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No Socioeconomic Inequalities in Mortality among Catholic Monks: A Quasi-Experiment Providing Evidence for the Fundamental Cause Theory. 天主教僧侣的死亡率不存在社会经济不平等:为 "根本原因理论 "提供证据的准实验。
IF 6.3 1区 医学 Q1 PSYCHOLOGY, SOCIAL Pub Date : 2024-11-14 DOI: 10.1177/00221465241291847
Alina Schmitz, Patrick Lazarevič, Marc Luy

We propose a novel approach to test the fundamental cause theory (FCT) by analyzing the association between socioeconomic status (SES), as measured by the order titles "brothers" and "padres," and mortality in 2,421 German Catholic monks born between 1840 and 1959. This quasi-experiment allows us to study the effect of SES on mortality in a population with largely standardized living conditions. Mortality analyses based on Kaplan-Meier product limit estimation show that there were no statistically significant survival differences between the high and lower SES monks. This holds for all birth cohorts, indicating that monastic life offers health protection for monks with a lower SES regardless the disease patterns, causes of death, or main risk factors in a given period. These findings support the FCT: Whereas SES-related differences in mortality are a widely confirmed finding in the general population, a context with largely standardized conditions eliminates the importance of SES-related resources.

我们提出了一种检验根本原因理论(FCT)的新方法,即分析社会经济地位(SES)(以 "兄弟 "和 "父亲 "的修道士头衔来衡量)与 1840 年至 1959 年间出生的 2421 名德国天主教修道士的死亡率之间的关系。通过这一准实验,我们可以在生活条件基本标准化的人群中研究社会经济地位对死亡率的影响。基于 Kaplan-Meier 乘积极限估计法的死亡率分析表明,在统计意义上,社会经济地位高的僧侣和社会经济地位低的僧侣之间没有显著的生存差异。这一点适用于所有出生组群,表明无论疾病模式、死亡原因或特定时期的主要风险因素如何,寺院生活都能为社会经济地位较低的僧侣提供健康保护。这些发现支持了 "僧侣生活 "理论:与社会经济地位相关的死亡率差异在普通人群中已被广泛证实,而在基本标准化的条件下,与社会经济地位相关的资源的重要性就不复存在了。
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引用次数: 0
The Heterogeneous Effects of College Education on Outcomes Related to Deaths of Despair. 大学教育对绝望死亡相关结果的异质性影响。
IF 6.3 1区 医学 Q1 PSYCHOLOGY, SOCIAL Pub Date : 2024-11-14 DOI: 10.1177/00221465241291845
Grzegorz Bulczak, Alexi Gugushvili, Jonathan Koltai

College education features prominently in research on determinants of deaths from substance use disorders and self-harm-outcomes collectively referred to as "deaths of despair" (DoD). Limited attention has been given to whether the protective effects of college education on indicators of despair vary by individuals' likelihood of college completion. We use data from the National Longitudinal Study of Adolescent to Adult Health for 6,145 individuals to test whether the protective effects of college completion on precursors to DoD vary according to individuals' propensity to attain a college degree. Understanding whether the benefits of college education differ depending on the propensity to complete it is important for designing effective educational policies. Using the heterogeneous treatment effects approach, we find that individuals with a relatively low propensity for graduating from college but who complete it have a lower likelihood of depressive symptoms, binge drinking, prescription drug abuse, and hard drug use.

在有关药物使用失调和自残导致死亡的决定因素的研究中,大学教育占据了重要位置,这些结果统称为 "绝望死亡"(DoD)。对于大学教育对绝望指标的保护作用是否会因个人完成大学学业的可能性而有所不同,人们的关注还很有限。我们利用全国青少年到成人健康纵向研究(National Longitudinal Study of Adolescent to Adult Health)中 6,145 人的数据,检验了大学毕业对绝望死亡前兆的保护作用是否会因个人获得大学学位的倾向而有所不同。了解大学教育的益处是否会因完成大学教育的倾向而有所不同,对于设计有效的教育政策非常重要。利用异质性治疗效果方法,我们发现大学毕业倾向相对较低但完成大学学业的人出现抑郁症状、酗酒、滥用处方药和使用硬性毒品的可能性较低。
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引用次数: 0
Disparities in the Life Course Origins of Dual Functionality. 双重功能生命历程起源的差异。
IF 6.3 1区 医学 Q1 PSYCHOLOGY, SOCIAL Pub Date : 2024-11-14 DOI: 10.1177/00221465241293191
Kenneth F Ferraro, Madison R Sauerteig-Rolston, Shawn Bauldry, Patricia A Thomas

Although research has identified how stressors are related to either physical or cognitive function in later life, we bridge these literatures by examining dual functionality (neither physical nor cognitive impairment) among Black, White, and Hispanic adults. Using data from the Health and Retirement Study (2006-2016), we investigated whether stressors and resources during childhood and adulthood are related to functional loss at baseline and longitudinally. Analyses revealed that lifetime trauma was associated with dual functionality impairment at baseline, but childhood stressors and everyday discrimination were prospectively associated with loss of dual functionality. Black and foreign-born Hispanic adults experienced earlier loss of dual functionality than White adults, and the effect of childhood stressors on the transition to impairment occurred earlier for U.S.-born Hispanic adults. Findings reveal the influence of exposures in childhood and adulthood on functional health in later life-and how resources may be a counterbalance to functional loss.

尽管已有研究确定了压力因素与晚年身体或认知功能的关系,但我们通过研究黑人、白人和西班牙裔成年人的双重功能(既非身体损伤也非认知损伤),在这些文献之间架起了一座桥梁。利用健康与退休研究(2006-2016 年)的数据,我们调查了童年和成年期的压力和资源是否与基线和纵向的功能丧失有关。分析表明,终生创伤与基线时的双重功能障碍有关,但童年时期的压力和日常歧视与双重功能丧失的前景有关。黑人和在外国出生的西班牙裔成年人比白人更早丧失双重功能,而童年压力因素对美国出生的西班牙裔成年人向功能受损过渡的影响发生得更早。研究结果揭示了童年和成年期的暴露对晚年功能健康的影响,以及资源是如何抵消功能丧失的。
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引用次数: 0
Work-Family Life Course Trajectories and Women’s Mental Health: The Moderating Role of Defamilization Policies in 15 European Territories 工作-家庭生活轨迹与女性心理健康:欧洲 15 个地区诽谤政策的调节作用
IF 5 1区 医学 Q1 PSYCHOLOGY, SOCIAL Pub Date : 2024-11-09 DOI: 10.1177/00221465241291690
Ariel Azar
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引用次数: 0
High School Curricular Rigor and Cognitive Function among White Older Adults 高中课程的严谨性与白人老年人的认知功能
IF 5 1区 医学 Q1 PSYCHOLOGY, SOCIAL Pub Date : 2024-10-22 DOI: 10.1177/00221465241283745
Sara M. Moorman, Jooyoung Kong
Most research on the strong relationship between education and cognitive aging has focused on years of schooling. Using data from the Wisconsin Longitudinal Study—a sample of White persons born in 1939—we explored whether greater curricular rigor in high school was also associated with better cognitive function in later life. We estimated multilevel structural equation models in data from 2,749 participants who attended 308 Wisconsin high schools, graduating in 1957. Independent of academic ability and performance and school-level financial and material resources, a more rigorous high school curriculum was associated with significantly better global cognitive functioning in 2020, when most participants were 81 years old. There was also a significant mediation via eventual degree attainment. The mediation was moderated such that men and participants from high socioeconomic status families benefited most from a rigorous curriculum. We discuss implications for modern educational policy.
关于教育与认知老化之间密切关系的研究大多集中在受教育年限上。我们利用威斯康星州纵向研究(Wisconsin Longitudinal Study)的数据--该研究对 1939 年出生的白人进行了抽样调查--探讨了高中阶段更严格的课程设置是否也与晚年更好的认知功能有关。我们对威斯康星州 308 所高中的 2749 名 1957 年毕业的参与者的数据进行了多层次结构方程模型估计。与学习能力和成绩以及学校层面的财力和物力资源无关,更严格的高中课程与 2020 年(大多数参与者 81 岁)全球认知功能的显著改善相关。最终学位的获得也有明显的中介作用。这种调节作用是有节制的,男性和来自社会经济地位高的家庭的参与者从严格的课程中获益最多。我们讨论了对现代教育政策的影响。
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引用次数: 0
Spatial and Ethno-national Health Inequalities: Health and Mortality Gaps between Palestinians and Jews in Israel. 空间和民族健康不平等:以色列巴勒斯坦人和犹太人之间的健康和死亡率差距。
IF 6.3 1区 医学 Q1 PSYCHOLOGY, SOCIAL Pub Date : 2024-10-22 DOI: 10.1177/00221465241283455
Ameed Saabneh

This research adopts an analytical spatial perspective to explain ethno-national health inequality between Palestinians and Jews in Israel. The work identifies the forces that instigated and maintained the spatial segregation of Palestinians and elaborates the role of segregation in generating health gaps between Palestinians and Jews. The analysis suggests a novel conceptualization of two types of segregation: (a) exclusion from the center and confinement to the periphery and (b) segregation within the geographic periphery. Using administrative data on COVID-19 incidence, hospitalization, and death and various health indicators for localities, I devise a decomposition method that evaluates the relative contribution of each type of segregation to the total health gap. The findings indicate that the segregation of Palestinians from the center and their confinement to peripheral regions are crucial determinants of their poor health outcomes and that the segregation of the Palestinian community within the geographic periphery also contributes to poorer health.

本研究采用空间分析视角来解释以色列巴勒斯坦人和犹太人之间的民族-国家健康不平等。这项工作确定了煽动和维持巴勒斯坦人空间隔离的力量,并阐述了隔离在造成巴勒斯坦人和犹太人之间健康差距方面的作用。分析提出了两种类型隔离的新概念:(a) 被排斥在中心地区之外,被限制在边缘地区;(b) 在地理边缘地区内的隔离。利用 COVID-19 发病率、住院和死亡的行政数据以及各地的各种健康指标,我设计了一种分解方法,以评估每种类型的隔离对总健康差距的相对贡献。研究结果表明,巴勒斯坦人与中心地带的隔离以及他们被限制在边缘地区,是他们健康状况较差的重要决定因素,而巴勒斯坦社区在地理边缘地区的隔离也是导致健康状况较差的原因之一。
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引用次数: 0
Underestimating the Relationship: Unpacking Both Socioeconomic Resources and Cognitive Function and Decline in Midlife to Later Life. 低估关系:解读社会经济资源与中年至晚年的认知功能和衰退。
IF 5 1区 医学 Q1 PSYCHOLOGY, SOCIAL Pub Date : 2024-10-17 DOI: 10.1177/00221465241276818
Pamela Herd,Katrina M Walsemann
Although there is robust evidence that socioeconomic position influences later-life cognitive function, two issues limit knowledge regarding the nature and magnitude of these relationships and potential policy interventions. First, most social science research tends to treat cognition as a unitary concept despite evidence that cognitive outcomes are not interchangeable. Second, most biomedical research focuses exclusively on education, with limited attention to economic resources despite robust social science theoretical and empirical rationales for their role. Relatedly, there has been limited attention to how these relationships may vary across cohorts, even as educational and economic contexts have changed. Using the Health and Retirement Study (N = 36,494), we show that failing to attend to different facets of cognition, socioeconomic resources, and cohort differences leads to underestimates in the magnitude of educational and economic disparities in cognitive function and decline. This has important implications for appropriate policy interventions to address these disparities.
尽管有确凿证据表明,社会经济地位会影响晚年认知功能,但有两个问题限制了人们对这些关系的性质和程度以及潜在政策干预措施的了解。首先,大多数社会科学研究倾向于将认知作为一个统一的概念,尽管有证据表明认知结果是不可互换的。其次,大多数生物医学研究只关注教育,而对经济资源的关注有限,尽管社会科学理论和经验证明了经济资源的作用。与此相关的是,即使教育和经济环境发生了变化,人们对这些关系在不同组群中如何变化的关注也很有限。我们利用《健康与退休研究》(N = 36,494)表明,如果不关注认知的不同方面、社会经济资源和队列差异,就会低估认知功能和认知能力下降方面的教育和经济差异的程度。这对采取适当的政策干预措施解决这些差异具有重要意义。
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引用次数: 0
Sex Educators' Strategies for Building Student Trust. 性教育工作者建立学生信任的策略。
IF 5 1区 医学 Q1 PSYCHOLOGY, SOCIAL Pub Date : 2024-10-17 DOI: 10.1177/00221465241286801
Golda Kaplan
Although clinicians have been the focus of research on trust in health care, much of the health guidance Americans receive occurs outside clinical settings. School-based health education is one such setting. Given the importance of interpersonal dynamics to clinicians' work, trust likely features heavily in achieving health educators' outcomes. This study asks: How do health educators approach building trust with students? In interviews with 39 sexual health educators in Ohio and Illinois, I find that educators report several strategies that they use in their attempt to build student trust: They use personal anecdotes and informality to distinguish themselves from teachers; adjust their approach based on their race, gender, or age if they perceive these identities impede trust; and emphasize lessons are factual when facing pushback. My findings reveal key differences in how clinicians and nonclinical professionals approach trust and more broadly, how organizational factors impact health professionals' approach to trust.
尽管临床医生一直是医疗保健信任度研究的重点,但美国人接受的大部分健康指导都是在临床环境之外进行的。学校健康教育就是这样一种环境。鉴于人际关系对临床医生工作的重要性,信任很可能是健康教育工作者取得成果的重要因素。本研究提出了以下问题:健康教育工作者如何与学生建立信任?在对俄亥俄州和伊利诺伊州的 39 名性健康教育工作者的访谈中,我发现教育工作者报告了他们在试图建立学生信任时使用的几种策略:他们利用个人轶事和非正式的方式将自己与教师区分开来;如果他们认为自己的种族、性别或年龄等身份会妨碍信任,就会根据这些身份调整自己的方法;在面对反驳时,他们会强调课程是真实的。我的研究结果揭示了临床医生和非临床专业人员在处理信任问题上的关键差异,更广泛地说,揭示了组织因素是如何影响医疗专业人员处理信任问题的。
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引用次数: 0
Forces to Be Reckoned with: Countervailing Powers and Physician Emotional Distress during COVID-19. 需要应对的力量:COVID-19 期间的抗衡力量与医生的情绪困扰。
IF 5 1区 医学 Q1 PSYCHOLOGY, SOCIAL Pub Date : 2024-10-17 DOI: 10.1177/00221465241281371
Tania M Jenkins,Liza Buchbinder,Mara Buchbinder
The "countervailing powers" framework conceptualizes health care as an arena for power contests among key stakeholders, drawing attention to the moves, countermoves, and alliances that have challenged physicians' dominance since the 1970s. Here, we focus on one of the lesser known micro-level consequences of such forces for physicians: emotional distress. We draw on 145 interviews with frontline physicians across four U.S. cities during the COVID-19 pandemic to trace physicians' experiences with three countervailing forces: the state, health care organizations, and patients. We find that threats to physician dominance eroded physicians' sense of mastery (perceived personal control) at work, thereby prompting emotional distress, including anger and moral conflict. Conversely, in certain cases, acts of resistance may have helped increase mastery, thus moderating distress. Our findings advance the countervailing powers framework by elucidating some of the micro-level, personal consequences of macro-level power struggles and offer practical implications for understanding contemporary threats to physician dominance.
反制力量 "框架将医疗保健概念化为主要利益相关者之间的权力角逐舞台,提请人们注意自 20 世纪 70 年代以来挑战医生主导地位的各种行动、反行动和联盟。在此,我们将重点关注这些力量对医生造成的一个鲜为人知的微观后果:情绪困扰。在 COVID-19 大流行期间,我们对美国四个城市的一线医生进行了 145 次访谈,追溯了医生在国家、医疗机构和患者这三种对抗力量面前的经历。我们发现,对医生主导地位的威胁削弱了医生在工作中的主人翁意识(个人控制感),从而引发了情绪困扰,包括愤怒和道德冲突。相反,在某些情况下,抵制行为可能有助于增强主人翁意识,从而减轻痛苦。我们的研究结果通过阐明宏观层面权力斗争的一些微观个人后果,推进了反制权力框架,并为理解当代医生主导地位面临的威胁提供了实际意义。
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引用次数: 0
Death of a Parent, Racial Inequities, and Cardiovascular Disease Risk in Early to Mid-adulthood. 父母亡故、种族不平等和成年早期至中期的心血管疾病风险。
IF 6.3 1区 医学 Q1 PSYCHOLOGY, SOCIAL Pub Date : 2024-10-05 DOI: 10.1177/00221465241273870
Michael A Garcia, Belinda L Needham, Bridget J Goosby, Robert A Hummer, Hui Liu, Debra Umberson

Black Americans experience the death of a parent much earlier in the life course than White Americans on average. However, studies have not considered whether the cardiovascular health consequences of early parental death vary by race. Using data from the National Longitudinal Study of Adolescent to Adult Health, we explore associations between early parental death and cardiovascular disease (CVD) risk in early to mid-adulthood (N = 4,193). We find that the death of a parent during childhood or adolescence (ages 0-17) or the transition to adulthood (ages 18-27) is associated with increased CVD risk for Black Americans, whereas parental death following the transition to adulthood (ages 28+) undermines cardiovascular health for both Black Americans and White Americans. These findings illustrate how a stress and life course perspective can help inform strategies aimed at addressing both the unequal burden of bereavement and high cardiovascular risk faced by Black Americans.

美国黑人在一生中经历父母死亡的时间比美国白人平均要早得多。然而,尚未有研究考虑过父母早逝对心血管健康的影响是否因种族而异。我们利用 "全国青少年到成人健康纵向研究"(National Longitudinal Study of Adolescent to Adult Health)的数据,探讨了父母早逝与成年早中期心血管疾病(CVD)风险之间的关联(N = 4,193)。我们发现,父母在童年或青少年时期(0-17 岁)或成年过渡期(18-27 岁)去世与美国黑人心血管疾病风险增加有关,而父母在成年过渡期(28 岁以上)去世则会损害美国黑人和美国白人的心血管健康。这些发现说明了压力和生命历程的观点如何有助于为旨在解决美国黑人所面临的不平等的丧亲负担和高心血管风险的策略提供信息。
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引用次数: 0
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Journal of Health and Social Behavior
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