Misery loves company? A meta-regression examining aggregate unemployment rates and the unemployment-mortality association

Purpose: Individual-level unemployment has been consistently linked to poor health and higher mortality, but some scholars have suggested that the negative effect of job loss may be lower during times and in places where aggregate unemployment rates are high. We review three logics associated with this moderation hypothesis: health selection, social isolation, and unemployment stigma. We then test whether aggregate unemployment rates moderate the individual-level association between unemployment and all-cause mortality. Methods: We use six meta-regression models (each using a different measure of the aggregate unemployment rate) based on 62 relative all-cause mortality risk estimates from 36 studies (from 15 nations). Results: We find that the magnitude of the individual-level unemployment-mortality association is approximately the same during periods of high and low aggregate-level unemployment. Model coefficients (exponentiated) were 1.01 for the crude unemployment rate (P = .27), 0.94 for the change in unemployment rate from the previous year (P = .46), 1.01 for the deviation of the unemployment rate from the 5-year running average (P = .87), 1.01 for the deviation of the unemployment rate from the 10-year running average (P = .73), 1.01 for the deviation of the unemployment rate from the overall average (measured as a continuous variable; P = .61), and showed no variation across unemployment levels when the deviation of the unemployment rate from the overall average was measured categorically. Heterogeneity between studies was significant (P < .001), supporting the use of the random effects model. Conclusions: We found no strong evidence to suggest that unemployment experiences change when macroeconomic conditions change. Efforts to ameliorate the negative social and economic consequences of unemployment should continue to focus on the individual and should be maintained regardless of periodic changes in macroeconomic conditions

Meta-analysis of marital dissolution and mortality: Reevaluating the intersection of gender and age

The study of marital dissolution (i.e. divorce and separation) and mortality has long been a major topic of interest for social scientists. We conducted meta-analyses and meta-regressions on 625 mortality risk estimates from 104 studies, published between 1955 and 2011, covering 24 countries, and providing data on more than 600 million persons. The mean hazard ratio (HR) for mortality in our meta-analysis was 1.30 (95% confidence interval [CI], 1.23–1.37) among HRs adjusted for age and additional covariates. The mean HR was higher for men (HR, 1.37; 95% CI, 1.27–1.49) than for women (HR, 1.22; 95% CI: 1.13–1.32), but the difference between men and women decreases as the mean age increases. Other significant moderators of HR magnitude included sample size; being from Western Europe, Israel, the United Kingdom and former Commonwealth nations; and statistical adjustment for general health status

Unmasking masked hypertension: prevalence, clinical implications, diagnosis, correlates and future directions

‘Masked hypertension’ is defined as having non-elevated clinic blood pressure (BP) with elevated out-of-clinic average BP, typically determined by ambulatory BP monitoring. Approximately 15–30% of adults with non-elevated clinic BP have masked hypertension. Masked hypertension is associated with increased risks of cardiovascular morbidity and mortality compared with sustained normotension (non-elevated clinic and ambulatory BP), which is similar to or approaching the risk associated with sustained hypertension (elevated clinic and ambulatory BP). The confluence of increased cardiovascular risk and a failure to be diagnosed by the conventional approach of clinic BP measurement makes masked hypertension a significant public health concern. However, many important questions remain. First, the definition of masked hypertension varies across studies. Further, the best approach in the clinical setting to exclude masked hypertension also remains unknown. It is unclear whether home BP monitoring is an adequate substitute for ambulatory BP monitoring in identifying masked hypertension. Few studies have examined the mechanistic pathways that may explain masked hypertension. Finally, scarce data are available on the best approach to treating individuals with masked hypertension. Herein, we review the current literature on masked hypertension including definition, prevalence, clinical implications, special patient populations, correlates, issues related to diagnosis, treatment and areas for future research

The association of posttraumatic stress disorder and quality of life during the first year after acute coronary syndrome

Acute coronary syndrome [ACS, including unstable angina (UA) or myocardial infarction (MI)] events can be psychologically traumatic experiences for patients given their unpredictable, sudden onset and life-threatening nature [1]. Although posttraumatic stress disorder (PTSD) is commonly associated with index events of war or assault, PTSD is also associated with life-threatening illness and in particular ACS with approximately 12% of patients developing PTSD [1] and [2]. PTSD due to ACS has a multitude of consequences, including increased risk of ACS recurrence and mortality [3] and [4] in addition to PTSD itself being a debilitating psychiatric condition. Sufferers of PTSD are burdened by symptoms that include re-experiencing the traumatic event via intrusive thoughts, flashbacks, or nightmares; avoiding reminders of the index event; persistent negative alterations in cognition and mood; or physiologic hyperarousal. As such, ACS-induced PTSD is likely associated with substantial detriment in quality of life (QOL). However, few studies have measured this association, and no study has investigated it among a general ACS population or longitudinally. Rather, prior studies were composed of ACS patients only in intensive care units (ICUs) or among armed-services veterans [5], [6] and [7] or are notable for limitations such as cross-sectional designs [5] and [7]

A Quantitative Genetic Analysis of the Associations Among Language Skills, Peer Interactions, and Behavioral Problems in Childhood: Results From a Sample of Twins

A body of empirical research has revealed that there are associations among language skills, peer interactions, and behavioral problems in childhood. At the same time, however, there has been comparatively less research devoted to exploring the mutual unfolding of these factors over the first few years of life. The current study is designed to partially address this gap in the literature by examining how language skills, negative peer interactions, and behavioral problems are interrelated in a sample of twins drawn from the Early Childhood Longitudinal Study–Birth Cohort (ECLS-B). Employing a quantitative genetic framework, the results of the current study revealed that variance in language skills, negative peer interactions, and externalizing behavioral problems were all due to a combination of genetic and environmental factors. Bivariate Cholesky models indicated that most of the covariance among language skills, negative peer interactions, and externalizing behavioral problems was due to common genetic factors. Additional analyses using a modified DeFries–Fulker approach nested within a path model revealed a bidirectional association between negative peer interactions and externalizing behavioral problems, wherein there appeared to be feedback loops between the two. Implications of the results are discussed and avenues for future research are offered

Meta-Analysis for Sociology – A Measure-Driven Approach

Meta-analytic methods are becoming increasingly important in sociological research. In this article we present an approach for meta-analysis which is especially helpful for sociologists. Conventional approaches to meta-analysis often prioritize “concept-driven” literature searches. However, in disciplines with high theoretical diversity, such as sociology, this search approach might constrain the researcher’s ability to fully exploit the entire body of relevant work. We explicate a “measure-driven” approach, in which iterative searches and new computerized search techniques are used to increase the range of publications found (and thus the range of possible analyses) and to traverse time and disciplinary boundaries. We demonstrate this measure-driven search approach with two meta-analytic projects, examining the effects of various social variables on all-cause mortality

Changes in Home Versus Clinic Blood Pressure With Antihypertensive Treatments: A Meta-Analysis

Home blood pressure (HBP) monitoring is recommended for assessing the effects of antihypertensive treatment, but it is not clear how the treatment-induced changes in HBP compare with the changes in clinic blood pressure (CBP). We searched PubMed using the terms “home or self-measured blood pressure,” and selected articles in which the changes in CBP and HBP (using the upper arm oscillometric method) induced by antihypertensive drugs were presented. We performed a systematic review of 30 articles published before March 2008 that included a total of 6794 subjects. As there was significant heterogeneity in most of the outcomes, a random effects model was used for the meta-analyses. The mean changes (±SE) in CBP and HBP (systolic/diastolic) were −15.2±0.03/−10.3±0.03 mm Hg and −12.2±0.04/−8.0±0.04 mm Hg respectively, although there were wide varieties of differences in the reduction between HBP and CBP. The reductions in CBP were correlated with those of HBP (systolic BP; r=0.66, B=0.48, diastolic BP; r=0.71, B=0.52, P<0.001). In 7 studies that also included 24-hour BP monitoring, the reduction of HBP was greater than that of 24-hour BP in systolic (HBP; −12.6±0.06 mm Hg, 24-hour BP; −11.9±0.04 mm Hg, P<0.001). In 5 studies that included daytime and nighttime systolic BP separately, HBP decreased 15% more than daytime ambulatory BP and 30% more than nighttime ambulatory BP. In conclusion, HBP falls ≈20% less than CBP with antihypertensive treatments. Daytime systolic BP falls 15% less and nighttime systolic BP falls 30% less than home systolic BP

Proposing a Pedigree Risk Measurement Strategy: Capturing the Intergenerational Transmission of Antisocial Behavior in a Nationally Representative Sample of Adults

An impressive literature has revealed that variation in virtually every measurable phenotype is the result of a combination of genetic and environmental influences. Based on these findings, studies that fail to use genetically informed modeling strategies risk model misspecification and biased parameter estimates. Twin- and adoption-based research designs have frequently been used to overcome this limitation. Despite the many advantages of such approaches, many available datasets do not contain samples of twins, siblings or adoptees, making it impossible to utilize these modeling strategies. The current study proposes a measurement strategy for estimating the intergenerational transmission of antisocial behavior (ASB) within a nationally representative sample of singletons using an extended pedigree risk approach that relies on information from first- and second-degree relatives. An evaluation of this approach revealed a pattern of findings that directly aligned with studies examining ASB using more traditional twin- and adoption-based research designs. While the proposed pedigree risk approach is not capable of effectively isolating genetic and environmental influences, this overall alignment in results provides tentative evidence suggesting that the proposed pedigree risk measure effectively captures genetic influences. Future replication studies are necessary as this observation remains preliminary. Whenever possible, more traditional quantitative genetic methodologies should be favored, but the presented strategy remains a viable alternative for more limited samples