@article {9541, title = {Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study}, journal = {BMJ}, volume = {360}, year = {2018}, pages = {k1046}, abstract = {Objective To assess the association of low socioeconomic status and risk factors for non-communicable diseases (diabetes, high alcohol intake, high blood pressure, obesity, physical inactivity, smoking) with loss of physical functioning at older ages. Design Multi-cohort population based study. Setting 37 cohort studies from 24 countries in Europe, the United States, Latin America, Africa, and Asia, 1990-2017. Participants 109 107 men and women aged 45-90 years. Main outcome measure Physical functioning assessed using the walking speed test, a valid index of overall functional capacity. Years of functioning lost was computed as a metric to quantify the difference in walking speed between those exposed and unexposed to low socioeconomic status and risk factors. Results According to mixed model estimations, men aged 60 and of low socioeconomic status had the same walking speed as men aged 66.6 of high socioeconomic status (years of functioning lost 6.6 years, 95\% confidence interval 5.0 to 9.4). The years of functioning lost for women were 4.6 (3.6 to 6.2). In men and women, respectively, 5.7 (4.4 to 8.1) and 5.4 (4.3 to 7.3) years of functioning were lost by age 60 due to insufficient physical activity, 5.1 (3.9 to 7.0) and 7.5 (6.1 to 9.5) due to obesity, 2.3 (1.6 to 3.4) and 3.0 (2.3 to 4.0) due to hypertension, 5.6 (4.2 to 8.0) and 6.3 (4.9 to 8.4) due to diabetes, and 3.0 (2.2 to 4.3) and 0.7 (0.1 to 1.5) due to tobacco use. In analyses restricted to high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was 8.0 (5.7 to 13.1) for men and 5.4 (4.0 to 8.0) for women, whereas in low and middle income countries it was 2.6 (0.2 to 6.8) for men and 2.7 (1.0 to 5.5) for women. Within high income countries, the number of years of functioning lost attributable to low socioeconomic status by age 60 was greater in the United States than in Europe. Physical functioning continued to decline as a function of unfavourable risk factors between ages 60 and 85. Years of functioning lost were greater than years of life lost due to low socioeconomic status and non-communicable disease risk factors. Conclusions The independent association between socioeconomic status and physical functioning in old age is comparable in strength and consistency with those for established non-communicable disease risk factors. The results of this study suggest that tackling all these risk factors might substantially increase life years spent in good physical functioning.}, keywords = {Cross-National, Gait speed, Risk Factors, Socioeconomic factors}, issn = {0959-8138}, doi = {10.1136/bmj.k1046}, url = {http://www.bmj.com/lookup/doi/10.1136/bmj.k1046https://syndication.highwire.org/content/doi/10.1136/bmj.k1046http://data.bmj.org/tdm/10.1136/bmj.k1046}, author = {Stringhini, Silvia and Carmeli, Cristian and Markus Jokela and Mauricio Avendano and McCrory, Cathal and d{\textquoteright}Errico, Angelo and Bochud, Murielle and Barros, Henrique and Costa, Giuseppe and Chadeau-Hyam, Marc and Delpierre, Cyrille and Gandini, Martina and Fraga, Silvia and Goldberg, Marcel and Giles, Graham G and Lassale, Camille and Kenny, Rose Anne and Kelly-Irving, Michelle and Paccaud, Fred and Layte, Richard and Muennig, Peter and Michael Marmot and Ribeiro, Ana Isabel and Severi, Gianluca and Andrew Steptoe and Shipley, Martin J and Zins, Marie and Johan P Mackenbach and Vineis, Paolo and Mika Kivim{\"a}ki} } @article {8164, title = {Mothering alone: cross-national comparisons of later-life disability and health among women who were single mothers}, journal = {Journal of Epidemiology and Community Health}, volume = {69}, year = {2015}, pages = {865-872}, publisher = {69}, abstract = {Background Single motherhood is associated with poorer health, but whether this association varies between countries is not known. We examine associations between single motherhood and poor later-life health in the USA, England and 13 European countries.Methods Data came from 25 125 women aged 50 who participated in the US Health and Retirement Study, the English Longitudinal Study of Ageing and Survey of Health, Ageing and Retirement in Europe. We tested whether single motherhood at ages 16 49 was associated with increased risk of limitations with activities of daily living (ADL), instrumental ADL and fair/poor self-rated health in later life.Results 33 of American mothers had experienced single motherhood before age 50, versus 22 in England, 38 in Scandinavia, 22 in Western Europe and 10 in Southern Europe. Single mothers had higher risk of poorer health and disability in later life than married mothers, but associations varied between countries. For example, risk ratios for ADL limitations were 1.51 (95 CI 1.29 to 1.98) in England, 1.50 (1.10 to 2.05) in Scandinavia and 1.27 (1.17 to 1.40) in the USA, versus 1.09 (0.80 to 1.47) in Western Europe, 1.13 (0.80 to 1.60) in Southern Europe and 0.93 (0.66 to 1.31) in Eastern Europe. Women who were single mothers before age 20, for 8 years, or resulting from divorce or non-marital childbearing, were at particular risk.Conclusions Single motherhood during early-adulthood or mid-adulthood is associated with poorer health in later life. Risks were greatest in England, the USA and Scandinavia. Selection and causation mechanisms might both explain between-country variation.}, keywords = {Adult children, Cross-National, Disabilities, Health Conditions and Status, Methodology}, doi = {10.1136/jech-2014-205149}, url = {http://jech.bmj.com/content/early/2015/04/10/jech-2014-205149.abstract}, author = {Lisa F Berkman and Yuhui Zheng and M. Maria Glymour and Mauricio Avendano and Axel Borsch-Supan and Erika L. Sabbath} }