A life course perspective

<jats:p>Child undernutrition and later-life non-communicable diseases (NCDs) are major global health issues. Literature suggests that undernutrition/famine exposure in childhood has immediate and long-term adverse health consequences. However, many studies have theoretical and methodological limitations. To add to the literature and overcome some of these limitations, we adopted a life course perspective and used more robust methods. We investigated the association between exposure to the 1959–1961 Chinese famine and later-life NCDs and if this association depends on: life stage at exposure, famine severity, and sex. We conducted a secondary data analysis of a large-scale, nationally representative, longitudinal study—the China Health and Retirement Longitudinal Study (2011–2018, 11,094 participants). We measured famine exposure/severity using self-reported experience, life stage using age at exposure, and health using the number of NCDs. We performed Poisson growth curve models. We obtained three findings. First, compared with unexposed participants, those exposed before age 18 had a higher risk of later-life NCDs, particularly if exposed in-utero (IRR = 1.90, 95% CI [1.70, 2.12], <jats:italic>p</jats:italic> < .001) and in the “first 1,000 days” of life (IRR = 1.86, 95% CI [1.73, 2.00], <jats:italic>p</jats:italic> < .001; for 0–6 months group, IRR = 1.95, 95% CI [1.67, 2.29], <jats:italic>p</jats:italic> < .001). Second, the famine effects among participants moderately and severely exposed were similar (IRR = 1.18, 95% CI [1.09, 1.28], <jats:italic>p</jats:italic> < .001 and IRR = 1.24, 95% CI [1.17, 1.32], <jats:italic>p</jats:italic> < .001). Third, the famine effects did not differ between females and males (IRR = 0.98, 95% CI [0.90, 1.07], <jats:italic>p</jats:italic> = .703). In an individual’s life course, in-utero and the “first 1,000 days” are a particularly sensitive time period with marked long-term implications for NCDs if undernutrition/famine is experienced in this period. However, this window remains open until young adulthood. This highlights the need to invest more in preventing and treating child/adolescent undernutrition to tackle later-life NCDs.</jats:p&gt

Genetic Variants of TSLP and Asthma in an Admixed Urban Population

Peer reviewe

Socioeconomic Determinants and Evolution of Health over the Later Life Course: Longitudinal Evidence from China, the U.S., and Europe

This thesis adopts a life course perspective to investigate how socioeconomic determinants impact later-life health. It pursues two lines of inquiry. The first line of inquiry revolves around the role of early-life exposure to famine in predicting health trajectories. The second line of inquiry revolves around the role of income also in predicting health trajectories. Empirical analyses rely on advanced analytical tools and various datasets, namely, the China Health and Retirement Longitudinal Study, the Health and Retirement Study from the U.S., the Survey of Health, Ageing and Retirement in Europe, and the Dutch Hunger Winter Families Study. Results from the first line of inquiry showed that individuals exposed to famine had a higher risk of non-communicable diseases and a faster pace of biological aging six decades later. Underlying mechanisms involve developmental time windows, cumulative advantage/disadvantage, and gender differences. Results from the second line of inquiry showed that for physical health the income–health gradient weakened as individuals age, whereas for cognitive health the income–health gradient strengthened with aging. Possible explanations are that physical health may be more biologically grounded and cognitive health may be more socially grounded. Taken together, these two lines of inquiry provide a comprehensive picture of how historical context and personal life history shape health trajectories. This thesis concludes by reflecting on the lifelong process of aging and health, the multidimensional nature of health, and cross-cultural similarities and differences in shaping individual health trajectories. -- Cette thèse adopte la perspective de parcours de vie pour étudier l'impact de déterminants socio-économiques sur la santé des adultes âgés. Elle poursuit deux axes de recherche. Le premier axe de recherche concerne le rôle de l'exposition à la famine au début de la vie pour prédire les trajectoires de santé. Le second axe de recherche concerne le rôle du revenu, également pour prédire dans la prédiction des trajectoires de santé. Les analyses empiriques s'appuient sur des outils analytiques avancés et diverses bases de données, à savoir le China Health and Retirement Longitudinal Study, le Health and Retirement Study, le Survey of Health, Ageing and Retirement in Europe, et le Dutch Hunger Winter Families Study. Les résultats de la première ligne de recherche ont montré que les individus exposés à la famine présentaient un risque plus élevé de maladies non transmissibles et un rythme de vieillissement biologique plus rapide six décennies plus tard. Les mécanismes sous-jacents renvoient aux questions des fenêtres temporelles de développement, des avantages/désavantages cumulatifs et des différences entre les sexes. Les résultats de la deuxième ligne de recherche ont montré que pour la santé physique, le gradient revenu-santé s'affaiblissait avec l'âge, alors que pour la santé cognitive, le gradient revenu-santé se renforçait avec l'âge. Une explication possible résident dans le fait que la santé physique est peut-être plus biologiquement ancrée alors que la santé cognitive est peut-être plus socialement ancrée. Ces deux lignes de recherche sont reliées fournissent une illustration de la façon dont le contexte historique et l'histoire de la vie personnelle façonnent les trajectoires de santé. Cette thèse se termine par un ensemble de réflexions sur le processus de vieillissement et de santé tout au long de la vie, la nature multidimensionnelle de la santé, ainsi que les similitudes et les différences interculturelles dans la formation des trajectoires de santé individuelles

Exogenous shocks and exchange rate regimes

Using a dynamic stochastic general equilibrium (DSGE) model with nominal price rigidity and imperfect competition, we examine the impact of terms-of-trade and foreign interest rate shocks on some key macroeconomic variables for a small open economy under different exchange rate regimes. Numerical solutions from the model are found consistent with empirical panel VAR results of 33 Asian economies for the period of 1980-2009. From both the theoretical model and empirical evidence, we find that (i) output responses to terms-of-trade and foreign interest rate shocks are smoother in floats, (ii) price responses to terms-of-trade shocks are smoother in floats than in pegs, while its responses to foreign interest shocks are more volatile in floats than in pegs, and (iii) the effects of terms-of-trade and foreign interest shocks are more prolonged under float

Socioeconomic Status and Later-Life Health: Longitudinal Evidence From Europe and China

Scholars are divided as to how the protective effect of SES on health (the SES-health gradient) varies over the later-life course: The age-as-leveler perspective suggests that the SES-health gradient weakens with age, whereas the cumulative (dis)advantages perspective suggests that it strengthens with age. To clarify this, we used SHARE 2004-2017 (73,407 respondents from 19 European countries) and CHARLS 2011-2018 (8,370 Chinese respondents). Congruent with the age-as-leveler perspective, growth curve models revealed that the overall protective effect of SES on multimorbidity was weaker for older than younger adults (the country-specific effects were significant in two thirds of the case). We interpret this as a selection effect. However, the within-participant protective effect of SES on multimorbidity did not vary over the later-life course (the country-specific effects were nonsignificant in the majority of the case). Findings suggest that extant cross-sectional studies should be interpreted with caution and that longitudinal, cross-national studies are needed

Effects of exendin-4 on the intrarenal renin-angiotensin system and interstitial fibrosis in unilateral ureteral obstruction mice: Exendin-4 and unilateral ureteral obstruction

Objective: The objective of this article is to investigate the renoprotecive effects of exendin-4 in a mouse model of unilateral ureteral obstruction (UUO) and explore the putative mechanisms. Methods: Male Balbc mice underwent sham operation or UUO surgery, and then received intraperitoneal injection of vehicle or exendin-4, respectively. After 14 days, mice were sacrificed and the left kidneys were collected and analyzed by histology, immunohistochemistry, Western blot, quantitative real-time reverse transcription polymerase chain reaction, radioimmunoassay and enzyme-linked immunosorbent assay. Results: As compared to the sham group, mice that underwent UUO surgery developed more severe tubular injury and interstitial fibrosis, as well as higher expression of fibronectin (FN), collagen-1 (Col-1) and α-smooth muscle actin (α-SMA). Also, we observed higher expression of angiotensin-converting enzyme (ACE) while lower expression of angiotensin-converting enzyme 2 (ACE2), higher levels of intrarenal angiotensin II (Ang II) while lower levels of intrarenal angiotensin-(1–7), and higher expression of transforming growth factor β1 (TGF-β1) and phosphorylation of Smad3 (p-Smad3) in the obstructed kidneys. Impressively, these pathologic changes were significantly attenuated in the mice group of UUO treated with exendin-4. Conclusion: Our present study indicates for the first time that exendin-4 exerts renoprotective effects in an experimental model of UUO, partly through regulating the balance of the intrarenal renin-angiotensin system and then inhibiting the Ang II-mediated TGF-β1/Smad3 signaling pathway