Educational attainment is a well-established social determinant of health. It affects health thro... more Educational attainment is a well-established social determinant of health. It affects health through many mechanisms such as neural development, biological aging, health literacy and health behaviors, sense of control and empowerment, and life chances. Education--from preschool to beyond college--is also one of the social determinants of health for which there are clear policy pathways for intervention. We reviewed evidence from studies of early childhood, kindergarten through 12th grade, and higher education to identify which components of educational policies and programs are essential for good health outcomes. We have discussed implications for public health interventions and health equity.
Epidemiologic studies of blood pressure have been conducted for over twenty-five years, but the r... more Epidemiologic studies of blood pressure have been conducted for over twenty-five years, but the results of this research can only be described as modest. The basic epidemiologic and demographic description of blood pressure distributions in human populations remains problematic and psychosocial studies have not yielded clear and solid hypotheses pointing the way to future research. There is no doubt that blood pressures vary among and between population groups, and there seems little doubt that variations in life-style are associated with these differences. It is puzzling that we have failed to discern systematic and patterned relationships among these variables. It is suggested that a more useful approach to research in this field would be to distinguish factors that affect general susceptibility to becoming ill from those that initiate or maintain particular disease states.
Journal of Epidemiology and Community Health, 2015
Health researchers and practitioners increasingly recognise the important role communities play i... more Health researchers and practitioners increasingly recognise the important role communities play in shaping individual health. Health researchers recognise the role of community factors as causes or determinants of health problems; use community-based methods for understanding complex health issues; and design community-level health solutions. In this commentary, we propose a fourth way to think about the role of communities in individual health by arguing that the community engagement process itself has implications for individual health and strong communities. This topic is especially important during adolescence, a developmental window of opportunity during which individuals need meaningful opportunities to contribute to the world around them.
... Other Titles: Pathways to health: the role of social factors. Authors: Haan, MN Kaplan, GA Sy... more ... Other Titles: Pathways to health: the role of social factors. Authors: Haan, MN Kaplan, GA Syme, S. Leonard. Issue Date: 1989. Publisher: Hentry J Kaiser Family Foundation. ... Consult the document(s) and/or contact the copyright holder for additional rights questions and requests.
ORIGINAL RESEARCH Suggested citation for this article: Krause N, Brand RJ, Kauhanen J, Kaplan GA,... more ORIGINAL RESEARCH Suggested citation for this article: Krause N, Brand RJ, Kauhanen J, Kaplan GA, Syme SL, Wong CC, et al. Work time and 11-year progression of carotid atherosclerosis in middle-aged Finnish men. Prev Chronic Dis 2009;6(1).
ORIGINAL RESEARCH Suggested citation for this article: Krause N, Brand RJ, Kauhanen J, Kaplan GA,... more ORIGINAL RESEARCH Suggested citation for this article: Krause N, Brand RJ, Kauhanen J, Kaplan GA, Syme SL, Wong CC, et al. Work time and 11-year progression of carotid atherosclerosis in middle-aged Finnish men. Prev Chronic Dis 2009;6(1).
Studies of the relationship between work time and health have been inconclusive. Consequently, we... more Studies of the relationship between work time and health have been inconclusive. Consequently, we sought to examine the effect of work time on progression of atherosclerosis. This prospective study of 621 middle-aged Finnish men evaluated effects of baseline and repeat measures of work time on 11-year progression of ultrasonographically assessed carotid intima-media thickness (IMT) and interactions with cardiovascular disease. Multiple linear regression models adjusted for 21 biological, behavioral, and psychosocial risk factors Working 3 (minimum), 5 (medium), or 7 (maximum) days per week at baseline was associated with 23%, 31%, and 40% 11-year increases in IMT, respectively. The relative change ratio (RCR) at maximum vs minimum was 1.14 for baseline days worked per week and 1.10 for hours worked per year of follow-up. Significant interactions existed between cardiovascular disease and work time. Men with ischemic heart disease (IHD) who worked the maximum of 14.5 hours per day ex...
... This latter group was unaffected by either supple mental intervention and can be thought of a... more ... This latter group was unaffected by either supple mental intervention and can be thought of as hard core', while the former group can be thought of as assignment error'. ... Am J Public Health 1979; 69(1): 25. ... Milbank Mem Fund Q 1976; 54(3): 367. 7 Brown E, Bloom JR. ...
Background: Implementation of screening guidelines for domestic violence has been challenging. Th... more Background: Implementation of screening guidelines for domestic violence has been challenging. The multifaceted "systems model" may provide an effective means to improve domestic violence screening, identification, and intervention in the healthcare setting.
The science of team science encompasses an amalgam of conceptual and methodologic strategies aime... more The science of team science encompasses an amalgam of conceptual and methodologic strategies aimed at understanding and enhancing the outcomes of large-scale collaborative research and training programs. This field has emerged rapidly in recent years, largely in response to growing concerns about the cost effectiveness of public-and private-sector investments in team-based science and training initiatives. The distinctive boundaries and substantive concerns of this field, however, have remained difficult to discern. An important challenge for the field is to characterize the science of team science more clearly in terms of its major theoretical, methodologic, and translational concerns. The articles in this supplement address this challenge, especially in the context of designing, implement ing, and evaluating cross-disciplinary research initiatives. This introductory article summa rizes the major goals and organizing themes of the supplement, draws links between the constituent articles, and identifies new areas of study within the science of team science. (Am J Prev Med 2008;35(2S):S77-S89)
Marmot. MG (School of Public Health. U. of California, Berkeley. CA 94720). SL Syme, A. Kagan, H.... more Marmot. MG (School of Public Health. U. of California, Berkeley. CA 94720). SL Syme, A. Kagan, H. Kato. JB Cohen and J. Belsky. Epi- demiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: Prevalence of coronary ...
The link between blood pressure measured at juvenile ages (3-18 years) and subsequent adult ages ... more The link between blood pressure measured at juvenile ages (3-18 years) and subsequent adult ages (30 and 50 years) was investigated in a community-based longitudinal study conducted in the San Francisco Bay Area from 1928 to the present. The original sample of 550 persons decreased 61 percent by age 50 years, leaving only 211 persons in the cohort. Blood pressure was measured annually up to age 18 years and each decade thereafter, providing a unique opportunity to link childhood and adult blood pressures over periods of up to 50 years. Juvenile blood pressure measured from age 6 years onward was a positive predictor of blood pressure at age 30 years. Blood pressure measured at age 50 years was predicted best by juvenile pressures measured at early school age and early puberty. The juvenile-adult blood pressure association was partly explained by controlling for smoking and parental history of cardiovascular disease, but was not explained by controlling for juvenile height or body mass. It was stronger in children from blue collar families. The reported correlations probably represent an underestimation of the true strength of the association because of a greater loss to follow-up among subjects with higher blood pressure and the effects of antihypertensive medication in adulthood.
Social class gradients have been explored in adults and children, but not extensively during adol... more Social class gradients have been explored in adults and children, but not extensively during adolescence. The first objective of this study was to examine the association between adolescent risk behaviors and a new indicator of adolescent relative social position, adolescent "perceived social mobility." Second, it investigated potential underlying demographic, socioeconomic, and psychosocial determinants of this indicator. Data were taken from the 2004 urban adolescent module of Oportunidades, a cross-sectional study of Mexican adolescents living in poverty. Perceived social mobility was calculated for each subject by taking the difference between their rankings on two 10-rung ladder scales that measured (1) projected future social status and (2) current subjective social status within Mexican society. Adolescents with higher perceived social mobility were significantly less likely to report alcohol consumption, drinking with repercussions, compensated sex, police detainment, physical fighting, consumption of junk food or soda, or watching ≥4 h of television during the last viewing. They were significantly more likely to report exercising during the past week and using a condom during last sexual intercourse. These associations remained significant with the inclusion of covariates, including parental education and household expenditures. Multiple logistic regression analyses show higher perceived social mobility to be associated with staying in school longer and having higher perceived control. The present study provides evidence for the usefulness of perceived social mobility as an indicator for understanding the social gradient in health during adolescence. This research suggests the possibility of implementing policies and interventions that provide adolescents with real reasons to be hopeful about their trajectories.
Background: Social isolation has been linked to mortality across a range of middle-aged and older... more Background: Social isolation has been linked to mortality across a range of middle-aged and older populations, although it has not been compared with other clinical risk factors in a national sample. Methods: Data came 12,403 adults from the National Health and Nutrition Examination Survey III and the National Death Index. The outcome was mortality after eight years. Predictor variables included individual social isolation factors and a composite score. Clinical predictors used for comparison included smoking, BMI, high blood pressure, and hypercholesterolemia. Logistic regressions and recursive partitioning - which classifies populations into low- and high- risk groups by choosing the best predictor variables were used to rank the importance of these predictors. Models were nationally weighted. Results: Male mortality was significantly predicted by current smoking (OR 1.81, CI 1.31-2.51), high blood pressure (OR 1.40, CI 1.06-1.85), and, most strongly, by social isolation (OR 2.25,...
Social capital has been shown to be associated with reduced mortality due to cardiovascular disea... more Social capital has been shown to be associated with reduced mortality due to cardiovascular disease. Our aim was to determine the association of time-varying community-level social capital (CSC) with recurrence of acute coronary syndrome using a retrospective cohort study design. A total of 34,752 men and women were identified, aged 30e85 years, who were hospitalized for acute coronary syndrome between January 1, 1998 and December 31, 2002 in Kaiser Permanente Northern California, USA, an integrated health care delivery system. The primary outcome was recurrent non-fatal or fatal acute coronary syndrome; median follow-up was 19 months. We estimated random-effects, three-level Cox proportional hazard models adjusting for sex, age, race/ethnicity, comorbidities, medication use, and revascularization procedures at level 1, median household income for the census block-group at level 2, and income inequality, racial/ethnic concentration, penetration of health maintenance organizations, and CSC at level 3. Our measure of CSC was the previously validated Petris Social Capital Index (PSCI). We found that a one-standard deviation increase in the PSCI, after adjusting for the above covariates, was significantly associated with decreased recurrence of acute coronary syndrome only for those living in areas where block-group level median household income was below the grand median compared to those living in areas where block-group level median household income was at the grand median or above. These results suggest that community-level social capital may be negatively associated with recurrence of acute coronary syndrome among lower-income individuals.
Educational attainment is a well-established social determinant of health. It affects health thro... more Educational attainment is a well-established social determinant of health. It affects health through many mechanisms such as neural development, biological aging, health literacy and health behaviors, sense of control and empowerment, and life chances. Education--from preschool to beyond college--is also one of the social determinants of health for which there are clear policy pathways for intervention. We reviewed evidence from studies of early childhood, kindergarten through 12th grade, and higher education to identify which components of educational policies and programs are essential for good health outcomes. We have discussed implications for public health interventions and health equity.
Epidemiologic studies of blood pressure have been conducted for over twenty-five years, but the r... more Epidemiologic studies of blood pressure have been conducted for over twenty-five years, but the results of this research can only be described as modest. The basic epidemiologic and demographic description of blood pressure distributions in human populations remains problematic and psychosocial studies have not yielded clear and solid hypotheses pointing the way to future research. There is no doubt that blood pressures vary among and between population groups, and there seems little doubt that variations in life-style are associated with these differences. It is puzzling that we have failed to discern systematic and patterned relationships among these variables. It is suggested that a more useful approach to research in this field would be to distinguish factors that affect general susceptibility to becoming ill from those that initiate or maintain particular disease states.
Journal of Epidemiology and Community Health, 2015
Health researchers and practitioners increasingly recognise the important role communities play i... more Health researchers and practitioners increasingly recognise the important role communities play in shaping individual health. Health researchers recognise the role of community factors as causes or determinants of health problems; use community-based methods for understanding complex health issues; and design community-level health solutions. In this commentary, we propose a fourth way to think about the role of communities in individual health by arguing that the community engagement process itself has implications for individual health and strong communities. This topic is especially important during adolescence, a developmental window of opportunity during which individuals need meaningful opportunities to contribute to the world around them.
... Other Titles: Pathways to health: the role of social factors. Authors: Haan, MN Kaplan, GA Sy... more ... Other Titles: Pathways to health: the role of social factors. Authors: Haan, MN Kaplan, GA Syme, S. Leonard. Issue Date: 1989. Publisher: Hentry J Kaiser Family Foundation. ... Consult the document(s) and/or contact the copyright holder for additional rights questions and requests.
ORIGINAL RESEARCH Suggested citation for this article: Krause N, Brand RJ, Kauhanen J, Kaplan GA,... more ORIGINAL RESEARCH Suggested citation for this article: Krause N, Brand RJ, Kauhanen J, Kaplan GA, Syme SL, Wong CC, et al. Work time and 11-year progression of carotid atherosclerosis in middle-aged Finnish men. Prev Chronic Dis 2009;6(1).
ORIGINAL RESEARCH Suggested citation for this article: Krause N, Brand RJ, Kauhanen J, Kaplan GA,... more ORIGINAL RESEARCH Suggested citation for this article: Krause N, Brand RJ, Kauhanen J, Kaplan GA, Syme SL, Wong CC, et al. Work time and 11-year progression of carotid atherosclerosis in middle-aged Finnish men. Prev Chronic Dis 2009;6(1).
Studies of the relationship between work time and health have been inconclusive. Consequently, we... more Studies of the relationship between work time and health have been inconclusive. Consequently, we sought to examine the effect of work time on progression of atherosclerosis. This prospective study of 621 middle-aged Finnish men evaluated effects of baseline and repeat measures of work time on 11-year progression of ultrasonographically assessed carotid intima-media thickness (IMT) and interactions with cardiovascular disease. Multiple linear regression models adjusted for 21 biological, behavioral, and psychosocial risk factors Working 3 (minimum), 5 (medium), or 7 (maximum) days per week at baseline was associated with 23%, 31%, and 40% 11-year increases in IMT, respectively. The relative change ratio (RCR) at maximum vs minimum was 1.14 for baseline days worked per week and 1.10 for hours worked per year of follow-up. Significant interactions existed between cardiovascular disease and work time. Men with ischemic heart disease (IHD) who worked the maximum of 14.5 hours per day ex...
... This latter group was unaffected by either supple mental intervention and can be thought of a... more ... This latter group was unaffected by either supple mental intervention and can be thought of as hard core', while the former group can be thought of as assignment error'. ... Am J Public Health 1979; 69(1): 25. ... Milbank Mem Fund Q 1976; 54(3): 367. 7 Brown E, Bloom JR. ...
Background: Implementation of screening guidelines for domestic violence has been challenging. Th... more Background: Implementation of screening guidelines for domestic violence has been challenging. The multifaceted "systems model" may provide an effective means to improve domestic violence screening, identification, and intervention in the healthcare setting.
The science of team science encompasses an amalgam of conceptual and methodologic strategies aime... more The science of team science encompasses an amalgam of conceptual and methodologic strategies aimed at understanding and enhancing the outcomes of large-scale collaborative research and training programs. This field has emerged rapidly in recent years, largely in response to growing concerns about the cost effectiveness of public-and private-sector investments in team-based science and training initiatives. The distinctive boundaries and substantive concerns of this field, however, have remained difficult to discern. An important challenge for the field is to characterize the science of team science more clearly in terms of its major theoretical, methodologic, and translational concerns. The articles in this supplement address this challenge, especially in the context of designing, implement ing, and evaluating cross-disciplinary research initiatives. This introductory article summa rizes the major goals and organizing themes of the supplement, draws links between the constituent articles, and identifies new areas of study within the science of team science. (Am J Prev Med 2008;35(2S):S77-S89)
Marmot. MG (School of Public Health. U. of California, Berkeley. CA 94720). SL Syme, A. Kagan, H.... more Marmot. MG (School of Public Health. U. of California, Berkeley. CA 94720). SL Syme, A. Kagan, H. Kato. JB Cohen and J. Belsky. Epi- demiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: Prevalence of coronary ...
The link between blood pressure measured at juvenile ages (3-18 years) and subsequent adult ages ... more The link between blood pressure measured at juvenile ages (3-18 years) and subsequent adult ages (30 and 50 years) was investigated in a community-based longitudinal study conducted in the San Francisco Bay Area from 1928 to the present. The original sample of 550 persons decreased 61 percent by age 50 years, leaving only 211 persons in the cohort. Blood pressure was measured annually up to age 18 years and each decade thereafter, providing a unique opportunity to link childhood and adult blood pressures over periods of up to 50 years. Juvenile blood pressure measured from age 6 years onward was a positive predictor of blood pressure at age 30 years. Blood pressure measured at age 50 years was predicted best by juvenile pressures measured at early school age and early puberty. The juvenile-adult blood pressure association was partly explained by controlling for smoking and parental history of cardiovascular disease, but was not explained by controlling for juvenile height or body mass. It was stronger in children from blue collar families. The reported correlations probably represent an underestimation of the true strength of the association because of a greater loss to follow-up among subjects with higher blood pressure and the effects of antihypertensive medication in adulthood.
Social class gradients have been explored in adults and children, but not extensively during adol... more Social class gradients have been explored in adults and children, but not extensively during adolescence. The first objective of this study was to examine the association between adolescent risk behaviors and a new indicator of adolescent relative social position, adolescent "perceived social mobility." Second, it investigated potential underlying demographic, socioeconomic, and psychosocial determinants of this indicator. Data were taken from the 2004 urban adolescent module of Oportunidades, a cross-sectional study of Mexican adolescents living in poverty. Perceived social mobility was calculated for each subject by taking the difference between their rankings on two 10-rung ladder scales that measured (1) projected future social status and (2) current subjective social status within Mexican society. Adolescents with higher perceived social mobility were significantly less likely to report alcohol consumption, drinking with repercussions, compensated sex, police detainment, physical fighting, consumption of junk food or soda, or watching ≥4 h of television during the last viewing. They were significantly more likely to report exercising during the past week and using a condom during last sexual intercourse. These associations remained significant with the inclusion of covariates, including parental education and household expenditures. Multiple logistic regression analyses show higher perceived social mobility to be associated with staying in school longer and having higher perceived control. The present study provides evidence for the usefulness of perceived social mobility as an indicator for understanding the social gradient in health during adolescence. This research suggests the possibility of implementing policies and interventions that provide adolescents with real reasons to be hopeful about their trajectories.
Background: Social isolation has been linked to mortality across a range of middle-aged and older... more Background: Social isolation has been linked to mortality across a range of middle-aged and older populations, although it has not been compared with other clinical risk factors in a national sample. Methods: Data came 12,403 adults from the National Health and Nutrition Examination Survey III and the National Death Index. The outcome was mortality after eight years. Predictor variables included individual social isolation factors and a composite score. Clinical predictors used for comparison included smoking, BMI, high blood pressure, and hypercholesterolemia. Logistic regressions and recursive partitioning - which classifies populations into low- and high- risk groups by choosing the best predictor variables were used to rank the importance of these predictors. Models were nationally weighted. Results: Male mortality was significantly predicted by current smoking (OR 1.81, CI 1.31-2.51), high blood pressure (OR 1.40, CI 1.06-1.85), and, most strongly, by social isolation (OR 2.25,...
Social capital has been shown to be associated with reduced mortality due to cardiovascular disea... more Social capital has been shown to be associated with reduced mortality due to cardiovascular disease. Our aim was to determine the association of time-varying community-level social capital (CSC) with recurrence of acute coronary syndrome using a retrospective cohort study design. A total of 34,752 men and women were identified, aged 30e85 years, who were hospitalized for acute coronary syndrome between January 1, 1998 and December 31, 2002 in Kaiser Permanente Northern California, USA, an integrated health care delivery system. The primary outcome was recurrent non-fatal or fatal acute coronary syndrome; median follow-up was 19 months. We estimated random-effects, three-level Cox proportional hazard models adjusting for sex, age, race/ethnicity, comorbidities, medication use, and revascularization procedures at level 1, median household income for the census block-group at level 2, and income inequality, racial/ethnic concentration, penetration of health maintenance organizations, and CSC at level 3. Our measure of CSC was the previously validated Petris Social Capital Index (PSCI). We found that a one-standard deviation increase in the PSCI, after adjusting for the above covariates, was significantly associated with decreased recurrence of acute coronary syndrome only for those living in areas where block-group level median household income was below the grand median compared to those living in areas where block-group level median household income was at the grand median or above. These results suggest that community-level social capital may be negatively associated with recurrence of acute coronary syndrome among lower-income individuals.
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