Migrants,health, and happiness: Evidence that health assessments travel with migrants and predict well-being

Health assessments correlate with health outcomes and subjective well-being. Immigrants offer an opportunity to study persistent social influences on health where the social conditions are not endogenous to individual outcomes. This approach provides a clear direction of causality from social conditions to health, and in a second stage to well-being. Natives and immigrants from across the world residing in 30 European countries are studied using survey data. The paper applies within country analysis using both linear regressions and two stage least squares. Natives’ and immigrants’ individual characteristics have similar predictive power for health, except Muslim immigrants who experience a sizeable health penalty. Average health reports in the immigrant's birth country have a significant association with the immigrant's current health. Almost a quarter of the birth country health variation is brought by the immigrants, while conditioning on socioeconomic characteristics. There is no evidence of the birth country predictive power declining neither as the immigrant spends more time in the residence country nor over the life course. The second stage estimates indicate that a one standard deviation improvement in health predicts higher happiness by 1.72 point or 0.82 of a standard deviation, more than four times the happiness difference of changing employment status from unemployed to employed. Studying life satisfaction yields similar results. Health improvements predict substantial increases in individual happiness.     

Labor market consequences of childhood onset type 1 diabetes

This paper examines the effect of the onset of Type 1 Diabetes Mellitus (T1DM) before 15 years of age on labor market outcomes and contributes to the literature on effects of childhood health on adult socioeconomic status. Using national Swedish socioeconomic register data 1991–2010 for 2485 individuals born 1972–1978 with onset of T1DM in 1977–1993, we find that T1DM in childhood has a negative effect on labor market outcomes later in life. Part of the T1DM effect is channeled through occupational field which may be related to both choice and opportunities. Although the magnitude of the effect is only directly generalizable to illnesses with similar attributes as T1DM, the results suggest that causality in the often observed correlation between health and socioeconomic status, at least partly, is explained by an effect running from health to earnings. This has implications for research and policy on strategies to reduce socioeconomic-related health inequality. Our findings also shed light on productivity losses, measured by employment status and earnings due to childhood onset T1DM, which have implications for both the individual and society.     

The effect of the health care supply environment on children's nutritional status in rural Nepal

This article examines the effect of access to health infrastructure, personnel and services on children's nutritional status in rural Nepal. Data for the study come from the 1996 Nepal Living Standards Survey, which includes individual- and household-level information on children's nutritional status and its environmental and socioeconomic determinants, and community-level information on the availability of health care infrastructure, personnel and services. The study uses a structural modelling approach to assess the relative contributions of the health care supply environment on children's anthropometric status via the pathway of maternal and child health (MCH) service use. The findings suggest that improvements in the availability of outreach clinics and the structural quality of the closest public facility would be expected to have statistically significant and large effects on the use of MCH services, and that increases in MCH service use would have a statistically significant impact on weight-for-age, but not weight-for-height or height-for-age. The overall impact of the heath care supply environment on nutritional status is assessed through a series of policy simulations.     

Factors affecting the health of residents in China: A perspective based on the living environment

Residents’ health is an important factor affecting social development and harmony. Based on 2010 China Family Panel Studies data of the Institute of Social Science Survey, Peking University and using a multi-classification logit regression model, we analyze the factors that affect the health status of residents in China. These factors include environmental pollution, which is a particularly important factor. Our study found that the impacts of residents’ characteristic variables, external living environment, and living habits vary. As residents age, their health status deteriorates. For the General, Less healthy, and Unhealthy groups, an income of less than CNY 10,000 significantly affects health status; however, when their income is greater than CNY 10,000, it no longer has a significant effect. For the Very unhealthy group, this particular threshold value is CNY 3000. At least one of urban–rural classification and residence registration status is significant, indicating that the urban–rural dual structure as well as the household registration system significantly affects residents’ health status. However, the direction of this effect is uncertain. Cooking water significantly affects the Less healthy and Unhealthy groups, and tap water is more conducive to health. Polluting enterprises within a radius of five kilometers mainly affect the Unhealthy group, but the direction of its impact is contrary to expectations. Smoking and drinking significantly affect the health status of the General, Less healthy, and Unhealthy groups. However, the direction of their impact was contrary to expectations. For the Very unhealthy group, drinking has a significant impact on residents’ health status, but the direction of the impact was again the opposite of what we expected. Smoking has no significant impact on the health status of this group. Exercise significantly affects the Less healthy and Unhealthy groups, but its influence has no obvious trend. Our study shows that living habits have a smaller influence on residents’ health status.     

The social gradient in health: The effect of absolute income and subjective social status assessment on the individual's health in Europe

Using data on individuals aged between 50 and 65 from 6 European countries, this study investigates the effect of absolute income and subjective social status assessment on health in the light of medical evidence indicating that the individual's position in the social hierarchy undermines his/her mental and physical health. The paper shows that individuals’ own income has a positive, but modest effect on health. Importantly, subjective social status assessment has a significant effect on all health measurements. Finally, the results show that individuals from deprived families (when at the age of 14) have poorer physical and mental health.     

Effects of a participatory approach,with systematic impact matrix analysis in herd health planning in organic dairy cattle herds

The animal health and welfare status in European organic dairy production does not in all aspects meet the organic principles and consumers’ expectations and needs to be improved. To achieve this, tailored herd health planning, targeted to the specific situation of individual farms could be of use. The aim of this study was to apply herd health planning in a structured participatory approach, with impact matrix analysis, not previously used in this context, in European organic dairy farms and to assess changes in animal health and welfare. Herd health planning farm visits were conducted on 122 organic dairy farms in France, Germany and Sweden. The farmer, the herd veterinarian and/or an advisor took part in the farm discussions. The researcher served as facilitator. Baseline data on the animal health status of the individual farm, collected from national milk recording schemes, were presented as an input for the discussion. Thereafter a systematic impact matrix analysis was performed. This was to capture the complexity of individual farms with the aim to identify the farm-specific factors that could have a strong impact on animal health. The participants (i.e. farmer, veterinarian and advisor) jointly identified areas in need of improvement, taking the health status and the interconnected farm system components into account, and appropriate actions were jointly identified. The researcher took minutes during the discussions, and these were shared with the participants. No intervention was made by the researcher, and further actions were left with the participants. The number of actions per farm ranged from 0 to 22. The change in mortality, metabolic diseases, reproductive performance and udder health was assessed at two time points, and potential determinators of the change were evaluated with linear regression models. A significant association was seen between change in udder health, as measured by the somatic cell count, and country. At the first follow-up, a significant association was also found between change in the proportion of prolonged calving interval and the farmers’ desire to improve reproductive health as well as with an increase in herd size, but this was not seen at the second follow-up. The degree of implementation of the actions was good (median 67%, lower quartile 40%, upper quartile 83%). To conclude, the degree of implementation was quite high, improvement of animal health could not be linked to the herd health planning approach. However, the approach was highly appreciated by the participants and deserves further study.     

(Un)Healthy in the City: Respiratory,Cardiometabolic and Mental Health Associated with Urbanity

Background

Research has shown that health differences exist between urban and rural areas. Most studies conducted, however, have focused on single health outcomes and have not assessed to what extent the association of urbanity with health is explained by population composition or socioeconomic status of the area. Our aim is to investigate associations of urbanity with four different health outcomes (i.e. lung function, metabolic syndrome, depression and anxiety) and to assess whether these associations are independent of residents’ characteristics and area socioeconomic status.

Methods

Our study population consisted of 74,733 individuals (42% males, mean age 43.8) who were part of the baseline sample of the LifeLines Cohort Study. Health outcomes were objectively measured with spirometry, a physical examination, laboratory blood analyses, and a psychiatric interview. Using multilevel linear and logistic regression models, associations of urbanity with lung function, and prevalence of metabolic syndrome, major depressive disorder and generalized anxiety disorder were assessed. All models were sequentially adjusted for age, sex, highest education, household equivalent income, smoking, physical activity, and mean neighborhood income.

Results

As compared with individuals living in rural areas, those in semi-urban or urban areas had a poorer lung function (β -1.62, 95% CI -2.07;-1.16), and higher prevalence of major depressive disorder (OR 1.65, 95% CI 1.35;2.00), and generalized anxiety disorder (OR 1.58, 95% CI 1.35;1.84). Prevalence of metabolic syndrome, however, was lower in urban areas (OR 0.51, 95% CI 0.44;0.59). These associations were only partly explained by differences in residents’ demographic, socioeconomic and lifestyle characteristics and socioeconomic status of the areas.

Conclusions

Our results suggest a differential health impact of urbanity according to type of disease. Living in an urban environment appears to be beneficial for cardiometabolic health but to have a detrimental impact on respiratory function and mental health. Future research should investigate which underlying mechanisms explain the differential health impact of urbanity.     

Disability incidence and official health status transitions in Russia

This paper examines determinants of being disabled in Russia, along with the probability of moving from one disability status to another, using data from 1994 through 2005 from the Russian Longitudinal Monitoring Survey. Results from multinomial probit regressions indicate that disability risk rises sharply with age, declines with income and self-reported good health, and is lower for women. Neither smoking nor drinking alcohol increases either the risk of being or becoming disabled. Recovery - health status improvement - improves with household size. Misclassification or measurement error is important: a surprisingly large proportion of “incurably” disabled Russians do in fact recover.This study has been funded in part by National Institute of Aging grant #2P30 AG17248-02 through the Population Aging Center at the University of Colorado at Boulder. We are grateful to Aleksandr Andreev for outstanding research assistance. Jeanine Braithwaite, John Komlos, Cem Mete, Mieke Meurs, Daniel Mont, Frank Sloan, and five anonymous referees contributed valuable comments. We acknowledge our appreciation without implicating them in remaining errors and misinterpretations.     

Depressive Symptom Severity and Community Collective Efficacy following the 2004 Florida Hurricanes

There is a lack of research investigating community-level characteristics, such as community collective efficacy, mitigating the impact of disasters on psychological health, specifically depression. We examined the association of community collective efficacy with depressive symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Cross-sectional anonymous questionnaires were distributed electronically to all Florida Department of Health (FDOH) personnel that assessed depressive symptom severity and collective efficacy nine months after the 2004 hurricane season. Analyses were conducted at the individual level and community level using zip codes. The majority of participants were female (81.9%), and ages ranged from 20 to 78 years (median = 49 years). The majority of participants (73.4%) were European American, 12.7% were African American, and 9.2% were Hispanic. Using multilevel analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with significantly lower depressive symptom severity (b = -0.09 [95% CI: -0.13, -0.04] and b = -0.09 [95% CI: -0.12, -0.06], respectively) even after adjusting for individual sociodemographic variables, community socioeconomic characteristics, individual injury/damage, and community storm damage. Lower levels of depressive symptom severity were associated with communities with high collective efficacy. Our study highlights the possible importance of programs that enrich community collective efficacy for disaster communities.     

Geochemical and man-made sources of lead and human health.

Multiple sources of Pb have been identified for human populations, but there is little agreement as to their relative significance. Marked regional geochemical anomalies in the distribution of Pb have been identified and, in one district, their impact on rural communities has been determined. The absorption of ingested Pb is modified by its chemical and physical form, by interaction with dietary minerals and lipids and by the nutritional status of the individual. Studies on children of various ethnic groups have demonstrated differences in soft tissue Pb burdens which may in part have a nutritional basis. Erythrocyte protoporphyrin determinations suggest that metabolic disturbances attributable to Pb may occur at soft tissue burdens previously regarded as acceptable. The problem of defining an adverse health effect in relation to environmental sources of Pb is discussed.     

Interactive and Independent Associations between the Socioeconomic and Objective Built Environment on the Neighbourhood Level and Individual Health: A Systematic Review of Multilevel Studies

Background

The research question how contextual factors of neighbourhood environments influence individual health has gained increasing attention in public health research. Both socioeconomic neighbourhood characteristics and factors of the built environment play an important role for health and health-related behaviours. However, their reciprocal relationships have not been systematically reviewed so far. This systematic review aims to identify studies applying a multilevel modelling approach which consider both neighbourhood socioeconomic position (SEP) and factors of the objective built environment simultaneously in order to disentangle their independent and interactive effects on individual health.

Methods

The three databases PubMed, PsycINFO, and Web of Science were systematically searched with terms for title and abstract screening. Grey literature was not included. Observational studies from USA, Canada, Australia, New Zealand, and Western European countries were considered which analysed simultaneously factors of neighbourhood SEP and the objective built environment with a multilevel modelling approach. Adjustment for individual SEP was a further inclusion criterion.

Results

Thirty-three studies were included in qualitative synthesis. Twenty-two studies showed an independent association between characteristics of neighbourhood SEP or the built environment and individual health outcomes or health-related behaviours. Twenty-one studies found cross-level or within-level interactions either between neighbourhood SEP and the built environment, or between neighbourhood SEP or the built environment and individual characteristics, such as sex, individual SEP or ethnicity. Due to the large variation of study design and heterogeneous reporting of results the identification of consistent findings was problematic and made quantitative analysis not possible.

Conclusions

There is a need for studies considering multiple neighbourhood dimensions and applying multilevel modelling in order to clarify their causal relationship towards individual health. Especially, more studies using comparable characteristics of neighbourhood SEP and the objective built environment and analysing interactive effects are necessary to disentangle health impacts and identify vulnerable neighbourhoods and population groups.     

Where You Live May Make You Old: The Association between Perceived Poor Neighborhood Quality and Leukocyte Telomere Length

Background

Strong evidence supports that living in disadvantaged neighborhoods has direct unfavorable impact on mental and physical health. However, whether it also has direct impact on cellular health is largely unknown. Thus we examined whether neighborhood quality was associated with leukocyte telomere length, an indicator of cellular aging.

Methods

In May 2014, we extracted and analyzed baseline data from the Netherlands Study of Depression and Anxiety (NESDA), a large epidemiological study of individuals age between 18–65 years (n=2902). Telomere length was determined using quantitative polymerase chain reaction. Neighborhood quality was assessed using modified measures of perceived neighborhood disorder, fear of crime, and noise. We used multivariable linear regression models to examine association between perceived neighborhood quality and telomere length with comprehensive adjustment for individual and community characteristics related to socioeconomic and demographic status, urbanization level, mental and physical health, and lifestyle.

Results

Compared to individuals who reported good neighborhood quality, the mean telomere length of those who reported moderate neighborhood quality was approximately 69 base pair shorter (β =-69.33, 95% CI: -119.49, -19.17, p= 0.007), and that of those who reported poor neighborhood quality were 174 base pair shorter (β =-173.80, 95% CI: -298.80, -49.01, p=0.006). For illustrative purposes, one could extrapolate these outcomes to 8.7 and 11.9 years in chronological age, respectively.

Conclusion

We have established an association between perceived neighborhood quality and cellular aging over and above a range of individual attributes. Biological aging processes may be impacted by socioeconomic milieu.     

Social determinants of self-reported health in women and men: understanding the role of gender in population health

Background

Women and men share similar health challenges yet women report poorer health. The study investigates the social determinants of self-reported health in women and men, and male-female differences in health.

Methods

Data on 103154 men and 125728 women were analysed from 57 countries in the World Health Survey 2002–2004. Item Response Theory was used to construct a composite measure of health. Associations between health and determinants were assessed using multivariate linear regression. Blinder-Oaxaca decomposition partitioned the inequality in health between women and men into an “explained" component that arises because men and women differ in social and economic characteristics, and an “unexplained" component due to the differential effects of these characteristics. Decomposition was repeated for 18 countries in the World Health Organization (WHO) African region and 19 countries in the WHO European region.

Results

Women''s health was significantly lower than men''s. Health was associated with education, household economic status, employment, and marital status after controlling for age. In the pooled analysis decomposition showed that 30% of the inequality was “explained", of which almost 75% came from employment, education, marital status. The differential effects of being in paid employment increased the inequality. When countries in Africa and Europe were compared, the “explained" component (31% and 39% respectively) was largely attributed to the social determinants in the African countries and to women''s longevity in the European countries. Being in paid employment had a greater positive effect on the health of males in both regions.

Conclusions

Ways in which age and the social determinants contribute to the poorer health status of women compared with men varies between groups of countries. This study highlights the need for action to address social structures, institutional discrimination and harmful gender norms and roles that differently influence health with ageing.     

Relative Contributions of Geographic,Socioeconomic, and Lifestyle Factors to Quality of Life,Frailty, and Mortality in Elderly

Background

To date, few studies address disparities in older populations specifically using frailty as one of the health outcomes and examining the relative contributions of individual and environmental factors to health outcomes.

Methodology/Principal Findings

Using a data set from a health survey of 4,000 people aged 65 years and over living in all regions of Hong Kong, we examined regional variations in self-rated health, frailty, and four-year mortality, and analyzed the relative contributions of lifestyle, socioeconomic status, and geographical location of residence to these outcomes using path analysis. We hypothesize that lifestyle, socioeconomic status, and regional characteristics directly and indirectly through interactions contribute to self-rated physical and psychological health, frailty, and four-year mortality.District variations directly affect self-rated physical health, and also exert an effect through socioeconomic position as well as lifestyle factors. Socioeconomic position in turn directly affects self-rated physical health, as well as indirectly through lifestyle factors. A similar pattern of interaction is observed for self-rated mental health, frailty, and mortality, although there are differences in different lifestyle factors and district associations. Lifestyle factors also directly affect physical and mental components of health, frailty, and mortality. The magnitude of direct district effect is comparable to those of lifestyle and socioeconomic position.

Conclusions/Significance

We conclude that district variations in health outcomes exist in the Hong Kong elderly population, and these variations result directly from district factors, and are also indirectly mediated through socioeconomic position as well as lifestyle. Provision and accessibility to health services are unlikely to play a significant role. Future studies on these district factors would be important in reducing health disparities in the older population.     

Is inconsistent reporting of self-assessed health persistent and systematic? Evidence from the UKHLS

In this paper, we investigate whether individuals provide consistent responses to self-assessed health (SAH) questions in the UK Household Longitudinal Study (UKHLS), and the potential implications for empirical research in case of inconsistent reporting behaviour. We capitalise on an opportunity in the UKHLS, asking respondents the same SAH question twice: with a self-completion and an open interview mode, within the same household interview over four waves. We estimate multivariate models to explore which individual characteristics are systematically relevant for the likelihood and frequency of inconsistent reporting. About 11–24% of those reported a particular SAH category in the self-completion reported inconsistently in the open interview. The probability of inconsistency is systematically associated with individual’s demographics, education, income, employment status, cognitive and non-cognitive skills. The same characteristics also predict the frequency of inconsistent reporting across four UKHLS waves. Analysis of the implications of reporting inconsistencies shows no impact of SAH measurement on the association between income and health. A set of dimensions of people’s physiological and biological health, captured using biomarkers, is associated equally with both SAH measures, suggesting that the interview mode does not play a role in the relationship between SAH and more objective health measures.     

Epidemiology of Helicobacter pylori infection and public health implications

This article summarizes the published literature concerning the epidemiology and public health implications of Helicobacter pylori infection published from April 2009 through March 2010. Prevalence of infection varied between 7 and 87% and was lower in European studies. All retrieved studies examining transmission of infection concluded that spread is from person-to-person. One study collecting stool and vomitus samples from patients with acute gastroenteritis detected H.?pylori DNA in 88% of vomitus and 74% of stool samples. Proposed risk factors for infection included male gender, increasing age, shorter height, tobacco use, lower socioeconomic status, obesity, and lower educational status of the parents in studies conducted among children. Decision analysis models suggest preventing acquisition of H.?pylori, via vaccination in childhood, could be cost-effective and may reduce incidence of gastric cancer by over 40%. As yet, no country has adopted public health measures to treat infected individuals or prevent infection in populations at risk.     

Breeding time, health and immune response in the chinstrap penguin Pygoscelis antarctica

Health status and immunocompetence have been proposed as important factors affecting individual variation in the attainment of breeding condition in birds. We studied individual variation in serological variables indicating health status (blood sedimentation rate, haematocrit, `buffy coat' layer, proportions of different types of leucocytes) in two groups of breeding chinstrap penguins Pygoscelis antarctica with breeding dates 9 days apart. We sampled these individuals shortly after hatching of their young and at the end of the chick-raising period. A group of failed breeders was also sampled. Birds of both sexes were included. We also measured the T-cell-mediated immune response as indicated by an in vivo hypersensitivity response to an intradermal injection of a mitogen (phytohaemagglutinin) in early and late breeders. Sex had no significant effect on most variables. Late breeders had poorer health (more leucocytes, especially heterophils and lymphocytes) and a lower T-cell-mediated immune response than early breeders. Failed breeders were more similar to late than to early breeders. Early breeders suffered a decline in health status throughout the chick-raising period. The impact of pathogens on variation in life history traits in avian populations may be important even in extreme Antarctic environments. Received: 18 December 1997 / Accepted: 1 March 1998     

Health and the 2008 Economic Recession: Evidence from the United Kingdom

Introduction

The economic recession which began in 2008 has resulted in a substantial increase in unemployment across many countries, including the United Kingdom. Strong association between unemployment and poor health status among individuals is widely recognised. We investigated whether the prevalence of poor health at a population level increased concurrent to the rise in unemployment during the economic recession, and whether the impact on health varied by geographical and socioeconomic circumstances.

Method

Health, demographic and socioeconomic measures on 1.36 million survey responses aged 16–64 were extracted from the Quarterly Labour Force Survey of the United Kingdom, collected every three months, from January 2006 to December 2010. The likelihood of self-reporting poor health status and specific types of health problems (depression, mental illness, cardiovascular and respiratory) across time were estimated separately using logistic regression. Explanatory variables included economic status (International Labour Organization definition), occupational class, age, gender, country of birth, ethnicity, educational qualifications, couple status, household tenure, number of dependents, and geographical region.

Results

Unemployment (age-gender adjusted) rose from 4.5% in January 2008 to 7.1% by September 2009. The reporting of poor health status increased from 25.7% in July 2009 to 29.5% by December 2010. Similar increases were found for cardiovascular and respiratory health problems; not depression or mental illness. The prevalence of poor health status among the unemployed decreased from 28.8% in July 2008, to 24.9% by March 2009; but this was followed by an increase in poor health experienced across all regions and by all socioeconomic groups, including those who remained employed, regardless of their occupational class.

Interpretation

Although our study found no exacerbation of pre-recession health inequalities, the rise in poor health status not only for the unemployed, but also among people who remained employed, regardless of their occupational class, justifies concern voiced among many public health commentators.     

Epidemiological studies in a highland population of new guinea: Environment,culture, and health status

In assessing the impact of European influence on sociocultural characteristics of the Murapin tribal community of the Western Highlands of Australian New Guinea, the authors have gathered and, where possible, quantified information on family size, polygamy, marital status, religious beliefs, education, linguistic ability, economic development, occupation, housing, clothing, alcohol intake, and dietary patterns. Our findings suggest that the results of contact have not been uniform but that various social characteristics have been influenced at differing rates. European influence has been greatest in religion, less significant in matters of occupation, education, economic development, and housing, and negligible as regards diet. This differential effect of contact affords hope that it will prove possible to discriminate between various social and nutritional factors in their influence on the health status and biological characteristics of the population as the process of acculturation proceeds.This work was supported by the National Heart Foundation of Australia.