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Lifelong Socio-economic Position and Later Life Health Related Behaviour: A Formal Mediation Approach

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Pathways to Health

Part of the book series: SpringerBriefs in Population Studies ((BRIEFSPOPULAT))

Abstract

Population ageing is one of the dominant trends of the 21st century. As morbidity and disability are concentrated in the older population, interventions to promote healthy ageing are needed in order to offset the effects that ageing will have on population health. Health related behaviour is a focal area for possible interventions since its association with various health outcomes is well documented. We used data from the English Longitudinal Study of Ageing, with a formal approach for the identification of mediating factors, in order to investigate the lifecourse socio-economic patterning of smoking, physical activity, dietary habits and alcohol use in later life. We found socio-economic gradients in smoking, physical activity and alcohol use, but fewer in healthy dietary habits. Both early and later life socio-economic circumstances influenced health related behaviour, but these associations differed between men and women as well as between age groups. We found that early life circumstances influence behaviour either directly or indirectly 65 years later. The complexity of the observed associations highlights the need for further research on the mechanisms underlying links between socio-economic position and later life health related behaviour.

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References

  • Birnie, K., Ben-Shlomo, Y., Gunnell, D., Ebrahim, S., Bayer, A., Gallacher, J., & Martin, R. M. (2011). Diet in childhood and adulthood and physical performance in old age: Findings from the Boyd Orr and Caerphilly cohorts. Journal of Epidemiology and Community Health, 65. https://doi.org/10.1136/jech.2011.143586.77.

    Article  Google Scholar 

  • Bourdieu, P. (1986). The forms of capital. In J. G. Richardson (Ed.), Handbook of theory and research for the sociology of education (pp. 241–258). New York: Greenwood Press.

    Google Scholar 

  • Daniel, R. M., De Stavola, B. L., & Cousens, S. N. (2011). gformula: Estimating causal effects in the presence of time-varying confounding or mediation using the g-computation formula. Stata Journal, 11(4), 479–517.

    Article  Google Scholar 

  • De Stavola, B. L., Daniel, R. M., Ploubidis, G. B., & Micali, N. (2015). Mediation analysis with intermediate confounding: Structural equation modeling viewed through the causal inference lens. American Journal of Epidemiology, 181(1), 64–80. https://doi.org/10.1093/aje/kwu239.

    Article  Google Scholar 

  • Demakakos, P., Nazroo, J., Breeze, E., & Marmot, M. (2008). Socioeconomic status and health: The role of subjective social status. Social Science & Medicine, 67(2), 330–340. https://doi.org/10.1016/j.socscimed.2008.03.038.

    Article  Google Scholar 

  • Doll, R., Peto, R., Boreham, J., & Sutherland, I. (2004). Mortality in relation to smoking: 50 years’ observations on male British doctors. British Medical Journal, 328(7455), 1519–1528. https://doi.org/10.1136/bmj.38142.554479.AE.

    Article  Google Scholar 

  • Durrant, G., & Goldstein, H. (2008). Analysing The Probability Of Attrition In A Longitudinal Survey. Retrieved from.

    Google Scholar 

  • Gjonca, E., Tabassum, F., & Breeze, E. (2009). Socioeconomic differences in physical disability at older age. Journal of Epidemiology and Community Health, 63(11), 928–935. https://doi.org/10.1136/jech.2008.082776.

    Article  Google Scholar 

  • Greenland, S. (1996). Basic methods for sensitivity analysis of biases. International Journal of Epidemiology, 25(6), 1107–1116. https://doi.org/10.1093/ije/25.6.1107-a.

    Article  Google Scholar 

  • Groot, W. (2000). Adaptation and scale of reference bias in self-assessments of quality of life. Journal of Health Economics, 19(3), 403–420.

    Article  Google Scholar 

  • Grundy, E., & Sloggett, A. (2003). Health inequalities in the older population: The role of personal capital, social resources and socio-economic circumstances. Social Science & Medicine, 56(5), 935–947.

    Article  Google Scholar 

  • Harper, S., Lynch, J., Hsu, W.-L., Everson, S. A., Hillemeier, M. M., Raghunathan, T. E., … Kaplan, G. A. (2002). Life course socioeconomic conditions and adult psychosocial functioning. International Journal of Epidemiology, 31(2), 395–403. https://doi.org/10.1093/ije/31.2.395.

    Article  Google Scholar 

  • Huisman, M., Kunst, A. E., & Mackenbach, J. P. (2003). Socioeconomic inequalities in morbidity among the elderly; a European overview. Social Science & Medicine, 57(5), 861–873.

    Article  Google Scholar 

  • Imai, K., Keele, L., & Tingley, D. (2010). A general approach to causal mediation analysis. Psychological Methods, 15(4), 309–334. https://doi.org/10.1037/a0020761.

    Article  Google Scholar 

  • Jivraj, S., Goodman, A., Ploubidis, G. B., & de Oliveira, C. (2017). Testing Comparability Between Retrospective Life History Data and Prospective Birth Cohort Study Data. Journals of Gerontology Series B-Psychological Sciences and Social Sciences. https://doi.org/10.1093/geronb/gbx042.

  • Kannel, W. B., & Sorlie, P. (1979). Some health benefits of physical-activity—Framingham-study. Archives of Internal Medicine, 139(8), 857–861. https://doi.org/10.1001/archinte.139.8.857.

    Article  Google Scholar 

  • Kaplan, G. A., Pamuk, E. R., Lynch, J. W., Cohen, R. D., & Balfour, J. L. (1996). Inequality in income and mortality in the United States: Analysis of mortality and potential pathways. British Medical Journal, 312(7037), 999–1003.

    Article  Google Scholar 

  • Kobayashi, L. C., Beeken, R. J., & Meisel, S. F. (2017). Biopsychosocial predictors of perceived life expectancy in a national sample of older men and women. Plos One, 12(12), e0189245. https://doi.org/10.1371/journal.pone.0189245.

    Article  Google Scholar 

  • Kuh, D. J., & Cooper, C. (1992). Physical activity at 36 years: Patterns and childhood predictors in a longitudinal study. Journal of Epidemiology and Community Health, 46(2), 114–119.

    Article  Google Scholar 

  • Leon, D. A., Saburova, L., Tomkins, S., McKee, M., & Shkolnikov, V. M. (2007). Alcohol consumption and public health in Russia. Lancet, 370(9587), 561–561. https://doi.org/10.1016/s0140-6736(07)61281-1.

    Article  Google Scholar 

  • Lindeboom, M., & van Doorslaer, E. (2004). Cut-point shift and index shift in self-reported health. Journal of Health Economics, 23(6), 1083–1099. https://doi.org/10.1016/j.jhealeco.2004.01.002. ISSN 0167-6296.

    Article  Google Scholar 

  • Little, R. J. A., & Rubin, D. B. (1989). The analysis of social-science data with missing values. Sociological Methods & Research, 18(2–3), 292–326.

    Article  Google Scholar 

  • Little, R. J. A., & Rubin, D. B. (2002). Statistical analysis with missing data (2nd ed.). Chichester: Willey.

    Book  Google Scholar 

  • Lynch, J. W., Kaplan, G. A., & Salonen, J. T. (1997). Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Social Science & Medicine, 44(6), 809–819. https://doi.org/10.1016/S0277-9536(96)00191-8.

    Article  Google Scholar 

  • Lynch, J. W., Smith, G. D., Kaplan, G. A., & House, J. S. (2000). Income inequality and mortality: Importance to health of individual income, psychosocial environment, or material conditions. British Medical Journal, 320(7243), 1200–1204.

    Article  Google Scholar 

  • Mackenbach, J., Stirbu, I., Roskam, A., Schaap, M., Menvielle, G., Leinsalu, M., & Kunst, A. (2008). Socioeconomic inequalities in health in 22 European countries. New England Journal of Medicine, 358, 2468–2481.

    Google Scholar 

  • Mackenbach, J. P. (2012). The persistence of health inequalities in modern welfare states: The explanation of a paradox. Social Science & Medicine, 75(4), 761–769. https://doi.org/10.1016/j.socscimed.2012.02.031.

    Article  Google Scholar 

  • Marmot, M., Banks, J., Blundell, R., Lessof, C., & Nazroo, J. (Eds.). (2002). Health, wealth and lifestyles of the older population in England: The 2002 English longitudinal study of ageing. Institute for Fiscal Studies.

    Google Scholar 

  • Ploubidis, G., DeStavola, B., & Grundy, E. (2011). Health differentials in the older population of England: An empirical comparison of the materialist, lifestyle and psychosocial hypotheses. BMC Public Health, 11(1), 390.

    Article  Google Scholar 

  • Ploubidis, G. B., Benova, L., Grundy, E., Laydon, D., & DeStavola, B. (2014). Lifelong Socio Economic Position and biomarkers of later life health: Testing the contribution of competing hypotheses. Social Science & Medicine, 119, 258–265. https://doi.org/10.1016/j.socscimed.2014.02.018.

    Article  Google Scholar 

  • Ploubidis, G. B., & Grundy, E. (2009). Later-life mental health in Europe: A country-level comparison. Journals of Gerontology Series B-Psychological Sciences and Social Sciences, 64(5), 666–676. https://doi.org/10.1093/geronb/gbp026.

    Article  Google Scholar 

  • Rabe-Hesketh, S., & Skrondal, A. (2008). Classical latent variable models for medical research. Statistical Methods in Medical Research, 17(1), 5–32. https://doi.org/10.1177/0962280207081236.

    Article  Google Scholar 

  • Rose, G. (1985). Sick individuals and sick populations. International Journal of Epidemiology, 14(1), 32–38. https://doi.org/10.1093/ije/14.1.32.

    Article  Google Scholar 

  • Schrijvers, C. T. M., Stronks, K., van de Mheen, H. D., & Mackenbach, J. P. (1999). Explaining educational differences in mortality: The role of behavioral and material factors. American Journal of Public Health, 89(4), 535–540.

    Article  Google Scholar 

  • Snowden, J. M., Rose, S., & Mortimer, K. M. (2011). Implementation of G-computation on a simulated data set: Demonstration of a causal inference technique. American Journal of Epidemiology, 173(7), 731–738. https://doi.org/10.1093/aje/kwq472.

    Article  Google Scholar 

  • Steptoe, A., Breeze, E., Banks, J., & Nazroo, J. (2012). Cohort profile: The English longitudinal study of ageing. International Journal of Epidemiology. https://doi.org/10.1093/ije/dys168.

    Article  Google Scholar 

  • Stringhini, S., Zaninotto, P., Kumari, M., Kivimäki, M., & Batty, G. D. (2016). Lifecourse socioeconomic status and type 2 diabetes: The role of chronic inflammation in the English longitudinal study of ageing. Scientific Reports, 6, 24780. https://doi.org/10.1038/srep24780, https://www.nature.com/articles/srep24780#supplementary-information.

  • Tammelin, T., Nayha, S., Hills, A. P., & Jarvelin, M. R. (2003). Adolescent participation in sports and adult physical activity. American Journal of Preventive Medicine, 24(1), 22–28.

    Article  Google Scholar 

  • Ten Have, T. R., & Joffe, M. M. (2012). A review of causal estimation of effects in mediation analyses. Statistical Methods in Medical Research, 21(1), 77–107. https://doi.org/10.1177/0962280210391076.

    Article  Google Scholar 

  • van de Mheen, H., Stronks, K., Looman, C., & Mackenbach, J. (1998). Does childhood socioeconomic status influence adult health through behavioural factors? International Journal of Epidemiology, 27(3), 431–437. https://doi.org/10.1093/ije/27.3.431.

    Article  Google Scholar 

  • Vanderweele, T. J. (2012). Mediation analysis with multiple versions of the mediatore. Epidemiology (Cambridge, Massachusetts), 23(3), 454–463.

    Article  Google Scholar 

  • Vanderweele, T. J., Vansteelandt, S., & Robins, J. M. (2014). Effect decomposition in the presence of an exposure-induced mediator-outcome confounder. Epidemiology, 25(2), 300–306. https://doi.org/10.1097/ede.0000000000000034.

    Article  Google Scholar 

  • Warburton, D. E. R., Nicol, C. W., & Bredin, S. S. D. (2006). Health benefits of physical activity: The evidence. Canadian Medical Association Journal, 174(6), 801–809. https://doi.org/10.1503/cmaj.051351.

    Article  Google Scholar 

  • Wardle, J., & Steptoe, A. (2003). Socioeconomic differences in attitudes and beliefs about healthy lifestyles. Journal of Epidemiology and Community Health, 57(6), 440–443. https://doi.org/10.1136/jech.57.6.440.

    Article  Google Scholar 

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Correspondence to George B. Ploubidis .

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Ploubidis, G.B., Benova, L., De Stavola, B., Grundy, E. (2019). Lifelong Socio-economic Position and Later Life Health Related Behaviour: A Formal Mediation Approach. In: Pathways to Health. SpringerBriefs in Population Studies. Springer, Dordrecht. https://doi.org/10.1007/978-94-024-1707-4_2

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  • DOI: https://doi.org/10.1007/978-94-024-1707-4_2

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