TY - JOUR T1 - Death by a thousand cuts: Stress exposure and black-white disparities in physiological functioning in late life. JF - The Journals of Gerontology, Series B Y1 - 2020 A1 - Courtney Boen KW - Life trajectories KW - Racial/ethnic differences KW - Stress AB -

OBJECTIVES: This paper investigates Black-White differences in stress-including diverse measures of chronic, acute, discrimination-related, and cumulative stress exposure-and examines whether race differences in these stress measures mediate Black-White disparities in C-reactive protein (CRP) and metabolic dysregulation in later life.

METHODS: Using data from the Health and Retirement Study (HRS) (2004-2012), this study uses stepwise OLS regression models to examine the prospective associations between multiple stressors-including traumatic and stressful life events, financial strain, chronic stress, everyday and major life discrimination, and measures of cumulative stress burden-and CRP and metabolic dysregulation. Mediation analyses assessed the contribution of stress exposure to Black-White disparities in the outcomes.

RESULTS: Blacks experienced more stress than Whites across domains of stress, and stress exposure was strongly associated with CRP and metabolic dysregulation. Race differences in financial strain, everyday and major life discrimination, and cumulative stress burden mediated Black-White gaps in the outcomes, with measures of cumulative stress burden mediating the greatest proportion of the racial disparities.

DISCUSSION: The "thousand cuts" that Blacks experience from their cumulative stress exposure across domains of social life throughout the life course accelerate their physiological deterioration relative to Whites and play a critical role in racial health disparities at older ages.

VL - 75 IS - 9 ER - TY - JOUR T1 - Associations of genetics, behaviors, and life course circumstances with a novel aging and healthspan measure: Evidence from the Health and Retirement Study. JF - PLoS Medicine Y1 - 2019 A1 - Liu, Zuyun A1 - Chen, Xi A1 - Thomas M Gill A1 - Ma, Chao A1 - Eileen M. Crimmins A1 - Morgan E. Levine KW - Genetics KW - Health Behavior KW - Life trajectories AB -

BACKGROUND: An individual's rate of aging directly influences his/her susceptibility to morbidity and mortality. Thus, quantifying aging and disentangling how various factors coalesce to produce between-person differences in the rate of aging, have important implications for potential interventions. We recently developed and validated a novel multi-system-based aging measure, Phenotypic Age (PhenoAge), which has been shown to capture mortality and morbidity risk in the full US population and diverse subpopulations. The aim of this study was to evaluate associations between PhenoAge and a comprehensive set of factors, including genetic scores, childhood and adulthood circumstances, and health behaviors, to determine the relative contributions of these factors to variance in this aging measure.

METHODS AND FINDINGS: Based on data from 2,339 adults (aged 51+ years, mean age 69.4 years, 56% female, and 93.9% non-Hispanic white) from the US Health and Retirement Study, we calculated PhenoAge and evaluated the multivariable associations for a comprehensive set of factors using 2 innovative approaches-Shapley value decomposition (the Shapley approach hereafter) and hierarchical clustering. The Shapley approach revealed that together all 11 study domains (4 childhood and adulthood circumstances domains, 5 polygenic score [PGS] domains, and 1 behavior domain, and 1 demographic domain) accounted for 29.2% (bootstrap standard error = 0.003) of variance in PhenoAge after adjustment for chronological age. Behaviors exhibited the greatest contribution to PhenoAge (9.2%), closely followed by adulthood adversity, which was suggested to contribute 9.0% of the variance in PhenoAge. Collectively, the PGSs contributed 3.8% of the variance in PhenoAge (after accounting for chronological age). Next, using hierarchical clustering, we identified 6 distinct subpopulations based on the 4 childhood and adulthood circumstances domains. Two of these subpopulations stood out as disadvantaged, exhibiting significantly higher PhenoAges on average. Finally, we observed a significant gene-by-environment interaction between a previously validated PGS for coronary artery disease and the seemingly most disadvantaged subpopulation, suggesting a multiplicative effect of adverse life course circumstances coupled with genetic risk on phenotypic aging. The main limitations of this study were the retrospective nature of self-reported circumstances, leading to possible recall biases, and the unrepresentative racial/ethnic makeup of the population.

CONCLUSIONS: In a sample of US older adults, genetic, behavioral, and socioenvironmental circumstances during childhood and adulthood account for about 30% of differences in phenotypic aging. Our results also suggest that the detrimental effects of disadvantaged life course circumstances for health and aging may be further exacerbated among persons with genetic predisposition to coronary artery disease. Finally, our finding that behaviors had the largest contribution to PhenoAge highlights a potential policy target. Nevertheless, further validation of these findings and identification of causal links are greatly needed.

VL - 16 IS - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/31211779?dopt=Abstract ER - TY - JOUR T1 - A life course approach to total tooth loss: Testing the sensitive period, accumulation, and social mobility models in the Health and Retirement Study. JF - Community Dentistry and Oral Epidemiology Y1 - 2019 A1 - Lee, Haena KW - Childhood adversity KW - Dental Care KW - Life trajectories AB -

OBJECTIVES: Childhood socio-economic status (SES) has long been associated with later-life oral health, suggesting that childhood is a sensitive period for oral health. Far less attention has been given to the long-term impact of childhood trauma, abuse, and smoking on later-life oral health. This study fills the gap in the literature by examining how adverse childhood experiences-social, psychological, and behavioral-shape total tooth loss over the life course, with an assessment of the sensitive period, accumulation, and social mobility models from life course research.

METHODS: Data are drawn from the 2012 Health and Retirement Study (HRS) merged with multiple HRS data sources to obtain childhood information (N = 6,427; age > 50). Adverse childhood experiences include childhood financial hardship, trauma, abuse, and smoking. Total tooth loss is measured to assess poor oral health in later life. Educational attainment and poverty status (since age 51) are measured as adult adversity. Current health conditions and health behaviors are assessed to reflect the correlates of oral health in later life.

RESULTS: The sensitive period model indicates that childhood trauma such as parental death or divorce (odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.04, 1.80), physical abuse (OR = 1.17, 95% CI = 1.03, 1.34), and low educational attainment (≤ high school; OR = 1.52, 95% CI = 1.04, 2.22) are associated with higher odds of total tooth loss in later life. Poverty status was not associated with the outcome. There was a clear graded relationship between accumulation of adverse experiences and oral health, which supports the accumulation model. In the social mobility model, older adults who occupied a stable disadvantageous position were more likely to be toothless (OR = 1.77, 95% CI = 1.08, 2.90) compared to those who did not face adversity in any case. Neither upward nor downward mobility mattered.

CONCLUSIONS: Failing oral health in older adults, especially total tooth loss, may have its roots in adverse experiences such as childhood trauma, abuse, and low educational attainment. Findings also suggest that oral health in later life may be more influenced by accumulation of adversity rather than changes in social and economic position over the life course.

U1 - http://www.ncbi.nlm.nih.gov/pubmed/31115080?dopt=Abstract ER - TY - JOUR T1 - Pets in the lives of older adults: A life course perspective JF - Anthrozoös Y1 - 2019 A1 - Bibbo, Jessica A1 - Angela L Curl A1 - Rebecca A Johnson KW - Decision making KW - Life trajectories KW - Pets AB - This study employed the life course perspective to investigate the convergence of two demographic shifts: the aging of the population and the increase of pet ownership. Specifically, we examined whether pet ownership, the degree of bond with a pet, and reasons for and against pet ownership differed between three age cohorts: the young-old (ages 51–64 years), older adults (ages 65–84), and the oldest-old (ages 85 and over). This study analyzed data from 1,367 respondents of the 2012 wave of the Health and Retirement Study (HRS) using bivariate statistics and multivariate regression models. We found evidence for differences in rates of pet ownership by race, ethnicity, age, number living in household, and whether someone was living with a spouse or partner, but not by gender, education, income, wealth, or health. The bond with a pet did not differ across age cohorts. Companionship was the most common reason for owning a pet across the three age groups, while concern about the resources (e.g., time and work) required of pet ownership was the most common reason for not living with a pet. Results were interpreted at the individual level using the life course perspective’s tenets of timing in lives, linked lives, and human agency, while taking the societal level tenet of historical time and place into account. While rates of pet ownership differed by age cohort, all participants reported a strong bond with their companion animal. Programs and policies can help facilitate these ongoing relationships. The life course perspective provides a useful framework to gain a deeper understanding of pet ownership and the human–animal bond throughout people’s lives. VL - 32 IS - 4 JO - Anthrozoös ER - TY - JOUR T1 - Heterogeneous trajectories of depressive symptoms in late middle age: Critical period, accumulation, and social mobility life course perspectives. JF - Journal of Aging and Health Y1 - 2018 A1 - Kwon, Eunsun A1 - BoRin Kim A1 - Lee, Hyunjoo A1 - So Jung Park KW - Depressive symptoms KW - Life trajectories KW - Socioeconomic factors AB -

OBJECTIVE: This study investigated patterns of depressive symptoms and whether socioeconomic status (SES) across the life course affects these trajectories using the critical period, accumulation, and social mobility models.

METHOD: This study uses data from 8,532 adults, age 51 to 64, collected over 12 years from the Health and Retirement Study (observations = 25,887). A latent class analysis was performed to examine distinct depressive symptom trajectories; life course models were studied with multinomial logistic regression.

RESULTS: Four heterogeneous latent classes were identified for depression: Declining, Low, Increasing, and High and Increasing. The High and Increasing group was associated with a disadvantaged childhood SES, accumulated exposure to socioeconomic risks, and persistent SES disadvantage supporting the three life course models.

DISCUSSION: There was evidence of distinct profiles of depressive symptoms in late middle age and of interrelated life course mechanisms underlying the influences of childhood SES on later life depression.

VL - 30 IS - 7 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28553816?dopt=Abstract ER - TY - JOUR T1 - Heterogeneous trajectories of physical and mental health in late middle age: Importance of life-course socioeconomic positions. JF - International Journal of Environmental Research and Public Health Y1 - 2017 A1 - Kwon, Eunsun A1 - So Jung Park KW - Depressive symptoms KW - Life trajectories KW - Socioeconomic factors AB - Drawing on life course and cumulative disadvantage theory, this study examines heterogeneous trajectories of functional limitations and depressive symptoms among late middle-aged individuals. This study used prospective data from 6010 adults, 51 to 64 years old, collected over a 12-year-period from the Health and Retirement Study. Considering the empirical proposition that several physical and mental trajectories may exist, Latent Class Growth Modeling was used. Five heterogeneous patterns of joint trajectories (Relatively healthy, Moderately improving, Steadily deteriorating, Steeply deteriorating, and Persistently high comorbid) were identified. Early life adversity was related to an increasing risk of declines in physical and mental health. The Persistently high comorbid class was characterized by a concentration of disadvantages over the life course. The development of public health interventions could help reduce co-existing physical and mental health problems, especially during late middle-age. VL - 14 IS - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28556801?dopt=Abstract ER - TY - JOUR T1 - The Life Course, Cohort Dynamics, and International Differences in Aging Trajectories JF - Demography Y1 - 2017 A1 - Steven A Haas A1 - Oi, Katsuya A1 - Zhou, Zhangjun KW - Cross-National KW - Life trajectories KW - SHARE AB - In recent years, population health research has focused on understanding the determinants of later-life health. Two strands of that work have focused on (1) international comparisons of later-life health and (2) assessing the early-life origins of disease and disability and the importance of life course processes. However, the less frequently examined intersection of these approaches remains an important frontier. The present study contributes to the integration of these approaches. We use the Health and Retirement Study family of data sets and a cohort dynamic approach to compare functional health trajectories across 12 high-income countries and to examine the role of life course processes and cohort dynamics in contributing to variation in those trajectories. We find substantial international variation in functional health trajectories and an important role of cohort dynamics in generating that variation, with younger cohorts often less healthy at comparable ages than the older cohorts they are replacing. We further find evidence of heterogeneous effects of life course processes on health trajectories. The results have important implications for future trends in morbidity and mortality as well as public policy. VL - 54 UR - http://link.springer.com/10.1007/s13524-017-0624-9http://link.springer.com/content/pdf/10.1007/s13524-017-0624-9.pdfhttp://link.springer.com/content/pdf/10.1007/s13524-017-0624-9.pdfhttp://link.springer.com/article/10.1007/s13524-017-0624-9/fulltext.html IS - 6 JO - Demography ER -