Sanna Read

Does Ethnic Diversity Erode Trust? Putnam’s ‘Hunkering Down’ Thesis Reconsidered

We use a multi-level modelling approach to estimate the effect of ethnic diversity on measures of generalized and strategic trust using data from a new survey in Britain with a sample size approaching 25,000 individuals. In addition to the ethnic diversity of neighbourhoods, we incorporate a range of indicators of the socio-economic characteristics of individuals and the areas in which they live. Our results show no effect of ethnic diversity on generalized trust. There is a statistically significant association between diversity and a measure of strategic trust, but in substantive terms, the effect is trivial and dwarfed by the effects of economic deprivation and the social connectedness of individuals.

Socioeconomic Inequalities in Mortality Rates in Old Age in the World Health Organization Europe Region

Socioeconomic adversity is among the foremost fundamental causes of human suffering, and this is no less true in old age. Recent reports on socioeconomic inequalities in mortality rate in old age suggest that a low socioeconomic position continues to increase the risk of death even among the oldest old. We aimed to examine the evidence for socioeconomic mortality rate inequalities in old age, including information about associations with various indicators of socioeconomic position and for various geographic locations within the World Health Organization Region for Europe. The articles included in this review leave no doubt that inequalities in mortality rate by socioeconomic position persist into the oldest ages for both men and women in all countries for which information is available, although the relative risk measures observed were rarely higher than 2.00. Still, the available evidence base is heavily biased geographically, inasmuch as it is based largely on national studies from Nordic and Western European countries and local studies from urban areas in Southern Europe. This bias will hamper the design of European-wide policies to reduce inequalities in mortality rate. We call for a continuous update of the empiric evidence on socioeconomic inequalities in mortality rate.

Social Contacts and Receipt of Help Among Older People in England: Are There Benefits of Having More Children?

OBJECTIVES To investigate whether number of children and, among parents, having a daughter is associated with older peoples likelihood of at least weekly face-to-face social contact and later receipt of help if needed. METHOD Multivariate analysis of data from Waves 1 and 2 of the English Longitudinal Study of Ageing (ELSA). RESULTS Older parents in England had higher chances of at least weekly face-to-face social contact than their childless counterparts but larger family size had only a slight additional effect. For parents, having at least one daughter was more important than number of children. Larger family size was positively associated with receipt of help from a child by parents with activities of daily living (ADL) or instrumental activities of daily living (IADL) limitations. Childless women were more likely than mothers to receive help from friends but even so had lower odds of receiving help from any informal source. Contact with a child in 2002 predicted receipt of help 2 years later. DISCUSSION These results show some advantages for older parents compared with childless individuals in terms of social contact and receipt of help and, among parents, an additional effect of having a daughter. Changes in family size distributions have implications for the support of older people and for planners of formal services.

Promoting positive motherhood among nulliparous pregnant women with an intense fear of childbirth: RCT intervention

This RCT intervention among nulliparous pregnant women with an intense fear of childbirth sought to promote preparedness for childbirth and to enhance positive parenting. Pregnant women (n = 8,611) filled in a ‘fear of childbirth’ questionnaire. Nulliparous women with severe fear of childbirth (n = 355) were randomized into intervention (n = 131; 41 refused) and control (n = 224) groups. They rated themselves on a preparedness scale in middle and late pregnancy, and on a motherhood scale three months after childbirth. The intervention included six psycho-education group sessions during pregnancy and one after childbirth. This intervention increased the mothers’ preparedness for childbirth, which predicted an increase in positive motherhood.

The relationship between generalized resistance resources, sense of coherence, and health among Finnish people aged 65-69

The present study investigated the appropriateness of Antonovskys model, in which generalized resistance resources (GRRs) facilitate an individuals sense of coherence (SOC); which in turn is assumed to sustain health. The proposed model was tested using a sample of 320 Finnish persons (132 of them were men and 188 women) aged 65-69 years. The GRRs investigated were family income, cognitive functioning, years of formal education, marital status, and physical exercise. Health was measured by means of a multidimensional indicator composed of physical, social and mental health. Structural Equation Modelling (SEM) within the framework of LISREL models were used to test the hypothesized model. The results showed that good cognitive functioning and physical activity in the whole sample, and marital status in men, were associated with a strong SOC, which in turn was positively related to physical, and especially, social and mental health.

Fertility history, health, and health changes in later life: A panel study of British women and men born 1923–49

We investigated associations between later-life health and fertility history for women and men, using the British Household Panel Survey. We modelled health and its rate of change jointly with sample retention over an 11-year period. For women, childlessness is associated with limitation of activity for health reasons and faster acquisition of the limitation. High parity (four or more children) is associated with poorer health for both women and men. For the parous, this association is also found when age at first birth is controlled. Early parenthood is associated with poorer health. For parents of two or more children, a birth interval of less than 18 months is associated with having a health limitation and an accelerated rate of acquiring it. We conclude that biosocial pathways link parenthood careers and the later-life health of both women and men, and that implications of closely spaced births for parents merit further attention.

Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review

Objectives: Previous studies of older European populations have established that disability and morbidity vary with indicators of socio-economic position (SEP). We undertook a systematic narrative review of the literature to ascertain to what extent there is evidence of similar inequalities in the subjective health and well-being of older people in Europe. Method: Relevant original research articles were searched for using Medline, Global Health, Embase, Social Policy and Practice, Cinahl, Web of Science and International Bibliography of the Social Sciences (IBSS). We included studies of SEP and indicators of subjective health and well-being (self-rated health; life satisfaction; quality of life) conducted since 1991 using population-based samples of older people in Europe and published 1995–2013. Results: A total of 71 studies were identified. Poorer SEP was associated with poorer subjective health and well-being. Associations varied somewhat depending on the SEP measure and subjective health and well-being outcome used. Associations were weaker when social support and health-related behaviours were adjusted for suggesting that these factors mediate the relationship between SEP and subjective health and well-being. Associations tended to be weaker in the oldest age groups. The patterns of associations by gender were not consistent and tended to diminish after adjusting for indicators of health and life circumstances. Conclusion: The results of this systematic narrative review of the literature demonstrate the importance of social influences on later life subjective health and well-being and indicate areas which need further investigation, such as more studies from Eastern Europe, more longitudinal studies and more research on the role of mediating factors.

Mental health among older married couples: the role of gender and family life

PurposeAs shared family context may be an important influence on mental health, and gender differences in mental health, in later life we investigated how gender, family-related variables and gender roles were associated with mental health in older married couples.MethodsUsing data on a sample of 2,511 married couples born between 1923 and 1953 (drawn from the British Household Panel Survey) we analysed differences in the mental health of husbands and wives by fertility history, length of marriage, presence of co-resident children, reported social support, hours of household work, attitudes to gender roles and health of husband and wife. Mental health in 2001 was measured using the General Health Questionnaire (GHQ-12). Multilevel modelling was used to assess effects in husbands and wives and variations between husbands and wives.ResultsResults showed that although the mental health of married couples was correlated, wives had poorer mental health than their husbands. The gender difference was smaller in couples who lived with a child aged 16 or more (and had no younger co-resident children) and in couples in which both spouses had experienced early parenthood. The influence of individual and family characteristics on mental health also differed between husbands and wives. For husbands, early fatherhood and co-residence with a child or children aged 16 or more increased the odds of poor mental health. For wives, having had a child when aged 35 or more appeared protective while having traditional gender role attitudes increased the odds of poorer mental health.ConclusionsThe role of family characteristics in the shared marital context has complex associations with mental health, some of which seem gender specific. Although wives express more mental distress, husbands in general show poorer mental health related to family characteristics.

Re-evaluating the Links Between Social Trust, Institutional Trust and Civic Association

The authors of this chapter examine data from the European Social Survey (ESS) and, using structural equation modelling techniques, develop measures for three elements of social capital; social trust, institutional trust and civic association. The analysis explores how these three elements are related after controlling for a range of social and psychological factors, including age, gender, income and personality type. The relationship between social trust and institutional trust is found to be resistant to controlling for sociodemographic variables and to controlling for life satisfaction.

Allostatic Load and Health in the Older Population of England: A Crossed-Lagged Analysis

Objective Allostatic load, a composite measure of accumulated physical wear and tear, has been proposed as an early sign of physiological dysregulation predictive of health problems, functional limitation, and disability. However, much previous research has been cross sectional and few studies consider repeated measures. We investigate the directionality of associations between allostatic load, self-rated health, and a measure of physical function (walking speed). Methods The sample included men and women 60 and older who participated in Wave 2 (2004) and Wave 4 (2008) of the English Longitudinal Study of Ageing (n = 6132 in Wave 2). Allostatic load was measured with nine biomarkers using a multisystem summary approach. Self-rated health was measured using a global 5 point summary indicator. Time to walk 8 ft was used as a measure of function. We fitted and tested autoregressive cross-lagged models between the allostatic load measure, self-rated health, and walking speed in Waves 2 and 4. Models were adjusted for age, sex, educational level, and smoking status at Wave 2 and for time-varying indicators of marital status, wealth, physical activity, and social support. Results Allostatic load predicted slower walking speed (standardized estimate = −0.08, 95% confidence interval [CI] = −0.10 to −0.05). Better self-rated health predicted faster walking speed (standardized estimate = 0.11, 95% CI = 0.08-0.13) as well as lower allostatic load (standardized estimate = −0.15, 95% CI = −0.22 to −0.09), whereas paths from allostatic load and walking speed to self-rated health were weaker (standardized estimates = −0.05 [95% CI = −0.07 to −0.02] and 0.06 [95% CI = 0.04–0.08]). Conclusions Allostatic load can be a useful risk indicator of subsequent poor health or function.