Physical activity during the transition from adolescence to adulthood

Journal ArticleWe examine how age, life course roles, and contextual variables relate to both the composition and the overall level of physical activity in late adolescence and early adulthood. Methods: Data on respondents age 15 to 29 y in the 2003 American Time Use Survey are used to estimate multivariate logistic regressions that assess what factors are associated with meeting the recommended level of physical activity. Results: The proportion of respondents who do 30 min or more of team sports declines over the 15 to 29 y age range even after controlling for life course and contextual covariates. Parenthood, employment status, and school enrollment have selective effects on the odds of meeting physical activity recommendations

Infant deaths in Utah, 1850-1939

Journal ArticleOf all the health revolutions that have taken place in the United States since 1850, the reduction of infant mortality is arguably the most dramatic and far-reaching. Because of the incompleteness and unreliability of surviving vital records,, we will probably never know precisely the rate of infant deaths a century ago. But an informed estimate would be that somewhere between 15 and 20 percent of all American infants born in the second half of the nineteenth century died before they could celebrate their first birthdays. It also seems probable that in some large cities and industrial towns, as well as in certain areas of the South, the rates were considerably higher, ranging upward to 30 percent

Double jeopardy: interaction effects of marital and poverty status on the risk of mortality

Journal ArticleThe purpose of this paper is to examine the hypothesis that marital and poverty status interact in their effects on mortality risks beyond their main effects. This study examines the epidemiological bases for applying an additive rather than a multiplicative specification when testing for interaction between two discrete risk factors. We specifically predict that risks associated with being nonmarried and with being poor interact to produce mortality risks that are greater than each risk acting independently. The analysis is based on men and women who were ages 25-74 during the 1971-1975 National Health and Nutrition Examination Survey I (NHANES I) and who were traced successfully in the NHANES I Epidemiologic Follow-Up Study in 1982-1984. Overall, being both poor and nonmarried places nonelderly (ages 25-64) men, but not women, at risk of mortality greater than that expected from the main effects. This study shows that for all-cause mortality, marital and poverty status interact for men but less so for women; these findings exist when interaction is assessed with either a multiplicative or an additive standard. This difference is most pronounced for poor, widowed men and (to a lesser degree) poor, divorced men. For violent/accidental deaths among men, the interaction effects are large on the basis of an additive model. Weak main and interaction effects were detected for the elderly (age 65 + )

Risk of mortality following widowhood: age and sex differences by mode of death

Journal ArticleThis study examines how spouses' deaths from sudden or lengthy illnesses differentially affect the mortality risks of surviving widows and widowers by age. Using the Panel Study of Income Dynamics, we find the mortality risk differs by gender, age, and type of widowhood. For nonelderly ( < 65) widowers, there is an elevated risk when their wives died suddenly. For older (≥65) widows, the mortality risk is lower than that of comparably aged married women when their husbands died after a long-term illness. These gender, age, and mode-of-death differences are consistent with role theory and theories of social support

Too many Japanese university students are still smoking tobacco

Although campus-wide smoking bans are slowly spreading throughout Japan, the uptake of these measures has been suboptimal and many Japanese university students continue to smoke. Educational facilities are in an ideal position to set positive examples for tobacco control, and the time is now right for more Japanese universities to actively encourage their students as health promotion advocates and role models for healthy behavior

Effects of childhood and middle-adulthood family conditions on later-life mortality: evidence from the Utah population database, 1850-2002

Journal ArticleHow do parents affect the health and longevity of their children? Parents can affect their children's life chances by transmitting a genetic endowment (or liability) for a long life while also providing resources and an environment that enhances (or limits) their children's longevity. Recently, more attention has been given to the role that very early conditions (including in utero) of childhood have on adult health outcomes ([1-3]). These and other investigators have been raising a fundamental question about human aging and whether the risk of mortality in the latter half of life is already "scripted" based on conditions arising during infancy, childhood, and adolescence

Fertility intentions following testing for a BRCA1 gene mutation

Journal ArticleObjective: To test whether fertility intentions differed among persons who tested positive, tested negative, or did not know their genetic status for a mutation of the BRCA1 gene. Method: Participants were members of a large Utah-based kindred with an identified mutation at the BRCA1 locus. Participants received genetic counseling prior to testing and were interviewed at baseline before testing and at three points after receiving test results from a genetic counselor. The sample included men and women who completed all interviews, were between ages 18 and 45, and were fertile, resulting in a sample of 101 respondents. The primary dependent variable measured whether a subject indicated that they were moderately or very sure at all three post-testing interviews that they intended to have additional children. Effects of BRCA1 mutation status on fertility intentions were estimated using multivariate logistic regressions where we controlled for gender, age, marital status, and baseline fertility intentions. Results: Female carriers were less likely to want additional children in relation to female noncarriers (odds ratio 0.12, 95% confidence interval 0.01-1.23; P = 0.074). No differences were found among men. There was a significant difference in the effect of mutation status on fertility intentions between males and females (Gender _x0001_ Carrier status interaction; P = 0.009). Persons who did not know their mutation status were less likely to want more children than noncarriers (odds ratio 0.09, 95% confidence interval 0.01-0.75; P = 0.027). Conclusion: Predictive genetic testing for late-onset cancer susceptibility affects family planning decision-making. Persons contemplating predictive testing should be informed about possible effects such testing may have on their plans for future fertility

The association between adult mortality risk and family history of longevity: the moderating effects of socioeconomic status

pre-printStudies consistently show that increasing levels of socioeconomic status (SES) and having a familial history of longevity reduce the risk of mortality. But do these two variables interact, such that individuals with lower levels of SES, for example, may experience an attenuated longevity penalty by virtue of having long-lived relatives? This article examines this interaction by analysing survival past age 40 based on data from the Utah Population Database on an extinct cohort of men born from the years 1840 to 1909. Cox proportional hazards regression and logistic regression are used to test for the main and interaction mortality effects of SES and familial excess longevity (FEL), a summary measure of an individual's history of longevity among his or her relatives. This research finds that the mortality hazard rate for men in the top 15th percentile of occupational status decreases more as FEL increases than it does among men in the bottom 15th percentile. In addition, the mortality hazard rate among farmers decreases more as FEL increases than it does for non-farmers. With a strong family history of longevity as a proxy for a genetic predisposition, this research suggests that a gene-environment interaction occurs whereby the benefits of familial excess longevity are more available to those who have occupations with more autonomy and greater economic resources and/or opportunities for physical activity

Fertility and post-reproductive longevity

Journal ArticleWe examine the effects of reproduction on longevity among mothers and fathers after age 60. This study is motivated by evolutionary theories of aging and theories predicting social benefits and costs of children to older parents. We use the Utah Population Database, that includes a large genealogical database from the Utah Family History Library. Cox proportional hazard models based on 13,987 couples married between 1860-1899 indicate that women with fewer children as well as those bearing children late in life live longer post-reproductive lives. As the burdens of motherhood increase, the relative gains in longevity of late fertile women increase compared to their non-late fertile counterparts. Husbands' longevity is less sensitive to reproductive history, although husbands have effects that are similar to those of their wives during the latter marriage cohort. We find some support for predictions based on evolutionary principles, but we also find evidence that implicates a role for shared marital environments

Biased estimation in policy research: an illustrative example of ridge regression in a health system model

Journal ArticleThe paper develops an argument for the necessity of examining individual coefficients in policy models. As a result of this need, it is posited that something other than OLS estimators should be used since they are inflated and have extremely large variances when multicollinearity is present. Further, it is argued that policy models are by definition theoretically nonorthogonal. Ridge regression as one of a class of biased estimators is offered as one possible approach to dealing with the nonorthogonality problem in policy research. The logic of the approach is articulated and an empirical model of a health system is estimated with ordinary least squares and ridge estimators. The models are compared and implications discussed