Financial loss and depressive symptoms in university students during the first wave of the COVID-19 pandemic: comparison between 23 countries

Objectives: To assess the association between students’ financial loss and depressive symptoms during the first wave of the coronavirus disease 2019 (COVID-19) pandemic and whether this association varied by countries having different levels of lockdown measures. Methods: This cross-sectional survey, conducted in spring 2020, included 91,871 students from 23 countries. Depressive symptoms were measured using the shortened Center for Epidemiological Studies Depression Scale and information on lockdowns retrieved from the COVID-19 government response tracker. The association between financial loss and depressive symptoms was investigated estimating prevalence ratios (PR) with multilevel Poisson models. Results: Some 13% of students suffered financial loss during the lockdown and 52% had a relatively high depression score, with large between-countries differences. Minimally and maximally adjusted models showed a 35% (PR = 1.35, 95% Confidence Interval (CI) = 1.29–1.42) and 31% (PR = 1.31, 95% CI = 1.26–1.37) higher prevalence of depressive symptoms in students who lost economic resources compared to students with stable economic resources. No substantial differences in the association were found across countries. Conclusion: Depressive symptoms were more frequent among students who suffered financial loss during the pandemic. Policy makers should consider this issue in the implementation of COVID-19 mitigating measure

Self-rated health in middle-aged and elderly Chinese : distribution, determinants and associations with cardio-metabolic risk factors

Background: Self-rated health (SRH) has been demonstrated to be an accurate reflection of a person's health and a valid predictor of incident mortality and chronic morbidity. We aimed to evaluate the distribution and factors associated with SRH and its association with biomarkers of cardio-metabolic diseases among middle-aged and elderly Chinese. Methods: Survey of 1,458 men and 1,831 women aged 50 to 70 years, conducted in one urban and two rural areas of Beijing and Shanghai in 2005. SRH status was measured and categorized as good (very good and good) vs. not good (fair, poor and very poor). Determinants of SRH and associations with biomarkers of cardio-metabolic diseases were evaluated using logistic regression. Results: Thirty two percent of participants reported good SRH. Males and rural residents tended to report good SRH. After adjusting for potential confounders, residence, physical activity, employment status, sleep quality and presence of diabetes, cardiovascular disease, and depression were the main determinants of SRH. Those free from cardiovascular disease (OR 3.68; 95%CI 2.39; 5.66), rural residents (OR 1.89; 95% CI 1.47; 2.43), non-depressed participants (OR 2.50; 95% CI 1.67; 3.73) and those with good sleep quality (OR 2.95; 95% CI 2.22; 3.91) had almost twice or over the chance of reporting good SRH compared to their counterparts. There were significant associations -and trend- between SRH and levels of inflammatory markers, insulin levels and insulin resistance. Conclusion: Only one third of middle-aged and elderly Chinese assessed their health status as good or very good. Although further longitudinal studies are required to confirm our findings, interventions targeting social inequalities, lifestyle patterns might not only contribute to prevent chronic morbidity but as well to improve populations' perceived health

Sleep quality in middle-aged and elderly Chinese: distribution, associated factors and associations with cardio-metabolic risk factors

Background Poor sleep quality has been associated with increased risk of heart disease, diabetes and mortality. However, limited information exists on the distribution and determinants of sleep quality and its associations with cardio-metabolic risk factors in Chinese populations. We aimed to evaluate this in the current study. Methods A cross-sectional survey conducted in 2005 of 1,458 men and 1,831 women aged 50–70 years from urban and rural areas of Beijing and Shanghai. Using a questionnaire, sleep quality was measured in levels of well, common and poor. Comprehensive measures of socio-demographical and health factors and biomarkers of cardio-metabolic disease were recorded. These were evaluated in association with sleep quality using logistic regression models. Results Half of the population reported good sleep quality. After adjusting for potential confounders, women and Beijing residents had almost half the probability to report good sleep quality. Good physical and mental health (good levels of self-rated health (OR 2.48; 95%CI 2.08 to 2.96) and no depression (OR 4.05; 95%CI 3.12 to 5.26)) related to an increased chance of reporting good sleep quality, whereas short sleep duration (<7 hrs OR 0.10; 95%CI 0.07 to 0.14)) decreased it substantially. There were significant associations between levels of sleep quality and concentrations of plasma insulin, total and LDL cholesterol, and index of insulin resistance. Conclusion Levels of good sleep quality in middle-age and elderly Chinese were low. Gender, geographical location, self-rated health, depression and sleep quantity were major factors associated with sleep quality. Prospective studies are required to distil the factors that determine sleep quality and the effects that sleep patterns exert on cardio-metabolic health

Changes in Employment Uncertainty and the Fertility Intention-Realization Link: An Analysis Based on the Swiss Household Panel.

How do changes in employment uncertainty matter for fertility? Empirical studies on the impact of employment uncertainty on reproductive decision-making offer a variety of conclusions, ranging from gender and socio-economic differences in the effect of employment uncertainty on fertility intentions and behaviour, to the effect of employment on changes in fertility intentions. This article analyses the association between a change in subjective employment uncertainty and fertility intentions and behaviour by distinguishing male and female partners' employment uncertainty, and examines the variation in these associations by education. Using a sample of men and women living in a couple from the Swiss Household Panel (SHP 2002-2011), we examine through multinomial analysis how changes in employment uncertainty and selected socio-demographic factors are related to individual childbearing decisions. Our results show strong gendered effects of changes in employment uncertainty on the revision of reproductive decisions among the highly educated population

Socio-Geographic Mobility and Health Status: a longitudinal analysis using the National Population Health Survey of Canada

The paper reviews arguments that associations between small area socio-economic conditions and individual health are likely to vary according to the type of health condition considered. We comment on the importance of longitudinal research to examine how far area conditions predict later health outcomes, and also how far area variations in health may result from selective migration processes predicted by health status. Using data for 1996 and 2002, from the National Population Health Survey of Canada, linked to small area data on social and on material deprivation in the area of residence for 6950 survey respondents at the two time points, we report on analyses to address these questions. The area measures of material and social deprivation were previously developed by Pampalon and colleagues at the Institut National de Santé Publique de Québec and related to the dissemination area matching the informant's postal code. The health outcomes considered were restriction of activity due to chronic conditions and psychological distress. Our findings suggest that individuals living in materially deprived areas in 2002 were more likely to be affected by health conditions resulting in restriction of activity. Prevalence of psychological distress was higher in areas with greater social deprivation in 2002. Most of these area differences were attenuated when adjustment was made for individual socio-demographic characteristics. Measures recorded in 1996 of individual characteristics and measures of deprivation for area of residence were used to predict change in health outcomes by 2002. Several individual factors (sex, age group, income, household composition) in 1996 were predictive of later health outcomes. After controlling for these individual characteristics the only significant association between health change and area deprivation was with development of restricted activity, which was more common among people who, in 1996, had lived in areas that ranked moderately high on material deprivation. We also report some evidence for selective migration effects, though these mainly seem to operate indirectly via socio-economic characteristics that predict both health outcomes and differential migration patterns. The clearest evidence on this point is for those in with psychological distress in 1996, who were particularly likely to move to an area which was more socially or materially deprived by 2002. This supports the idea that area differences in psychological distress are partly the result of selective migration effects

Differences between women's and men's socioeconomic inequalities in health: longitudinal analysis of the Canadian population, 1994-2003

Background: Socioeconomic inequalities in health are ubiquitous in developed countries; however, whether these inequalities differ between women and men over time is less clear. Objective: To estimate the potentially different health effects of changes in socioeconomic position (SEP) on changes in health for working-age women and men over a 10-year period. Three main questions were addressed: (1) are there health differences between women and men over time, (2) do changes in SEP lead to health inequalities and (3) do changes in SEP impact health differently for women and men? Methods: Generalised estimating equations models were used to analyse cycles 1–5 of the Canadian National Population Health Survey for four measures of health, number of chronic conditions, self-rated health, functional health and mental distress, and three measures of SEP, income, education and employment status. Results: Health inequalities by sex/gender and by changes in SEP were present for all four outcomes in age-adjusted models; however, after controlling for time-dependent social structure, behaviour, and psychosocial factors the relationships persisted only for chronic conditions and psychological distress. There was no evidence that these effects differed, over time, between women and men. Conclusions: Men and women in this nationally representative sample of Canadians do not differentially embody changes in SEP, although both sex/gender and changes in SEP independently impact health.S Luchenski, A Quesnel-Vallée, J Lync

Work and Pay in Flexible and Rgulated Labor Market : A Generalized Perspective on Insitutional Evolution in Inequality Trends in Europe and the US

In recent years a "unified theory" has emerged out of labor economics, which argues that a combination of "macroeconomic shocks" and flexible labor market institutions in the U.S. has produced strong upward trends in wage inequality, while these same shocks have produced high unemployment and low employment growth in Europe as a side effect of the wage stability preserved by that continent's rigid labor market institutions. This paper takes issue with the common view that inequality trends are best explained by a model of stable institutions interacting with changing macroeconomic forces. It argues that European institutions in fact have changed, and that institutional changes which were triggered by the broader macroeconomic forces have affected the form as well as the size of inequality trends. While the U.S. has experienced rising strong skill-based wage inequality, institutional change in France has produced an upward trend in the density of insecure jobs and an increased concentration of low-skill workers in insecure jobs. These results challenge the view that low employment rates is the sole mechanism through which European labor markets have absorbed asymmetric shocks to their demand for labor

Assessing the role of individual and neighbourhood characteristics in HIV testing: evidence from a population based survey

OBJECTIVES: Individuals living in deprived neighbourhoods have poor health outcomes, including human immunodeficiency virus (HIV) infection mortality. We assessed the association between individual and neighbourhood characteristics, and HIV testing across Canada. METHODS: We used logistic regression modelling to evaluate this association in 2219 men and 2815 women, aged 18-54 years, in Canada, using data from the National Population Health Survey (1996/7),. Socio-economic characteristics and presence of a sexually transmitted infection (STI) were the individual level characteristics. Small area of residence was classified according to categories of material and social deprivation; these were the ’neighbourhood’ variables in the model. RESULTS: Ethnic minority women were less likely to report an HIV test than white women (OR 0.44, 95% CI: 0.23 to 0.86). Women without a regular doctor were significantly less likely to report ever having had an HIV test (OR 0.57, 95% CI: 0.35 to 0.93). Adjusting for individual level characteristics, we found that men and women living in the most materially deprived neighbourhoods were slightly less likely to report HIV testing than those living in the least deprived neighbourhoods (Men - OR 0.61, 95% CI: 0.34 to 1.08; Women - OR 0.62, 95% CI: 0.38 to 1.00). DISCUSSION: Thus, living in poor neighbourhoods was associated with poor uptake of an HIV test. These economic disparities should be taken in account while designing future prevention strategies. Ethnic minority women were less likely to go for HIV testing and culturally appropriate messages may be required for prevention in ethnic minorities