Pathways from fertility history to later life health: results from analyses of the English study of ageing

Background: Previous research shows associations between fertility histories and later life health. The childless, those with large families, and those with a young age at entry to parenthood generally have higher mortality and worse health than parents of two or three children. These associations are hypothesised to reflect a range of biosocial influences but underlying mechanisms are poorly understood. Objectives: To identify pathways from fertility histories to later life health by examining mediation through health related behaviours, social support and strain, and wealth. Additionally to examine mediation through allostatic load –an indicator of multisystem physical dysregulation hypothesised to be an outcome of chronic stress. Methods: Associations between fertility histories, mediators and outcomes were analysed using path models. Data were drawn from the English Longitudinal Study of Ageing. Outcomes studied were a measure of allostatic load based on 9 biomarkers and self-reported long-term illness which limited activities. Results: Early parenthood (<20 for women, <23 for men) was positively associated with higher (worse) allostatic load and long-term illness. These associations were partly mediated through wealth, smoking, and physical activity. Wealth, smoking, physical activity and and social strain also mediated associations between larger family size, itself associated with early parenthood, and health outcomes. We found no significant associations between childlessness and allostatic load or long-term illness except for an assocaition between childlessness and long-term illness among women in models adjusted only for age. Conclusions: In England early parenthood and larger family size are associated with less wealth and poorer health behaviours and this accounts for much of the association with health. At least part of this operates through stress related physiological dysfunction (allostatic load)

Study engagement and burnout profiles among Finnish higher education students

A person-oriented approach was applied to identify profiles of study engagement and burnout (i.e., exhaustion, cynicism, inadequacy) in higher education in a large and representative sample of 12,394 higher education students at different phases of their studies in universities and polytechnics in Finland. Four profiles were identified: Engaged (44%), engaged-exhausted (30%) inefficacious (19%) and burned-out (7%). The engaged students had the most positive engagement accompanied with the least burnout symptoms compared to other groups. The engaged-exhausted students experienced emotional exhaustion simultaneously with academic engagement. The inefficacious group had heightened experience of inadequacy as a student. The burned-out students showed very high cynicism and inadequacy and very low academic engagement compared to the other groups. Of these groups, the engaged students tended to be in the earlier stages in their studies, whereas the burned-out and inefficacious students had been studying the longest. The pattern suggests that students starting out with high engagement and that burnout becomes more common later in the academic career. Supporting demands-resources model, the covariates reflecting the demands were higher and those reflecting resources were lower among the burned-out and inefficacious students compared to the engaged students.Peer reviewe

Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review

Objectives: Previous studies of older European populations have established that disability and morbidity vary with indicators of socio-economic position (SEP). We undertook a systematic narrative review of the literature to ascertain to what extent there is evidence of similar inequalities in the subjective health and well-being of older people in Europe. Method: Relevant original research articles were searched for using Medline, Global Health, Embase, Social Policy and Practice, Cinahl, Web of Science and IBSS. We included studies of SEP and indicators of subjective health and well-being (self-rated health; life satisfaction; quality of life) conducted since 1991 using population based samples of older people in Europe and published 1995-2013. Results: A total of 71 studies were identified. Poorer SEP was associated with poorer subjective health and well-being. Associations varied somewhat depending on the SEP measure and subjective health and well-being outcome used. Associations were weaker when social support and health related behaviours were adjusted for suggesting that these factors mediate the relationship between SEP and subjective health and well-being. Associations tended to be weaker in the oldest age groups. The patterns of associations by gender were not consistent and tended to diminish after adjusting for indicators of health and life circumstances. Conclusion: The results of this systematic narrative review of the literature demonstrate the importance of social influences on later life subjective health and well-being and indicate areas which need further investigation, such as more studies from Eastern Europe, more longitudinal studies and more research on the role of mediating factors

Socioeconomic position and subjective health and well-being among older people in Europe

Poorer people are more likely to have a poorer health. Socioeconomic inequality in health extends worldwide and remains persistent in Europe despite increases in wealth, educational attainment, proportions of working in non-manual jobs, and expenditure on health services. All age groups are affected. We reviewed the evidence on health inequalities in Europe, focusing on older people, a group which is growing fast and is vulnerable to adverse socioeconomic circumstances

Paying for social care in later life: the majority of people in England want change but retaining a mix of public and private funding

Sanna Read, Raphael Wittenberg, and Nicholas Mays summarise research carried out by a team from the Policy Innovation and Evaluation Research Unit (a collaboration between LSE’s Care Policy and Evaluation Centre and the London School of Hygiene and Tropical Medicine) examining whether people think social care should be funded by the state, or whether service users should continue to contribute to the cost. They find that three out of four want the state to contribute more but the user to continue to pay at least for some of the social care costs

Fertility history, health, and health changes in later life: a panel study of British women and men born 1923-49.

We investigated associations between later-life health and fertility history for women and men, using the British Household Panel Survey. We modelled health and its rate of change jointly with sample retention over an 11-year period. For women, childlessness is associated with limitation of activity for health reasons and faster acquisition of the limitation. High parity (four or more children) is associated with poorer health for both women and men. For the parous, this association is also found when age at first birth is controlled. Early parenthood is associated with poorer health. For parents of two or more children, a birth interval of less than 18 months is associated with having a health limitation and an accelerated rate of acquiring it. We conclude that biosocial pathways link parenthood careers and the later-life health of both women and men, and that implications of closely spaced births for parents merit further attention

School burnout trends and sociodemographic factors in Finland 2006–2019

Purpose: To identify the changes of school burnout for Finnish adolescents in lower (grades 8–9) and upper secondary schools (grades 10–11) during years 2006–2019; and to examine the associations of personal—(gender, family socioeconomic, and immigrant status) and school-related (school level, urban–rural area) sociodemographic demands and resources in school burnout. Methods: We used nationally representative data on 949,347 students in secondary school in Finland between 2006 and 2019. Generalized Linear Models were used to assess the effects of year, gender, school level, parental education, unemployment, immigrant status, and urban–rural area and the interactions of year, gender, and school level with each of the remaining sociodemographic variables on school burnout. Results: School burnout increased among girls and slightly declined among boys. The increase intensified in girls and the decline in boys stagnated after 2011. The educational level of the parents had a constant protective impact over time, the gradient for boys slightly larger compared to girls. Urban areas contributed to the trend of increasing school burnout among girls but not among boys. Parental unemployment and immigration background were associated with the increasing trend of school burnout over time, although somewhat mitigated by parental education. Conclusion: The results showed the trends in school burnout are often gendered and appeared to worsen aligned with the school budget cuts after 2011. In addition to considering school burnout related to lower parental education and urbanization, it is important to support those students in families experiencing unemployment and/or immigration, especially when concurring with lower parental education

Pathways from parenthood history to later life health: Results from analyses of the English Longitudinal Study of Ageing

We analysed the extent to which associations between parenthood histories and later life health are mediated by wealth, health-related behaviours, social support and strain. A sample of men and women aged 50+ who participated in the English Longitudinal Study of Ageing waves 1-3 was used (n = 6,207). Parenthood history included number of natural children, having adopted or step children and timing of first and last birth. Mediators were wealth, social support and strain, smoking and physical activity. Health outcomes were allostatic load and limiting long-term illness. The path models were adjusted for age, education, marital history, childhood health and intergenerational contacts. The association between a higher number of children and health was mediated by wealth in men and women, and by smoking and social strain in women. The association between having an adopted or step child and health was mediated through wealth. In addition to mediation through wealth, physical activity and smoking, mothers had a direct association between early childbirth and allostatic load. Among fathers, the direct paths from early and late childbirth to health remained, although some of the effects were mediated through wealth and physical activity

Parenthood history, allostatic load and health in old age

Associations between parenthood histories and health in later lif

Allostatic load – a challenge to measure multisystem physiological dysregulation. Pathways Node at NCRM.

Allostatic load is a sub-clinical dysregulation state, resulting from the body’s response to stress. Allostatic load accumulates gradually over the life course and affects a number of physiological systems. Measuring multisystem dysregulation , and changes in it over time, is very challenging. In this paper, we discuss composite measures used to capture allostatic load and the challenges involved in deriving and using these measures. Our focus is on measuring allostatic load in later life