We investigated disparities in diabetes between the US-born and foreign-born populations using three diabetes measures: diagnosed diabetes, undiagnosed diabetes, and total diabetes, either diagnosed or undiagnosed diabetes. We analyzed adults aged 30-84 years drawn from the National Health and Nutrition Examination Survey 2009-2018 (n = 21,390). Of cohorts in 2009-2018, foreign-born adults had significantly higher age-standardized prevalence of diagnosed (12.6% vs. 10.6%) and undiagnosed diabetes (4.5% vs. 2.6%), and total diabetes (17.1% vs. 13.2%) than US-born adults. Results from logistic and multinomial regressions adjusting for age, sex, race/ethnicity, limited access to healthcare and BMI showed that the foreign-born had significantly higher odds of total diabetes (OR: 1.25, 95% CI: 1.04-1.50) and undiagnosed diabetes (OR: 1.83, 95% CI: 1.44-2.32) compared to the US-born. There was no significant difference in diagnosed diabetes by nativity (OR: 1.12, 95% CI: 0.96-1.53). Our results show that foreign-born adults were at higher risk of diabetes than US-born adults, and the difference by nativity was largely attributable to BMI and racial/ethnic composition. In addition, we demonstrated the importance of choosing measures of diabetes in studying diabetes mainly due to the foreign-born group's high prevalence of undiagnosed diabetes, which biases the prevalence of diabetes downward when diagnosed diabetes is used.
Data from the Interplay of Genes and Environment across Multiple Studies (IGEMS) consortium were used to examine predictions of different models of gene-by-environment interaction to understand how genetic variance in self-rated health (SRH) varies at different levels of financial strain. A total of 11,359 individuals from 10 twin studies in Australia, Sweden, and the United States contributed relevant data, including 2,074 monozygotic and 2,623 dizygotic twin pairs. Age ranged from 22 to 98 years, with a mean age of 61.05 (SD = 13.24). A factor model was used to create a harmonized measure of financial strain across studies and items. Twin analyses of genetic and environmental variance for SRH incorporating age, age2, sex, and financial strain moderators indicated significant financial strain moderation of genetic influences on self-rated health. Moderation results did not differ across sex or country. Genetic variance for SRH increased as financial strain increased, matching the predictions of the diathesis-stress and social comparison models for components of variance. Under these models, environmental improvements would be expected to reduce genetically based health disparities.
This study explores the short-term relationships between sex ratio at birth and late fetal mortality in Italy from 1910 to 2016. As the leading scholars' attention traditionally focused on long-term trends and variations in the sex ratios at birth among different populations, less interest regarded short-term fluctuations as they were mainly seen as an effect of random variability. We detrended the national series of males proportion among live births and stillbirths by their medium-term component to consider the annual deviations from a normal trend. After controlling for fertility tendencies and wars effects, regression models seem to show the effects of stillbirth on the proportion of male newborns. A sensitivity analysis was also carried out to assess the effects of the perinatal deaths on the proportion of males at birth, combining stillbirths and early neonatal losses to control the possible misspecification between stillborn infants and early neonatal deaths. The significance of late fetal mortality reflects the mortality excess among male fetuses during the intrauterine life, showing evidence for the in utero hypothesis selection.
This paper investigates the association between advanced maternal age and under-5 mortality and morbidity in Turkey, and is the first such study in the country to use a sibling comparison model to analyze this phenomenon. The study is based on data obtained from the 2013 Turkey Demographic and Health Survey, and analyzes the association of advanced maternal age with: (1) under-five mortality, using Cox proportional hazard models and their stratified versions to compare sibling groups born to the same mother in the 1978-2013 period, and (2) under-five morbidity; specifically, being born with low birth weight, stunting, underweight, and wasting based on between- and within-sibling groups models for the 2008-2013 period. Overall, our findings suggest that the hazard of under-5 mortality increases as maternal age increases. We conclude that period effects have failed to reverse the impeding effects of advanced maternal age on child mortality. Between-sibling group models indicate a positive but close to null association between advanced maternal age and child morbidity in general, although these positive associations vanish once we apply within-sibling group models. This result can be partially attributed to our controlling for unobserved characteristics specific to sibling groups, in addition to other methodological differences.
Studies of the current Chilean population performed using classical genetic markers have established that the Chilean population originated primarily from the admixture of European people, particularly Spaniards, and Amerindians. A socioeconomic-ethno-genetic cline was established soon after the conquest. Spaniards born in Spain or Chile occupied the highest Socioeconomic Strata, while Amerindians belonged to the lowest. The intermediate strata consisted of people with different degrees of ethnic admixture; the larger the European admixture, the higher the Socioeconomic Level. The present study of molecular genomic markers sought to calculate the percentage of Amerindian admixture and revealed a finer distribution of this cline, as well as differences between two Amerindian groups: Aymara and Mapuche. The use of two socioeconomic classifications - Class and Socioeconomic Level - reveals important differences. Furthermore, Self-reported Ethnicity (self-assignment to an ethnic group) and Self-reported Ancestry (self-recognition of Amerindian ancestors) show variations and differing relationships between socioeconomic classifications and genomic Amerindian Admixture. These data constitute a valuable input for the formulation of public healthcare policy and show that the notions of Ethnicity, Socioeconomic Strata and Class should always be a consideration in policy development.
Few studies have examined the biosocial pathways linking socioeconomic status (SES) to accelerated aging in a population-based sample of southern US women. Even fewer have examined the importance of chronic compared to perceived stress in linking SES to women's salivary telomere length (STL). Using data from a probability-based sample of 156 US women and structural equation modeling, we examined three pathways - chronic stress exposure, stress appraisal, and coping behavior - linking SES to STL. SES was positively associated with STL (βTE = 0.16, p < .05). Everyday discrimination was negatively associated with STL (βDE = -0.21, p < .05), but perceived stress was positively associated with STL (βDE = 0.20, p < .05). Current smoking decreased STL (βDE = -0.19, p < .01). Perceived stress acted to suppress the negative relationship of chronic stress exposure on STL. Given the dearth of STL studies that include measures of both perceived and chronic stress, our study supports the importance of disentangling stress measures and a biosocial approach to the study of accelerated aging.
This study investigates two sources of education effects on obesity - achieved educational attainment and inherited genetic endowment for education. In doing so, we accomplish two goals. First, we assess the role of genetic confounding in the association between education and health. Second, we consider the heterogeneity in the extent to which genetic potential for education is realized, and we examine its impact on obesity. Data come from the National Longitudinal Study of Adolescent to Adult Health. Using a polygenic score approach, we find that, net of genetic confounding, holding a college degree is associated with a lower likelihood of obesity. Moreover, among individuals who hold a college degree, those with a high education polygenic score (a greater genetic propensity to succeed in education) are less likely to be obese than those with a relatively low education polygenic score. However, when individuals with a high education polygenic score do not have a college degree, their risk of obesity is similar to that of non-college-educated individuals with a low education polygenic score, suggesting that the effect of genetic endowment for education on obesity is conditional on college education.