Breast feeding and resilience against psychosocial stress

BACKGROUND: Some early life exposures may result in a well controlled stress response, which can reduce stress related anxiety. Breast feeding may be a marker of some relevant exposures. AIMS: To assess whether breast feeding is associated with modification of the relation between parental divorce and anxiety. METHODS: Observational study using longitudinal birth cohort data. Linear regression was used to assess whether breast feeding modifies the association of parental divorce/separation with anxiety using stratification and interaction testing. Data were obtained from the 1970 British Cohort Study, which is following the lives of those born in one week in 1970 and living in Great Britain. This study uses information collected at birth and at ages 5 and 10 years for 8958 subjects. Class teachers answered a question on anxiety among 10 year olds using an analogue scale (range 0–50) that was log transformed to minimise skewness. RESULTS: Among 5672 non‐breast fed subjects, parental divorce/separation was associated with a statistically significantly raised risk of anxiety, with a regression coefficient (95% CI) of 9.4 (6.1 to 12.8). Among the breast fed group this association was much lower: 2.2 (−2.6 to 7.0). Interaction testing confirmed statistically significant effect modification by breast feeding, independent of simultaneous adjustment for multiple potential confounding factors, producing an interaction coefficient of −7.0 (−12.8 to −1.2), indicating a 7% reduction in anxiety after adjustment. CONCLUSIONS: Breast feeding is associated with resilience against the psychosocial stress linked with parental divorce/separation. This could be because breast feeding is a marker of exposures related to maternal characteristics and parent–child interaction

Labour force sequences, unemployment spells and their effect on subjective well-being set points

Drawingupon recent psychological literature, we examine the effect of employment statuses pre- and post-unemployment on levels of subjective well-being (SWB),and the return to pre-unemployment levels, i.e. set points. Data came from the British Household Panel Survey. SWB was measured using the GHQ-12 and a question on life satisfaction; Employment status was self-reported. Multilevel, jointed, piecewise, growth curve regression models were used to explore associations by gender, specifically whether different labour force sequences produced different growth curves and rates of adaptation. Overall, there was a tendency for men and women to return to well-being set points for both outcomes. However, findings showed differences by labour force sequence and SWB measure. Women who experienced unemployment between spells of employment returned to their SWB setpoint at a faster rate of return for GHQ than for life satisfaction, while for men, the rates of return were similar to each other. Women who were employed prior to unemployment and then became economically inactive showed a return to their GHQ set point, but there was no return to their life satisfaction setpoint. Economically inactive participants pre-unemployment, who then gained employment, also showed a return to their well-being set point. After economic inactivity and then unemployment, only men experienced a significant increase in life satisfaction upon return to economic inactivity. The findings showed that following unemployment, return to subjective well-being setpoint was quicker for people who became employed than for people who became economically inactive. There were also differences in the return to SWB setpoint by type of economic inactivity upon exiting unemployment

A Case Study of the Application of a Multilevel Growth Curve Model and the Prediction of Health Trajectories

This case study provides guidance on the application of a multilevel growth curve model and the prediction of health trajectories. Using our secondary data analysis as an example, we introduce definitions of the multilevel growth curve model, random intercept and slope, and the intraclass correlation coefficient. We discuss time centering and time metrics, marginal effects for drawing frailty trajectories, as well as multiple imputation for handling missing values

Why are poorer children at higher risk of obesity and overweight? A UK cohort study

There is limited evidence on which risk factors attenuate income inequalities in child overweight and obesity; whether and why these inequalities widen as children age. Method: Eleven thousand nine hundred and sixty five singletons had complete data at age 5 and 9384 at age 11 from the Millennium Cohort Study (UK). Overweight (age 5 : 15%; age 11 : 20%) and obesity (age 5 : 5%; age 11 : 6%) were defined using the International Obesity Taskforce body mass index cut-points. To measure socioeconomic inequalities, we used quintiles of family income and as risk factors, we considered markers of maternal health behaviours and of children’s physical activity, sedentary behaviours and diet. Binary and multinomial logistic regression models were used. Results: The unadjusted analyses revealed stark income inequalities in the risk of obesity at age 5 and 11. At age 5, children in the bottom income quintile had 2.0 (95% CI: 1.4–2.8) increased relative risk of being obese whilst at age 11 they had 3.0 (95% CI: 2.0–4.5) increased risk compared to children in the top income quintile. Similar income inequalities in the risk of overweight emerged by age 11. Physical activity and diet were particularly important in explaining inequalities. Income inequalities in obesity and overweight widened significantly between age 5 and 11 and a similar set of risk factors protected against upward and promoted downward movements across weight categories. Conclusions: To reduce income inequalities in overweight and obesity and their widening across childhood the results support the need of early interventions which take account of multiple risk factors

Time trends in mental well-being: the polarisation of young people's psychological distress

PURPOSE: Previous research on time trends of young people's mental health in Britain has produced conflicting findings: evidence for deterioration in mental health during the late 20th century followed by stability and slight improvement during the early 21st century is contrasted with evidence showing continued deterioration. The present study adds to the evidence base by assessing time trends in means, variances, and both low and high psychological distress scores covering a similar period. METHODS: GHQ-12 (Likert scale) was regressed on time (adjusting for age) using a sample of young people aged 16-24 between 1991 and 2008 from the British Household Panel Study. Change in variance was assessed using Levene's homogeneity of variance test across 9-year intervals. Polarisation was assessed by a comparison of the prevalence of scores ≥1 standard deviation and ≥1.5 standard deviations above and below the pooled mean. RESULTS: There was a small but significant increase in mean GHQ-12 among young women (b 0.048; 95% CI 0.016, 0.080) only. Variance increased significantly (p < 0.05) across 9-year intervals in seven out of nine comparisons for women and in six out of nine comparisons for men. There were significant increases in low (OR: 1.19; 95% CI 1.05, 1.35), high (OR: 1.27; 95% CI 1.13, 1.42), and very high scores (OR: 1.42; 95% CI 1.23, 1.64) for young women, and increases in low (OR: 1.39; 95% CI 1.21, 1.59) and very low (OR: 1.53; 95% CI 1.21, 1.92) scores for young men. CONCLUSIONS: The evidence suggests a polarisation of the psychological distress of young women in Britain between 1991 and 2008

Mixed ethnicity and behavioural problems in the Millennium Cohort Study

BACKGROUND: The population of mixed ethnicity individuals in the UK is growing. Despite this demographic trend, little is known about mixed ethnicity children and their problem behaviours. We examine trajectories of behavioural problems among non-mixed and mixed ethnicity children from early to middle childhood using nationally representative cohort data in the UK. METHODS: Data from 16 330 children from the Millennium Cohort Study with total difficulties scores were analysed. We estimated trajectories of behavioural problems by mixed ethnicity using growth curve models. RESULTS: White mixed (mean total difficulties score: 8.3), Indian mixed (7.7), Pakistani mixed (8.9) and Bangladeshi mixed (7.2) children had fewer problem behaviours than their non-mixed counterparts at age 3 (9.4, 10.1, 13.1 and 11.9, respectively). White mixed, Pakistani mixed and Bangladeshi mixed children had growth trajectories in problem behaviours significantly different from that of their non-mixed counterparts. CONCLUSIONS: Using a detailed mixed ethnic classification revealed diverging trajectories between some non-mixed and mixed children across the early life course. Future studies should investigate the mechanisms, which may influence increasing behavioural problems in mixed ethnicity children

Relationship Satisfaction and Concordance in Attitudes to Maternal Employment in British Couples with Young Children

Changes in paid labor in families have occurred within the wider context of societal changes in gendered attitudes to work. However, changes in behavior and attitudes are not necessarily correlated with each other, and their associations with family relationships are complex. This study uses data from over 12,000 two-parent families in the U.K.’s Millennium Cohort Study, a nationally representative cohort of children born during 2000–2002. The study investigates the potential association between relationship satisfaction and discordance between attitudes to maternal employment and mothers’ actual participation in paid labor, as well as agreement in attitudes within couples. Results show that attitudes in favor of maternal employment and actual maternal employment are generally associated with better relationship satisfaction for both mothers and fathers. In addition, discordance between an individual’s attitudes and behavior in relation to maternal employment, and discordant attitudes within couples, is both associated with significantly lower relationship satisfaction compared with concordant couples

Birth Order and First Sexual Experience: Do Siblings Influence Sexual Debut in Adolescents?

Birth order may foster specific roles for individuals within the family and set in train a dynamic that influences the development of specific behaviors. In this paper, we explored the relationship between birth order, sex, timing of sexual initiation, and its consequences for risky sexual behavior and sexual health. We conducted a path analysis to simultaneously estimate direct and indirect effects using data from the National Survey of Sexual Attitudes and Lifestyles (NATSAL-3). Whereas women born as only-children were more likely to sexually debut at later ages, middle-child boys were significantly more prone to initiate sexual intercourse earlier compared with first-borns. As expected, early sexual initiation was associated with riskier behaviors and sexual health outcomes. These associations were partially moderated by siblings role as confidants about sexuality. Our findings have implications for preventive programs aimed at promoting healthy sexual debuts and behaviors over the life span

Comparing socio-economic inequalities in healthy ageing in the United States of America, England, China and Japan: evidence from four longitudinal studies of ageing

Healthy ageing has become a popular topic worldwide. So far, a consensus measure of healthy ageing has not been reached; and no studies have compared the magnitude of socio-economic inequality in healthy ageing outside Europe. This study aims to create a universal measure of healthy ageing and compare socio-economic inequalities in healthy ageing in the United States of America (USA), England, China and Japan. We included 10,305 American, 6,590 English, 5,930 Chinese and 1,935 Japanese participants for longitudinal analysis. A harmonised healthy ageing index (HAI) was developed to measure healthy ageing multi-dimensionally. Educational, income and wealth rank scores were derived accounting for the entire socio-economic distribution and the sample size of each category of socio-economic indicator. Associations between socio-economic rank scores and HAIs were assessed using multi-level modelling to calculate the Slope Indices of Inequality. Healthy ageing trajectories were predicted based on the full-adjusted age-cohort models. We found that education was a universally influential socio-economic predictor of healthy ageing. Moving from the highest to the lowest educational groups was associated with a 6.7 (5.2–8.2), 8.2 (6.0–10.4), 13.9 (11.4–16.3) and 6.1 per cent (3.9–8.2%) decrease in average HAI at 60 years in the USA, England, China and Japan, respectively. After 60 years, the educational inequality in healthy ageing kept increasing in the USA and China. The educational inequality in healthy ageing in China was also greater than any other socio-economic inequality in the four countries. Wealth was more influential in predicting healthy ageing inequality among American, English and Japanese participants, while income was more influential among Chinese participants. The socio-economic inequality in healthy ageing in Japan was relatively small. Chinese and American participants had worse healthy ageing profiles than Japanese and English participants

Domains and Measurements of Healthy Aging in Epidemiological Studies: A Review

Purpose of the Study: Few studies have recommended the essential domains of healthy aging and their relevant measurement to assess healthy aging comprehensively. This review is to fill the gap, by conducting a literature review of domains and measures of healthy aging in epidemiological studies. Design and Methods: A literature search was conducted up to March 31, 2017, supplemented by a search of references in all relevant articles in English. We made a final selection of 50 studies across 23 countries or regions. Results: Nineteen studies applied Rowe and Kahn’s three standards to assess healthy aging. Thirty-seven studies measured physical capabilities mainly by (instrumental) activities of daily living. Cognitive functions were included in 33 studies. Nineteen of them applied Mini-Mental State Examination (MMSE). Twenty-six studies considered metabolic and physiological health, but they mainly asked the self-reported absence of diseases. Twenty-four studies assessed psychological well-being by employing diverse scales. Questions about participation in social activities were mainly asked to measure social well-being in 22 studies. Sixteen studies considered individuals’ general health status, which was mainly measured by self-rated health. Security questions were asked in five studies. Health behaviors were taken into account by three studies. Fifteen studies either applied SF-12/36 or developed health indices to assess healthy aging. Implications: This review summarizes detailed scales or methods that have been used to assess healthy aging in previous epidemiological studies. It also discusses and recommends the essential domains of healthy aging, and the relevant instruments for further epidemiological research to use in the assessment of healthy aging