Objective: Both social stratification (e.g., social rank) as well as economic resources (e.g., income) are thought to contribute to socioeconomic health disparities. It has been proposed that ...subjective socioeconomic status (an individual's perception of his or her hierarchical rank) provides increased predictive utility for physical health over and above more traditional, well-researched socioeconomic constructs such as education, occupation, and income. Method: PsycINFO and PubMed databases were systematically searched for studies examining the association of subjective socioeconomic status (SES) and physical health adjusting for at least 1 measure of objective SES. The final sample included 31 studies and 99 unique effects. Meta-analyses were performed to: (a) estimate the overlap among subjective and objective indicators of SES and (b) estimate the cumulative association of subjective SES with physical health adjusting for objective SES. Potential moderators such as race and type of health indicator assessed (global self-reports vs. more specific and biologically based indicators) were also examined. Results: Across samples, subjective SES shows moderate overlap with objective indicators of SES, but associations are much stronger in Whites than Blacks. Subjective SES evidenced a unique cumulative association with physical health in adults, above and beyond traditional objective indicators of SES (Z = .07, SE = .01, p < .05). This association was stronger for self-rated health than for biologically based and symptom-specific measures of health. Almost all available data were cross-sectional and do not allow for strong causal inference. Conclusions: Subjective SES may provide unique information relevant to understanding disparities in health, especially self-rated health.
Objective: Adverse childhood experiences may be associated with cardiometabolic morbidity and mortality in adulthood. There is heterogeneity in this literature regarding the type of items in ...cumulative adversity indices, sample sizes, demographics, and covariates. The present review used quantitative meta-analysis to examine this association and potential moderators. Method: Included studies had a measure of cumulative adversity (an index of at least 2 adverse childhood experiences from age 0 to 18) and a measure of cardiometabolic disease: cardiovascular disease (CVD) clinical outcomes (hypertension, coronary heart disease, ischemic heart disease, myocardial infarction, stroke, cerebrovascular disease) and metabolic outcomes (diabetes, metabolic syndrome) at age 18 or older. Given different interpretations of odds ratios (OR) versus hazard ratios (HR), effects were pooled separately. Overall, 9 HR studies (15 effects) based on 179,612 participants and 29 OR studies (62 effects) based on 247,393 participants were included. Results: On the basis of retrospectively assessed adversity, combined studies showed a significant estimated effect of cumulative childhood adversity on adult cardiometabolic disease (HR = 1.42, 95% CI 1.20, 1.67; OR = 1.36 1.27, 1.46). Results varied somewhat by type of cardiometabolic disease, analytic strategy, and number and type of covariates. Conclusions: The literature suggests that cumulative childhood adversity is modestly related to adult cardiometabolic disease, with effects somewhat stronger for CVD clinical outcomes. The absence of a consistent operational and conceptual definition of adversity and paucity of prospective designs temper the conclusions. It is time for further evaluation of the types and timing of childhood events that have maximal impact on adult cardiometabolic disease.
Low socioeconomic status (SES) is a reliable correlate of poor physical health. Rather than treat SES as a covariate, health psychology has increasingly focused on the psychobiological pathways that ...inform understanding why SES is related to physical health. This review assesses the status of research that has examined stress and its associated distress, and social and personal resources as pathways. It highlights work on biomarkers and biological pathways related to SES that can serve as intermediate outcomes in future studies. Recent emphasis on the accumulation of psychobiological risks across the life course is summarized and represents an important direction for future research. Studies that test pathways from SES to candidate psychosocial pathways to health outcomes are few in number but promising. Future research should test integrated models rather than taking piecemeal approaches to evidence. Much work remains to be done, but the questions are of great health significance.
Childhood socioeconomic status and adult health Cohen, Sheldon; Janicki-Deverts, Denise; Chen, Edith ...
Annals of the New York Academy of Sciences,
February 2010, Letnik:
1186, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Socioeconomic status (SES) exposures during childhood are powerful predictors of adult cardiovascular morbidity, cardiovascular mortality, all‐cause mortality, and mortality due to a range of ...specific causes. However, we still know little about when childhood SES exposures matter most, how long they need to last, what behavioral, psychological, or physiological pathways link the childhood SES experience to adult health, and which specific adult health outcomes are vulnerable to childhood SES exposures. Here, we discuss the evidence supporting the link between childhood and adolescent SES and adult health, and explore different environmental, behavioral, and physiological pathways that might explain how early SES would influence adult health. We also address the ages when SES exposures matter most for setting adult health trajectories as well as the role of exposure duration in SES influences on later health. While early childhood exposures seem to be potent predictors of a range of health outcomes, we emphasize that later childhood and adolescent exposures are risks for other health outcomes.
A Pandemic of the Poor Pellowski, Jennifer A; Kalichman, Seth C; Matthews, Karen A ...
The American psychologist,
05/2013, Letnik:
68, Številka:
4
Journal Article
Recenzirano
Odprti dostop
The U.S. HIV/AIDS epidemic has evolved over the past 30 years and is now concentrated in socially marginalized and disenfranchised communities. The health disparities in this epidemic are striking, ...with most HIV infections occurring in sexual minorities and communities of color. While widely recognized, the health disparities in HIV and AIDS are not often discussed. In this article, we examine the factors underlying health disparities in the U.S. HIV epidemic. We first discuss the interlocking relationships between biological, social, and behavioral factors that drive HIV/AIDS epidemics. Guided by a well-established conceptual model of health disparities, we then describe the social positions of those most affected by HIV and AIDS, particularly racial and gender groups. Structural and economic conditions-including environmental resources, constraints, access to care, and psychosocial influences-are examined in relation to HIV disease trajectories. Greater attention to contextual factors and comorbidities is needed to reduce the health disparities in HIV/AIDS.
Objectives This prospective study examined whether changes in traditional and novel coronary heart disease (CHD) risk factors are greater within a year of the final menstrual period (FMP), relative ...to changes that occur before or after that interval, in a multiethnic cohort. Background Understanding the influence of menopause on CHD risk remains elusive and has been evaluated primarily in Caucasian samples. Methods SWAN (Study of Women's Health Across the Nation) is a prospective study of the menopausal transition in 3,302 minority (African American, Hispanic, Japanese, or Chinese) and Caucasian women. After 10 annual examinations, 1,054 women had achieved an FMP not due to surgery and without hormone therapy use before FMP. Measured CHD risk factors included lipids and lipoproteins, glucose, insulin, blood pressure, fibrinogen, and C-reactive protein. We assessed which of 2 models provided a better fit with the observed risk factor changes over time in relation to the FMP: a linear model, consistent with chronological aging, or a piecewise linear model, consistent with ovarian aging. Results Only total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B demonstrated substantial increases within the 1-year interval before and after the FMP, consistent with menopause-induced changes. This pattern was similar across ethnic groups. The other risk factors were consistent with a linear model, indicative of chronological aging. Conclusions Women experience a unique increase in lipids at the time of the FMP. Monitoring lipids in perimenopausal women should enhance primary prevention of CHD.
Highlights • We review 55 studies of cardiovascular risk factors, obesity, and sleep in youth. • There are 39 studies of sleep and risk factors, most of which are cross-sectional. • In ...cross-sectional studies, the most consistent evidence links sleep to glucose/insulin. • Data from 16 longitudinal studies suggest that short sleep predicts obesity. • More longitudinal studies that use objective sleep measures are needed.
IMPORTANCE: Sexual harassment and sexual assault are prevalent experiences among women. However, their association with health indices is less well understood. OBJECTIVE: To investigate the ...association of history of sexual harassment and sexual assault with blood pressure, mood, anxiety, and sleep among midlife women. DESIGN, SETTING, AND PARTICIPANTS: Nonsmoking women without cardiovascular disease were recruited from the community to undergo physical measurements (blood pressure, height, weight), medical history, and questionnaire psychosocial assessments (workplace sexual harassment, sexual assault, depression, anxiety, sleep). EXPOSURES: Sexual harassment and sexual assault. MAIN OUTCOMES AND MEASURES: Blood pressure, depressive symptoms, anxiety, and sleep characteristics. RESULTS: Among the 304 nonsmoking women aged 40 to 60 years who participated in the study, all were free of clinical cardiovascular disease, and the mean (SD) age was 54.05 (3.99) years. A total of 19% reported a history of workplace sexual harassment (n = 58), and 22% reported a history of sexual assault (n = 67). Sexual harassment was related to significantly greater odds of stage 1 or 2 hypertension among women not taking antihypertensives (odds ratio OR, 2.36; 95% CI, 1.10-5.06; P = .03) as well as clinically poor sleep (OR, 1.89; 95% CI, 1.05-3.42; P = .03), after adjusting for covariates. Sexual assault was associated with significantly greater odds of clinically elevated depressive symptoms (OR, 2.86; 95% CI, 1.42-5.77; multivariable P = .003), clinically relevant anxiety (OR, 2.26; 95% CI, 1.26-4.06; P = .006), and clinically poor sleep (OR, 2.15; 95% CI, 1.23-3.77; multivariable P = .007), after adjusting for covariates. CONCLUSIONS AND RELEVANCE: Sexual harassment and sexual assault are prevalent experiences among midlife women. Sexual harassment was associated with higher blood pressure and poorer sleep. Sexual assault was associated with poorer mental health and sleep. Efforts to improve women’s health should target sexual harassment and assault prevention.
Chemotherapy remains the standard of care for most cancers worldwide, however development of chemoresistance due to the presence of the drug-effluxing ATP binding cassette (ABC) transporters remains ...a significant problem. The development of safe and effective means to overcome chemoresistance is critical for achieving durable remissions in many cancer patients. We have investigated the energetic demands of ABC transporters in the context of the metabolic adaptations of chemoresistant cancer cells. Here we show that ABC transporters use mitochondrial-derived ATP as a source of energy to efflux drugs out of cancer cells. We further demonstrate that the loss of methylation-controlled J protein (MCJ) (also named DnaJC15), an endogenous negative regulator of mitochondrial respiration, in chemoresistant cancer cells boosts their ability to produce ATP from mitochondria and fuel ABC transporters. We have developed MCJ mimetics that can attenuate mitochondrial respiration and safely overcome chemoresistance in vitro and in vivo. Administration of MCJ mimetics in combination with standard chemotherapeutic drugs could therefore become an alternative strategy for treatment of multiple cancers.
Inadequate sleep among adolescents has negative consequences for self-regulation, emotional well-being, and risk behaviors. Using multiple assessment methods, we evaluated the adequacy of sleep among ...healthy adolescents from a lower socioeconomic community and expected differences by race.
A total of 250 healthy high school students enrolled in public school (mean age: 15.7 years; 57% black, 54% female) from families of low to middle class according to the Hollingshead scale participated in weeklong assessments of sleep duration and fragmentation, assessed by using actigraphy; sleep duration and perceived quality, assessed by using daily diaries; and daytime sleepiness and sleep delay, assessed by using a questionnaire.
Students slept during the school week a mean ± SD of 6.0 ± 0.9 hours per night according to actigraphy and 6.8 ± 1.1 hours according to daily diary, and during the weekend, a mean of 7.4 ± 1.2 and 8.7 ± 1.4 hours, respectively. Black participants and male participants slept less and had more fragmented sleep; female participants reported poorer quality of sleep in their daily diaries and more daytime sleepiness. The results remained significant after adjustments for age, physical activity, smoking status, and percentile BMI.
Most students slept less than the 8 to 9 hours suggested by the guidelines of the Centers for Disease Control and Prevention. Black male participants had the least amount of sleep, which may play a role in the substantial risks experienced by this demographic group. Our findings are consistent with recommendations that pediatricians should routinely screen their adolescent patients about their sleep, especially those from at-risk subgroups.
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