DOCSLIB.ORG

And Schizophrenia: Cross-Sectional Analyses Using the Evidence from 1.9 Million Chinese Adults

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
And Schizophrenia: Cross-Sectional Analyses Using the Evidence from 1.9 Million Chinese Adults Open access Research BMJ Open: first published as 10.1136/bmjopen-2018-026532 on 4 September 2019. Downloaded from Individual-level and area-level socioeconomic status (SES) and schizophrenia: cross-sectional analyses using the evidence from 1.9 million Chinese adults Yanan Luo,1 Lei Zhang,1 Ping He,2 Lihua Pang,1 Chao Guo,1 Xiaoying Zheng1 To cite: Luo Y, Zhang L, He P, ABSTRACT Strengths and limitations of this study et al. Individual-level and Objectives Health disparities in schizophrenia are area-level socioeconomic well established. However, it is less understood ► This study is the first study to report the empirical status (SES) and schizophrenia: whether area-level socioeconomic status (SES) is cross-sectional analyses using results of the interaction of individual-level and differentially associated with schizophrenia depending on the evidence from 1.9 million area-level socioeconomic status (SES) and their individual-level SES. Therefore, using a nationally large Chinese adults. BMJ Open association with schizophrenia from a multilevel representative data, this study investigated the association 2019;9:e026532. doi:10.1136/ perspective in mainland China. bmjopen-2018-026532 between individual-level SES, area-level SES and their ► We used a very large-size and population-based interaction with schizophrenia in Chinese adults from a design survey to study the relationship between in- ► Prepublication history and multilevel perspective. additional material for this dividual-level and area-level SES and schizophrenia. Setting Household interviews in 734 counties (districts), paper are available online. To ► The use of International Statistical Classification 2980 towns (streets) and 5964 communities (villages) view these files, please visit of Diseases, 10th Revision Symptom Checklist for from 31 provinces, People's Republic of China, as part the journal online (http:// dx. doi. Mental Disorders as diagnostic tools, as well as the of the cross-sectional survey of Second China National org/ 10. 1136/ bmjopen- 2018- use of experienced clinical psychiatrists as inter- Sample Survey on Disability. 026532). viewers, improved the comparability of the diagnos- Participants 1 909 205 men and women aged 18 years tic process. Received 08 September 2018 old and above. Revised 12 March 2019 ► The population migration between the counties may Primary and secondary outcome measures A screen http://bmjopen.bmj.com/ affect our study results, although the impact of pop- Accepted 07 June 2019 followed by clinical diagnosis was used to identify ulation migration on results is small because of the schizophrenia, and schizophrenia was ascertained restriction from China’s strict migration regulating. according to the International Statistical Classification of ► Further studies need to understand the mechanisms Diseases, 10th Revision (code F20). of SES and schizophrenia, because the cross-sec- Results 1-SD increase in individual SES was associated tional design in this study cannot draw causal with decreased risk of schizophrenia (OR=0.45, 95% inferences. CI 0.43 to 0.46). 1-SD increase in area-level SES was associated with increased risk of schizophrenia (OR=1.30, 95% CI 1.24 to 1.37). The interaction of individual SES on September 30, 2021 by guest. Protected copyright. and area-level SES was statistically significant OR( =1.05, 2–2.5 times mortality rate higher than the 3 95% CI 1.02 to 1.08); as the level of area SES increased, general population, and accompanied by schizophrenia risk of lower SES people grew faster than decreased physical functioning, social partic- the risk of higher SES people. ipation and self-care ability.4 Accumulating © Author(s) (or their Conclusions Area-level SES is particularly important employer(s)) 2019. Re-use evidence reported the social disparities in permitted under CC BY-NC. No to mental health of low SES individuals, with low SES schizophrenia, which increased the mental commercial re-use. See rights people in high SES counties having the highest risk of health inequalities and high burden for and permissions. Published by schizophrenia than other groups. Action to reduce SES healthcare system.5 BMJ. disparities in schizophrenia will require attention to the In considering how to reduce schizophrenia 1Institute of Population area-level context of low SES adults. Research, Peking University, social disparities and perfecting the level Beijing, China of healthcare system, the context in which 2China Center for Health INTRODUCTION risk factors are produced needs to be better Development Studies, Peking Schizophrenia is global public health understood. Robust evidence demonstrates University, Beijing, China concern, causing a total loss of 16.8 million an association between area-level socioeco- 6 Correspondence to disability adjusted life years (DALY) world- nomic status (SES) and schizophrenia. Indi- 1 Xiaoying Zheng; wide and being the leading cause of mental viduals who live in more advantaged areas xzheng@ pku. edu. cn disability.2 People with schizophrenia have are often accompanied by fewer health risk Luo Y, et al. BMJ Open 2019;9:e026532. doi:10.1136/bmjopen-2018-026532 1 Open access BMJ Open: first published as 10.1136/bmjopen-2018-026532 on 4 September 2019. Downloaded from factors and lower mortality rates for schizophrenia.6 7 People’s Republic of China (1996 Amendment). Data Many mechanisms, such as the cost of available resources, are available from the Data Access committee of China environmental exposures (eg, social stress and household Disabled Persons Federation (http://www. cdpf. org. cn/ crowding), elevated inflammation, infections, greater special/ dlzt/ cydc/ index. htm) for researchers who meet allostatic load and vitamin D deficiency, may contribute the criteria for access to confidential data. to schizophrenia as a function of area-level SES.7–10 It is clear that, independent of individual-level SES, area- Patient and public involvement level SES is associated with the risk of schizophrenia.11 It is a population-based survey conducted to ascertain However, it is unclear whether this linkage of area SES the prevalence, socioeconomic conditions and demand will be stronger or weaker depending on individual SES. of rehabilitation services of the handicapped persons in Four relevant theoretical models were used to interpret China. The results of this survey will help stakeholders that how area SES and individual SES may interact in rela- to understand the survival status of the disabled and find tion to health: the double jeopardy hypothesis, collective the useful medical and rehabilitation services for them. A resources model, fundamental cause theory and the rela- total of 1 909 205 individuals aged 18 years or older from tive deprivation hypothesis.12 13 The first three models all 31 provinces, autonomous regions and municipalities in predict the similar pattern, which indicate that the health China participated in this survey. Of these, 7628 patients of lower SES individuals will be particularly worse off if with schizophrenia were involved. Study subjects only they reside in lower SES areas. Whereas the relative depri- participated the collection of study data. All patients can vation hypothesis regards that the health of lower SES be informed of the health examinations results in free of individuals may be worse if they live in higher SES areas charge in this survey. than if they reside in lower SES areas. To our best knowledge, little evidence was focusing Schizophrenia assessment area-level SES and the cross-level interaction between This survey identified schizophrenia by the combination area-level and individual-level SES with schizophrenia of self-reports or family members’ reports and on-site in Chinese mainland. Moreover, no evidence used the diagnosis by psychiatrists: counties as the units to study this issue. As the particu- First, this survey used a questionnaire to screen partici- larly important administrative unit in China, county, with pants who were likely to be meeting thresholds to indicate average 500 000persons, is the lowest most basic layer at psychiatric morbidity/difficulties. People meeting thresh- which the public health policy functioned.14 Studying olds to indicate psychiatric morbidity/difficulties was the schizophrenia issue at the county level would be defined as persons who were affected by psychiatric disor- very helpful for perfecting the level of mental health- ders for more than 1 year and experienced disturbance in care system and promoting psychiatric policies in China. cognition, emotion and behaviour that had impacted on Accordingly, this study would use a nationally large repre- their daily living activities and social participation. This http://bmjopen.bmj.com/ sentative data to investigate county-level and individu- survey used a screening questionnaire to identify partic- al-level SES and their interaction with schizophrenia in ipants who were meeting thresholds to indicate psychi- Chinese mainland. atric morbidity/difficulties by face-to-face interview. This questionnaire was developed according to the ‘Guide- lines and Principles for the Development of Disability METHODS Statistics’, recommended by the United Nations.16 It had Study population been tested in three pilot studies and had been demon- 17 Participants in this analysis were members of Second strated high reliability in Chinese population. The on September 30, 2021 by guest. Protected copyright. National Sample Survey on Disability. This survey is a questionnaire
Load more

Recommended publications
  • Socioeconomic Status and Increasing Mid-Life Mortality Planning Meeting
    Socioeconomic Status and Increasing Mid-life Mortality Planning Meeting June 16, 2017 Keck Center of the National Academies Washington, DC 20001 Meeting Summary Revised October 14, 2017 This meeting summary was prepared by Rose Li and Associates, Inc., under contract to the National Institute on Aging HHSN271201400038C/0025. The views expressed in this document reflect both individual and collective opinions of the meeting participants and not necessarily those of the National Institutes of Health, the National Academies of Sciences, Engineering, and Medicine, or any organization represented at the meeting. Writing and editing contributions to earlier versions of this meeting summary by the following individuals is gratefully acknowledged: Jere Behrman, Jason Boardman, Laura Dwyer-Lindgren, Dana Glei, John Haaga, Robert Hummer, Amelia Karraker, Rose Li, Ryan Masters, David Miller, Shannon Monnat, Jennifer Karas Montez, Samuel Thomas, Nancy Tuvesson, Maxine Weinstein, and John Wilmoth. SES and Increasing Mid-Life Mortality Planning Meeting June 16, 2017 Table of Contents Executive Summary ......................................................................................................................... iii Meeting Summary........................................................................................................................... 1 Introduction .............................................................................................................................................. 1 Overview of Trends and Differentials
    [Show full text]
  • Socioeconomic Status (SES) and Psychiatric Disorders*
    Soc PsychiatryPsychiatr Epidemiol (1990)25:4147 Social Psychiatryand Spfinger-Verlag1990 Psychiatric Epidemiology Socioeconomic status (SES) and psychiatric disorders* Are the issues still compelling? B. R Dohrenwend New York State PsychiatricInstitute and Social PsychiatryResearch Unit, ColumbiaUniversity, New York, USA Summary. One of the most consistent findings in psychia- Despite these changes in concepts and methods, there tric epidemiology prior to 1980 has been that socioeco- was remarkable consistency in the findings of the first and nomic status (SES) was inversely related to the recent pre- second generation studies with regard to relations be- valence of a variety of important types of disorder. The tween the psychiatric disorders and various demographic findings raised and re-raised major issues about the role of factors, most notably gender and socioeconomic status adversity in these disorders. In recent years, however, re- (SES). For SES, inverse relations were found with total search interest in these issues has been declining. At the rates aggregated across subtypes, for schizophrenia, for same time, marked changes have been taking place in the the personality disorders consisting largely of antisocial case identification and diagnostic procedures available for behaviors and substance abuse, and for symptom scales of epidemiological research. In this paper, I inquire into nonspecific distress (Dohrenwend et al. 1980 a; Dohren- whether these changes in diagnostic concepts and meth- wend 1983). ods have led to a change in the "facts" that gave rise to the These findings have raised and re-raised over the years issues about the role of SES. I rely particularly on results the classic social stress-social selection issue.
    [Show full text]
  • Parental Socioeconomic Status Or IQ? an Exploration of Major Determinants of U.S
    Parental Socioeconomic Status or IQ? An Exploration of Major Determinants of U.S. Poverty The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citation Smith, Dillon M. 2018. Parental Socioeconomic Status or IQ? An Exploration of Major Determinants of U.S. Poverty. Student paper, EC970, Department of Economics, Harvard University. Citable link http://nrs.harvard.edu/urn-3:HUL.InstRepos:36853954 Terms of Use This article was downloaded from Harvard University’s DASH repository, and is made available under the terms and conditions applicable to Other Posted Material, as set forth at http:// nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of- use#LAA Parental Socioeconomic Status or IQ? An Exploration of Major Determinants of U.S. Poverty Dillon M. Smith 4/30/2018 Abstract The Bell Curve by Charles Murray and Richard Herrnstein is one of the most controversial academic works of the last few decades. Using data from the National Longitudinal Survey of Youths (1979), we performed a number of regressions of poverty status in 1989 on parental socioeconomic status, IQ, race, sex, and age. We replicate their results which show that IQ is a more important predictor of poverty status than parental socioeconomic status (SES). We extend their analysis to other groupings and find that, while similar, the underlying relationship between the variables and poverty status varies across groups. We then compared ratios of the percentage of the top 25% to bottom 25% of either IQ or parental SES in poverty. We found that parental SES had three times the predictive power as SES for black respondents and twice the predictive power for Hispanic respondents over whites, also finding a greater proportion of respondents in poverty at all levels for minority groups than for white respondents with a similar relationship for females compared to males.
    [Show full text]
  • Age, Socioeconomic Status and Obesity Growth
    NBER WORKING PAPER SERIES AGE, SOCIOECONOMIC STATUS AND OBESITY GROWTH Charles L. Baum II Christopher J. Ruhm Working Paper 13289 http://www.nber.org/papers/w13289 NATIONAL BUREAU OF ECONOMIC RESEARCH 1050 Massachusetts Avenue Cambridge, MA 02138 August 2007 We thank seminar participants at the National Bureau of Economic Research and Triangle Health Economics Workshop for useful comments, as well as Darius Lakdawalla for help obtaining measures of job-related physical demands. The views expressed herein are those of the author(s) and do not necessarily reflect the views of the National Bureau of Economic Research. © 2007 by Charles L. Baum II and Christopher J. Ruhm. All rights reserved. Short sections of text, not to exceed two paragraphs, may be quoted without explicit permission provided that full credit, including © notice, is given to the source. Age, Socioeconomic Status and Obesity Growth Charles L. Baum II and Christopher J. Ruhm NBER Working Paper No. 13289 August 2007 JEL No. I12 ABSTRACT The rapid growth in obesity represents a major public concern. Although body weight tends to increase with age, the evolution of obesity over the lifecycle is not well understood. We use longitudinal data from the National Longitudinal Survey of Youth to examine how body weight changes with age for a cohort moving through early adulthood. We further investigate how the age-obesity gradient differs with socioeconomic status (SES) and begin to examine channels for these SES disparities. Our analysis uncovers three main findings. First, weight rises with age but is inversely related to SES at given ages. Second, the SES-obesity gradient widens over the lifecycle, a result consistent with research examining other health outcomes such as overall status or specific medical conditions.
    [Show full text]
  • Contributing Factors in Adolescents' Mental Well-Being—The
    sustainability Article Contributing Factors in Adolescents’ Mental Well-Being—The Role of Socioeconomic Status, Social Support, and Health Behavior Gabriella Nagy-Pénzes 1,2 , Ferenc Vincze 2 and Éva Bíró 2,* 1 Doctoral School of Health Sciences, University of Debrecen, 26. Kassai Street, 4028 Debrecen, Hungary; [email protected] 2 Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 26. Kassai Street, 4028 Debrecen, Hungary; [email protected] * Correspondence: [email protected]; Tel.: +36-52-512-765 (ext. 77405) Received: 16 September 2020; Accepted: 16 November 2020; Published: 18 November 2020 Abstract: Mental disorders are common in adolescents, and for effective interventions we should be aware of their determinants. However, there are only a small number of studies investigating the combined effect of multiple factors. Therefore, our aim is to assess the impact of socioeconomic status, social support, and health behavior on adolescents’ mental well-being. A cross-sectional health survey of 1641 children was carried out in accordance with the study protocol of the Hungarian Health Behavior in School-aged Children survey. Multivariate multiple regression was used to analyze the main determinants of mental well-being. The boys’ mental well-being was favorable compared to girls; lower subjective family wealth was associated with lower life satisfaction and depressive mood. Life satisfaction was positively related to healthy eating, social support, and physical activity. Unhealthy eating, sedentary lifestyle, and lower social support were associated with higher depression scores. Higher social support reduces psychosomatic symptoms, while unhealthy eating and spending a lot of time in front of the computer increase them.
    [Show full text]
  • Socioeconomic Status and Health: Dimensions and Mechanisms
    NBER WORKING PAPER SERIES SOCIOECONOMIC STATUS AND HEALTH: DIMENSIONS AND MECHANISMS David M. Cutler Adriana Lleras-Muney Tom Vogl Working Paper 14333 http://www.nber.org/papers/w14333 NATIONAL BUREAU OF ECONOMIC RESEARCH 1050 Massachusetts Avenue Cambridge, MA 02138 September 2008 We thank Sherry Glied and Peter Smith for comments. This research has been supported by the National Science Foundation GRFP and the National Institutes on Aging. The views expressed herein are those of the author(s) and do not necessarily reflect the views of the National Bureau of Economic Research. NBER working papers are circulated for discussion and comment purposes. They have not been peer- reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications. © 2008 by David M. Cutler, Adriana Lleras-Muney, and Tom Vogl. All rights reserved. Short sections of text, not to exceed two paragraphs, may be quoted without explicit permission provided that full credit, including © notice, is given to the source. Socioeconomic Status and Health: Dimensions and Mechanisms David M. Cutler, Adriana Lleras-Muney, and Tom Vogl NBER Working Paper No. 14333 September 2008 JEL No. I1 ABSTRACT This paper reviews the evidence on the well-known positive association between socioeconomic status and health. We focus on four dimensions of socioeconomic status -- education, financial resources, rank, and race and ethnicity -- paying particular attention to how the mechanisms linking health to each of these dimensions diverge and coincide. The extent to which socioeconomic advantage causes good health varies, both across these four dimensions and across the phases of the lifecycle.
    [Show full text]
  • Measuring Student Socioeconomic Status: Toward a Comprehensive Approach
    SCHOOL FINANCE SERIES Measuring Student Socioeconomic Status Toward a Comprehensive Approach Peter W. Cookson Jr. MAY 2020 Measuring Student Socioeconomic Status: Toward a Comprehensive Approach Peter W. Cookson Jr. Acknowledgments The author thanks Linda Darling-Hammond, Janel George, Stephanie Levin, and Caitlin Scott for their careful reading of the report and for their timely and wise editorial suggestions. In addition, I thank Erin Chase and Aaron Reeves for their editing and design contributions to this project and the entire LPI communications team for its invaluable support in developing and disseminating this report. Without their generosity of time and spirit, this work would not have been possible. This research was supported by the Raikes Foundation. Core operating support for the Learning Policy Institute is provided by the Sandler Foundation and the William and Flora Hewlett Foundation. We are grateful to them for their generous support. The ideas voiced here are those of the author and not those of our funders. External Reviewers This report benefited from the insights and expertise of two external reviewers: Kristin Blagg, Senior Research Associate at the Urban Institute; and Thurston Domina, Professor and Program Coordinator of Policy, Leadership, and School Improvement at the University of North Carolina, Chapel Hill. We thank them for the care and attention they gave the report. The appropriate citation for this report is: Cookson, P. W., Jr. (2020). Measuring student socioeconomic status: Toward a comprehensive approach. Palo Alto, CA: Learning Policy Institute. This report can be found online at https://learningpolicyinstitute.org/product/ measuring-student-socioeconomic-status. This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License.
    [Show full text]
  • Obesity and Inequities
    Obesity and inequities Guidance for addressing inequities in overweight and obesity Obesity and inequities Guidance for addressing inequities in overweight and obesity Written by: Belinda Loring Aileen Robertson Abstract This policy guidance aims to support European policy-makers to improve the design, implementation and evaluation of interventions and policies to reduce inequities in overweight and obesity. The prevalence of obesity in Europe is rising in many countries, and rising fastest in low socioeconomic population groups. There is a strong relationship between obesity and low socioeconomic status, especially for women. Reducing health inequities is a key strategic objective of Health 2020 – the European policy framework for health and well-being endorsed by the 53 Member States of the WHO European Region in 2012. This guide seeks to assist European policy-makers in contributing to achieving the objectives of Health 2020 in a practical way. It draws on key evidence, including from the Review of social determinants and the health divide in the WHO European Region. It sets out options to reduce the unequal distribution of obesity in Europe, through approaches which address the social determinants of obesity and the related health, social and economic consequences of the obesity inequity gradient. Keywords HEALTH POLICY OBESITY OVERWEIGHT SOCIAL DETERMINANTS OF HEALTH SOCIOECONOMIC FACTORS Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe UN City, Marmorvej 51 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office website (http://www.euro.who.int/pubrequest).
    [Show full text]
  • Socioeconomic Status, Reactions to Choice Deprivation in Group
    Grand Valley State University ScholarWorks@GVSU Papers from the International Association for Cross- IACCP Cultural Psychology Conferences 2018 Socioeconomic Status, Reactions to Choice Deprivation in Group Contexts, and the Role of Perceived Restrictions on Personal Freedom Charis Eisen Kobe University, [email protected] Keiko Ishii Kobe University Hidefumi Hitokoto Fukuoka University Follow this and additional works at: https://scholarworks.gvsu.edu/iaccp_papers Part of the Psychology Commons This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License. Recommended Citation Eisen, C., Ishii, K., & Hitokoto, H. (2018). Socioeconomic status, reactions to choice deprivation in group contexts, and the role of perceived restrictions on personal freedom. In M. Karasawa, M. Yuki, K. Ishii, Y. Uchida, K. Sato, & W. Friedlmeier (Eds.), Venture into cross-cultural psychology: Proceedings from the 23rd Congress of the International Association for Cross-Cultural Psychology. https://scholarworks.gvsu.edu/iaccp_papers/153/ This Article is brought to you for free and open access by the IACCP at ScholarWorks@GVSU. It has been accepted for inclusion in Papers from the International Association for Cross-Cultural Psychology Conferences by an authorized administrator of ScholarWorks@GVSU. For more information, please contact [email protected]. SOCIOECONOMIC STATUS, CHOICE DEPRIVATION, AND PERSONAL FREEDOM 2 Abstract This research examined whether socioeconomic status (SES) predicts reactions to situations in which a group member decides for the entire group, thereby depriving other group members of personal choice. We found, as predicted, that Americans with higher subjective SES accepted choice deprivation less and demanded personal choice more than subjectively lower SES Americans.
    [Show full text]
  • Social Inequalities in Health: Disentangling the Underlying Mechanisms
    Social Inequalities in Health: Disentangling the Underlying Mechanisms Noreen Goldman Office of Population Research Princeton University I gratefully acknowledge support from the Behavioral and Social Research Program of the National Institute on Aging (grant R01-AG16790) and the National Institute of Child Health and Human Development (P30-HD32030). I would also like to thank Maryann Belanger for her tireless assistance in tracking down bibliographic materials and Burt Singer, Anne Pebley, Angus Deaton, and Maxine Weinstein for their advice and comments. Forthcoming: Conference Proceedings of the seminar on "Demography and Epidemiology: Frontiers in Population Health and Aging,” Georgetown University, Washington D.C. February 9-10, 2001. New York Academy of Sciences. Abstract Differentials in health and longevity by socioeconomic status and by the nature of social relationships have been found in innumerable studies in the social and medical sciences. Three categories of explanations for the observed patterns have been proposed: causal mechanisms through which the social environment affects health status or the risk of dying; selection or reverse causal pathways whereby a person’s health status affects their social position; and artifactual mechanisms such as measurement error. The general consensus among researchers is that the observed disparities in health are driven largely by a complex set of causal processes rather than by selection or by artifactual mechanisms. This paper explores the set of arguments and strategies that researchers have used to arrive at this conclusion. As part of this undertaking, we assess whether inferences regarding the minor contribution of selection to the overall association between social factors and health are justifiable.
    [Show full text]
  • Are Psychosocial Factors Mediators of Socioeconomic Status and Health Connections? a Progress Report and Blueprint for the Future
    Ann. N.Y. Acad. Sci. ISSN 0077-8923 ANNALS OF THE NEW YORK ACADEMY OF SCIENCES Issue: The Biology of Disadvantage Are psychosocial factors mediators of socioeconomic status and health connections? A progress report and blueprint for the future Karen A. Matthews,1 Linda C. Gallo,2 and Shelley E. Taylor3 1University of Pittsburgh, Pittsburgh, PA. 2San Diego State University, San Diego, CA. 3University of California at Los Angeles, Los Angeles, CA Address for correspondence: Karen A. Matthews, Ph.D., Department of Psychiatry, University of Pittsburgh, 3811 O’Hara Street, Pittsburgh, PA 15213. [email protected] The association between socioeconomic status (SES) and physical health is robust. Yet, the psychosocial mediators of SES-health association have been studied in relatively few investigations. In this chapter, we summarize and critique the recent literature regarding negative emotions and cognitions, psychological stress, and resources as potential pathways connecting SES and physical health. We discuss the psychosocial origins of the SES-health links and outline how psychosocial factors may lead to persistently low SES. Weconclude that psychosocial resources may play a critical mediating role, and the origins of the SES-health connection are apparent in childhood. Weoffer a blueprint for future research, which we hope contributes to a better understanding of how SES gets under the skin across the life span. Keywords: socioeconomic status; emotions; stress; resources; development health. From a psychosocial perspective, the lead- Introduction ing candidate pathways are the frequency and in- It is well established that socioeconomic status (SES) tensity of exposure to stress and related emotional is a strong correlate of health across the lifespan.
    [Show full text]
  • Cancer Patient Survival by Socioeconomic Status in the Netherlands: a Review for Six Common Cancer Sites
    Journal ofEpidemiology and Community Health 1994;48:441-446 441 J Epidemiol Community Health: first published as 10.1136/jech.48.5.441 on 1 October 1994. Downloaded from Cancer patient survival by socioeconomic status in The Netherlands: a review for six common cancer sites Carola T M Schrijvers, Johan P Mackenbach Abstract of common cancer sites: colon, rectum, lung Study objective - To study the size and prostate, breast, and cervix. consistency of socioeconomic differences in cancer patient survival as reported in published studies. Methods Methods - A systematic review was con- The study material was selected through Med- ducted. Several criteria were developed to line and the references of papers and books, select the study material, which resulted which resulted in 40 papers on socioeconomic in 14 reports on socioeconomic differences differences in cancer survival. To enable a use- in survival for cancers of the colon, ful comparison of the results of the reviewed rectum, lung, prostate, breast, and cervix. studies to be made some exclusion criteria were These present results on patients from the developed. United States, Japan, Australia, United Studies on patients diagnosed in the 1950s Kingdom, Sweden, Finland, and Ger- or earlier were excluded. many. The results are summarised in a Hospital based studies were excluded be- relative risk of dying or survival ratio for cause cancer patients treated in specific hos- the lowest socioeconomic status group pitals may not be representative of cancer compared with the highest. patients in the general population. In particular, Results - For cancers ofthe colon, rectum, socioeconomic contrast may be larger in the breast, and cervix, patients from higher general population than in a hospital popu- socioeconomic status groups had a better lation.
    [Show full text]