[News release] Researchers identify mechanisms linking early adversity, disease later in life

Researchers identify mechanisms linking early adversity, disease later in life.

From the 20 May 2015 University of Georgia news release

May 20th, 2015 Author: Cal Powell  |  706-542-3536  |  More about Cal
Contact: Kandauda Wickrama  |  706-542-4926  | More about Kandauda

Athens, Ga. – Early socioeconomic adversity, such as poverty, low education and disadvantaged community, has both direct and indirect long-term effects on young adults’ cardio-metabolic disease risk, according to researchers within the University of Georgia College of Family and Consumer Sciences.

K.A.S. Wickrama, the Athletic Association Endowed Professor in human development and family science, and his research team explored a “resource focused model” examining the positive psychosocial resources—self-esteem, personality and educational attainment—linking adolescents’ early life experiences to young adults’ health outcomes as measured by nine bio-markers including blood pressure, blood glucose level and body mass index.

The research showed that in addition to early adversity’s direct impact on cardio-metabolic health, it also negatively influenced the development of these psychosocial resources, which, in turn, proved detrimental to disease risk, including diseases such as diabetes, heart disease or stroke.

The study included data from more than 12,000 young adults currently aged 25-34 who participated in the National Longitudinal Study of Adolescent to Adult Health over a 13-year period. Wickrama has published extensively from this data set.

“Youth in a poor family or poor community likely feel less valuable, have lower self-worth and lower self-esteem than youth in families with more socioeconomic capital,” Wickrama said. “Also, early socioeconomic adversity manifests itself directly in the form of impaired cognitive development and educational attainment.”

This connection between psychosocial resources and disease risk is likely due to multiple factors, researchers said, including neurological pathways and poor health behaviors.

Researchers also found gender differences relative to the association between psychosocial resources and cardio-metabolic risk.

The association was statistically significant for women but not for men, they noted. For men, researchers said, early adversity impairs development of psychosocial resources, but those impaired resources do not seem to lead to cardio-metabolic risk for young adults as it does for women.

The paper, “Early socioeconomic adversity, youth positive development and young adults’ cardio-metabolic disease risk,” appeared in the March issue of Health Psychology and is one of three recent papers on the subject produced by Wickrama’s research team.

Co-authors include Catherine Walker O’Neal, a postdoctoral research associate, and Tae Kyoung Lee, a doctoral candidate, both in the human development and family science department within the college.

Another paper, “Stressful life experiences in adolescence and cardio-metabolic risk factors in young adulthood,” was published online in February by the Journal of Adolescent Health.

Using a stress-focused model, the paper links early adversity to poor physical health outcomes based on stressful events that can lead to a rush into adulthood, such as teenage pregnancy or dropping out of high school.

“There is a physical effect on your body from being in these stressful environments,” O’Neal said. “This is a long-term effect that you really can’t easily overcome.”

Researchers refer to this phenomenon as a person’s allostatic load, or weathering.

“Think of a rock continually exposed to the elements day after day,” O’Neal said. “It gets weathered and worn down, and you can’t restore the rock to its original state. In the same way, recovering from the physical effects of these stressors is incredibly difficult.”

A third paper, “Stress and resource pathways connecting early socioeconomic adversity to young adults’ physical health risk,” was published in the Journal of Youth Adolescence late last year.

This paper shows that both the resource and stress pathways connecting early socioeconomic adversity to cardio-metabolic health operate independently.

Researchers suggested through these studies that vulnerable groups of children can be identified early for prevention and intervention efforts.

“I think our findings definitely could be very applicable to intervention and prevention work,” O’Neal said. “I think we show multiple intervening points and areas where you could step in and stop the cycle.”

An abstract of the Health Psychology paper is available at http://psycnet.apa.org/?&fa=main.doiLanding&doi=10.1037/hea0000208.

 

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Health Insurance: Those Who Are Covered, Recover

 

From the 7 August 2012 article at Science News Daily

Underinsured CVD patients die sooner than patients with private insurance, irrespective of race…

Insurance status is a better predictor of survival after a serious cardiac event than race, and may help explain racial disparities in health outcomes for cardiovascular disease. A new study by Derek Ng, from the Johns Hopkins Bloomberg School of Public Health in the US, and his team shows that race is not linked to an increased risk of death but being underinsured is a strong predictor of death among those admitted into hospital with a serious cardiac event. Their work appears online in the Journal of General Internal Medicine, published by Springer…

…

g and colleagues looked at whether the risk of early death was associated with insurance status or race. They took into account the potential effects of neighborhood socioeconomic status and disease severity. They analyzed data from a sample of patients admitted to one of three Maryland hospitals for three specific cardiovascular events: 4,908 with acute myocardial infarction (or heart attack); 6,758 with coronary atherosclerosis (or furring up of the arteries); and 1,293 with stroke.

They found that underinsured patients died sooner than patients with private insurance, whereas the survival rates were comparable between whites and blacks. More specifically, underinsured patients had a 31 percent higher risk of early death after a heart attack and a 50 percent higher risk after atherosclerosis. This survival effect was independent of race, neighborhood socioeconomic status and disease severity.

The authors conclude: “Among those admitted to the hospital with an acute cardiovascular event, there was an increased risk of mortality among subjects who were underinsured compared to those who had private insurance. Given the recent changes in health insurance and healthcare reform, these results underscore the need to closely investigate the factors relating to health insurance that may explain these disparities. Indeed, targeting these factors may relieve the burden of mortality disproportionally affecting those who are underinsured.”

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Analysis Of Interventions In 5 Diseases Offers Guidelines To Help Close The Gap

 

Racial/Ethnic Disparities in Self-Rated Health Status among Adults with and Without Disabilities — United States, 2004–2006. MMWR 2008:57(39);1069-1073.

 

From the 19th July 2012 article at Medical News Today

Major disparities exist along racial and ethnic lines in the United States for various medical conditions, but guidance is scarce about how to reduce these gaps. Now, a new “roadmap” has been unveiled to give organizations expert guidance on how to improve health equity in their own patient populations.

Finding Answers, a national program based at the University of Chicago and funded by the Robert Wood Johnson Foundation, seeks evidence-based solutions to reduce racial and ethnic health disparities. Its new roadmap, outlined as part of a symposium of six papers published in the Journal of General Internal Medicine (JGIM), builds upon seven years of administering grants, reviewing literature, and providing technical assistance to reduce health disparities.

The roadmap’s architects hope it can provide direction on creating effective and sustainable interventions as the health disparities field shifts from measuring the problem to taking action. ..

…The paper highlights the initial need for recognizing disparities and commitment to their reduction, and suggests that programs to reduce disparities should be integrated into broader quality improvement efforts at clinics, hospitals and other health systems.

“In the past, people did disparities work or quality work, but the two wouldn’t touch one another,” Chin said. “We’re merging the quality improvement field and the disparities field.”

The roadmap also contains advice on designing interventions to address disparities, drawing upon systemic reviews of disparities research in various diseases. Five such reviews – on HIV,colorectal cancer, cervical cancer, prostate cancer and asthma – accompany the roadmap article in the JGIM symposium.

Researchers identified characteristics of successful interventions across the five new articles and previously published reviews of cardiovascular disease, diabetes, depression and breast cancer. Effective projects were found to utilize team approaches to care, patient navigation, cultural tailoring, collaboration with non-health care partners such as families or community members, and interactive skill-based training.

The reviews also identified potential targets for reducing health disparities that have yet to be examined..

..While offering general guidelines for best practices, the authors point out that the specifics of any organization’s effort to reduce disparities must be custom-fit to the patient population and community. …

References for this article

The paper, “A Roadmap and Best Practices for Organizations to Reduce Racial and Ethnic Disparities in Health Care,” was published on July 13 by the Journal of General Internal Medicine. Five systematic reviews of disparities interventions in HIV, colorectal cancer, cervical cancer, prostate cancer and asthma accompany the main article. The articles are open access, and can be read here:http://www.springerlink.com/content/0884-8734/27/8/
The publications were funded by Finding Answers: Disparities Research for Change, a Robert Wood Johnson Foundation program, with direction and technical assistance from the University of Chicago. More information about Finding Answers and the Roadmap to Reduce Disparities can be found athttp://www.solvingdisparities.org.
University of Chicago Medical Center

 

 

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Social Factors May Affect Lifespan More Than Race, Location

Study finds work, education have greater impact, By Robert Preidt in the  Tuesday, April 17, 2012 article at HealthDay

A group of socioeconomic factors such as education, income and work are better indicators of your chances of living to age 70 than race or geography, a new study shows.

The findings challenge the long-held belief that race or the region of the country where you reside are the best markers of how long you may live, according to researchers from Stanford University School of Medicine in Stanford, Calif.

Previous research has found large differences in life expectancy in various regions of the United States. For example, people tend to die younger in large urban areas and in the South. A study published last year found that men in five counties in Mississippi lived an average of 66.5 years, several years less than the national average of 75.4 years for men.

Racial disparities also are a well-established factor in life expectancy. For example, a recent study found that white men live an average of about seven years longer than black men, and white women live about five years longer than black women, according to a Stanford University news release.

In the new study, the researchers examined data on the probability of survival to age 70 for people in counties across the United States. The data was initially categorized according to sex and race, but the researchers then considered how other factors affect life expectancy.

The analysis showed that when factors related to local social conditions — such as education, income, and job and marital status — are included, health differences based on race and region virtually disappear….

 

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The Impact Of Socioeconomic Factors On The Racial Gap In Life Expectancy

While I believe there that there is no simple cause-effect explanation for life expectancy, there are striking correlations (as income levels) that need to be addressed to promote justice for all of us…

From the 11 April 2011 article at Medical News Today

Differences in factors such as income, education and marital status could contribute overwhelmingly to the gap in life expectancy between blacks and whites in the United States, according to one of the first studies to put a number on how much of the divide can be attributed to disparities in socioeconomic characteristics.

A Princeton University study recently published in the journal Demography reveals that socioeconomic differences can account for 80 percent of the life-expectancy divide between black and white men, and for 70 percent of the imbalance between black and white women.

Numerous existing studies on the topic have found that mortality differences are associated with certain socioeconomic disparities, but have not determined to what extent the life expectancy gap can be explained by such contrasts, noted author Michael Geruso, a doctoral student in Princeton’s Department of Economics. …

 

Is the health of people living in rural areas different from those in cities? Evidence from routine data linked with the Scottish Health Survey

From the 25 February 2012 Full Text Report summary

This study has shown how linked data can be used to explore the possible influence of area of residence on health. We were unable to find a consistent pattern that people living in rural areas have materially different health to that of those living in primary cities. Instead, we found stronger relationships between compositional determinants (age, gender and socio-economic status) and health than contextual factors (including rurality).

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Full Text Reports...

Is the health of people living in rural areas different from those in cities? Evidence from routine data linked with the Scottish Health Survey

Source:  BMC Health Services Research

Background

To examine the association between rurality and health in Scotland, after adjusting for differences in individual and practice characteristics.

Methods

Design: Mortality and hospital record data linked to two cross sectional health surveys. Setting: Respondents in the community-based 1995 and 1998 Scottish Health Survey who consented to record-linkage follow-up. Main outcome measures: Hypertension, all-cause premature mortality, total hospital stays and admissions due to coronary heart disease (CHD).

Results

Older age and lower social class were strongly associated with an increased risk of each of the four health outcomes measured. After adjustment for individual and practice characteristics, no consistent pattern of better or poorer health in people living in rural areas was found, compared to primary cities. However, individuals living in…

View original post 102 more words

How A Parent’s Education Can Affect The Mental Health Of Their Offspring

How A Parent’s Education Can Affect The Mental Health Of Their Offspring

From the 29 January 2012 article at ScienceNews Today

New research sheds light on cycle of low socioeconomic status and depression Could depression in adulthood be tied to a parent’s level of education? A new study led by Amélie Quesnel-Vallée, a medical sociologist from McGill University, suggests this is the case…

 

…

The team found that higher levels of parental education meant fewer mental health issues for their adult children. “However, we also found much of that association may be due to the fact that parents with more education tend to have children with more education and better paying jobs themselves,” explained Quesnel-Vallée. “What this means is that the whole process of climbing up the social ladder that is rooted in a parent’s education is a crucial pathway for the mental health of adult children.”

These findings suggest that policies aimed at increasing educational opportunities for all, regardless of social background, may help break the intergenerational cycle of low socioeconomic status and poor mental health. “Children don’t get to choose where they come from. I think we have a responsibility to address health inequalities borne out of the conditions of early childhood,” said Quesnel-Vallée.

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