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Archana Singh-Manoux

Publications and source records attributed to Archana Singh-Manoux.

16 recordsLinked to original sources
PubMed2006

What does self rated health measure? Results from the British Whitehall II and French Gazel cohort studies.

OBJECTIVES: To investigate the determinants of self rated health (SRH) in men and women in the British Whitehall II study and the French Gazel cohort study. METHODS: The cross sectional analyses reported in this paper use data from wave 1 of the Whitehall II study (1985-88) and wave 2 of the Gazel study (1990). Determinants were either self reported or obtained through medical screening and employer's records. The Whitehall II study is based on 20 civil service departments located in London. The Gazel study is based on employees of France's national gas and electricity company (EDF-GDF). SRH data were available on 6889 men and 3403 women in Whitehall II and 13 008 men and 4688 women in Gazel. RESULTS: Correlation analysis was used to identify determinants of SRH from 35 measures in Whitehall II and 33 in Gazel. Stepwise multiple regressions identified five determinants (symptom score, sickness absence, longstanding illness, minor psychiatric morbidity, number of recurring health problems) in Whitehall II, explaining 34.7% of the variance in SRH. In Gazel, four measures (physical tiredness, number of health problems in the past year, physical mobility, number of prescription drugs used) explained 41.4% of the variance in SRH. CONCLUSION: Measures of mental and physical health status contribute most to the SRH construct. The part played by age, early life factors, family history, sociodemographic variables, psychosocial factors, and health behaviours in these two occupational cohorts is modest.

Adult↗
PubMed2006

The relationship between parenting dimensions and adult achievement: evidence from the Whitehall II Study.

This article examines the association between three dimensions of perceived parenting--warmth, strictness, and expectation--and adult cognitive and socioeconomic achievement outcomes. Structural equation models (N = 7,035) were used to examine simultaneously the influence of parenting on adult achievement while controlling for the influence of parental socioeconomic circumstances. Very low and very high level of parental warmth was associated with poor adult achievement. Strictness had a negative and parental expectation a positive relationship with adult achievement. These associations were independent of parental socioeconomic circumstances. Own education was found to mediate 27-56% of the relationship between parenting dimensions and adult achievement. Parental expectation was most strongly related to adult achievement. We conclude that parenting plays a significant role in the development of adult achievement: both cognitive ability and socioeconomic achievement. Moderate levels of warmth, low levels of strictness, and high parental expectation are associated with high adult achievement.

Achievement↗
PubMed2005

The role of cognitive ability (intelligence) in explaining the association between socioeconomic position and health: evidence from the Whitehall II prospective cohort study.

Associations among cognitive ability, socioeconomic position, and health have been interpreted to imply that cognitive ability could explain social inequalities in health. The authors test this hypothesis by examining three questions: Is cognitive ability related to health? To what extent does it explain social inequalities in health? Do measures of socioeconomic position and cognitive ability have independent associations with health? Relative indices of inequality were used to estimate associations, using data from the Whitehall II study (baseline, 1985-1988), a British prospective cohort study (4,158 men and 1,680 women). Cognitive ability was significantly related to coronary heart disease, physical functioning, and self-rated health in both sexes and additionally to mental functioning in men. It explained some of the relation between socioeconomic position and health: 17% for coronary heart disease, 33% for physical functioning, 12% for mental functioning, and 39% for self-rated health. In analysis simultaneously adjusted for all measures of socioeconomic position, cognitive ability retained an independent association only with physical functioning in women. These results suggest that, although cognitive ability is related to health, it does not explain social inequalities in health.

Adult↗
PubMed2005

Socioeconomic position across the lifecourse: how does it relate to cognitive function in mid-life?

PURPOSE: To examine the association between socioeconomic position (SEP) over the lifecourse and cognitive function in middle age. Two alternative models were assessed: the "direct effects model" where temporally distinct measures of SEP have only direct effects on adult cognition, and the "indirect effects" model where the effect of early life SEP are mediated through later life measures of SEP. METHODS: Data are from the Whitehall II study (N=10,308 at baseline), a longitudinal cohort study of British civil servants, aged between 46 and 68 years at the time of cognitive testing. Structural equation models were used to compare the fit of direct and indirect effects models, and quantify the effects of different measures of SEP on cognition. Childhood SEP, education, and adult SEP were used to model SEP across the lifecourse. Cognitive function was assessed as a latent construct composed of the following: verbal memory, AH 4-I, Mill Hill, phonemic and semantic fluency. RESULTS: The indirect effects model provided a better fit to the data. Childhood SEP had no direct effect on cognitive function but had a substantial "indirect effect," mediated through education and adult SEP. 78.4% of the effect of education in men and 100% in women was indirect. CONCLUSIONS: Socioeconomic differences in adult cognition are a result of the socioeconomic trajectory of individuals throughout their lifecourse. Early measures of SEP influence cognition indirectly, through their influence on later measures of SEP.

Adult↗
PubMed2005

High blood pressure was associated with cognitive function in middle-age in the Whitehall II study.

BACKGROUND AND OBJECTIVES: Research shows elevated levels of blood pressure in midlife to be linked to impaired cognitive performance in old age. However, it remains unclear if this association extends to younger age groups. The objective of this study was to examine the association between hypertension and a range of cognitive abilities in middle aged men and women. METHODS: Data are from the Whitehall II study. Measures of blood pressure were obtained at baseline (1985-1988) and two subsequent phases of data collection (1991-1994 and 1997-1999). Cognitive function (memory test, AH 4-I, Mill-Hill, phonemic and semantic fluency) was assessed (1997-1999) when participants (N = 5,838) were aged 46-68 years old. RESULTS: Results show a small inverse association between both diastolic and systolic blood pressure and cognitive performance, independent of age, education, employment grade, smoking status, alcohol consumption, use of antihypertensive medication, diagnoses of diabetes, and cardiovascular disease. Similar associations were seen with prospective and cross-sectional analyses. The effect of hypertension was stronger in women, and stronger for cognitive measures assessing executive function. CONCLUSION: Expanding on previous studies on older participants, the present study reports a small, but significant association between hypertension and poor cognitive performance in middle-aged men and women.

Adult↗
PubMed2005

Optimism and pessimism as predictors of change in health after death or onset of severe illness in family.

The authors prospectively examined changes in health after a major life event (death or onset of severe illness in family) among 5,007 employees (mean age=44.8 years) whose optimism and pessimism levels were assessed in 1997 and major life events in 2000. Health was indicated by sickness absence days during a period covering 36 months prior to the event and 18 months after the event. Increase in sick days after the event was smaller and returned to the prevent level more quickly among highly optimistic individuals than among their counterparts with low optimism. Parallel changes were not observed in relation to pessimism. These findings suggest that optimism may reduce the risk of health problems and may be related to a faster recovery after a major life event.

Acute Disease↗
PubMed2005

Effects of physical activity on cognitive functioning in middle age: evidence from the Whitehall II prospective cohort study.

OBJECTIVES: We examined the association between physical activity and cognitive functioning in middle age. METHODS: Data were derived from a prospective occupational cohort study of 10308 civil servants aged 35-55 years at baseline (phase 1; 1985-1988). Physical activity level, categorized as low, medium, or high, was assessed at phases 1, 3 (1991-1994), and 5 (1997-1999). Cognitive functioning was tested at phase 5, when respondents were 46-68 years old. RESULTS: In both prospective (odds ratio [OR] = 1.65; 95% confidence interval [CI]=1.30, 2.10) and cross-sectional (OR=1.79; 95% CI=1.38, 2.32) analyses, low levels of physical activity were a risk factor for poor performance on a measure of fluid intelligence. Analyses aimed at assessing cumulative effects (summary of physical activity levels at the 3 time points) showed a graded linear relationship with fluid intelligence, with persistently low levels of physical activity being particularly harmful (OR=2.21; 95% CI=1.37, 3.57). CONCLUSIONS: Low levels of physical activity are a risk factor for cognitive functioning in middle age, fluid intelligence in particular.

Adult↗
PubMed2004

Role of socialization in explaining social inequalities in health.

This paper argues that social selection, materialist/structural and cultural/behavioural explanations for social inequalities in health are related to each other through the mechanism of socialization, seen here as a process through which societies shape patterns of behaviour and being that then affect health. Socialization involves the inter- and intragenerational transfer of attitudes, beliefs and behaviours. Parallels between socialization theory and Bourdieu's concept of habitus are also drawn, and the implications for social epidemiology are discussed. Four key areas that would benefit from research within the socialization framework are identified: health behaviours, psychological vulnerability, social skills and future time perspective.

Health Status↗
PubMed2004

Alcohol consumption and cognitive function in the Whitehall II Study.

The authors investigated the relation between alcohol consumption and cognitive function in a United Kingdom cohort study (4,272 men, 1,761 women) with median follow-up of 11 years. Measures of alcohol consumption were obtained at baseline (1985-1988) and four subsequent phases of data collection. Cognitive function (memory test, AH4, Mill-Hill, phonemic and semantic fluency) was assessed at phase 5 (1997-1999), when participants were aged 46-68 years. Of people who reported drinking alcohol in the past year, those who consumed at least one drink in the past week, compared with those who did not, were significantly less likely to have poor cognitive function. The beneficial effect extended to those drinking more than 240 g per week (approximately 30 drinks). The effect was stronger for women than men and was not confined to those with evidence of vascular disease. Similar associations were found in cross-sectional and longitudinal analyses. The relations were not explained by confounding by smoking and by physical and mental health and, to a large extent, were not mediated by cholesterol or blood pressure. However, the relations were weakened when social position was added to the model. The authors concluded that for middle-aged subjects, increasing levels of alcohol consumption were associated with better function regarding some aspects of cognition. Nonetheless, it is not proposed that these findings be used to encourage increased alcohol consumption.

Adult↗
PubMed2004

Socioeconomic trajectories across the life course and health outcomes in midlife: evidence for the accumulation hypothesis?

BACKGROUND: Recent research in social epidemiology has established the importance of considering the accumulation of advantage and disadvantage across the life course when examining adult health outcomes. This paper examines (1) accumulation across trichotomous categories of socioeconomic position (SEP), and (2) accumulation in analysis stratified by adult SEP. METHODS: Data are from the Whitehall II study. Each participant was categorized as having high (0), intermediate (1), or low (2) SEP at three time points in the life course, leading to 27 socioeconomic trajectories. These trajectories were summarized to yield a scale ranging from 0 (high SEP at all three time points) to 6 (low SEP at all three time points). Logistic regression was used to examine odds of incident coronary heart disease (CHD), poor mental and physical functioning, and minor psychiatric disorder. RESULTS: There was a graded linear relationship between accumulation of socioeconomic exposure and health. Men with a score of 6 had increased odds of CHD (2.53, 95% CI: 1.3, 5.1), poor physical functioning (2.19, 95% CI: 1.4, 4.1), and poor mental functioning (2.60, 95% CI: 1.4, 4.9) compared with men with a score of 0. In women there was an accumulation effect for CHD and physical functioning. No cumulative effect of SEP on minor psychiatric disorder was observed. The effects of accumulation were weaker in analyses stratified by adult SEP, with early deprivation followed by high adult SEP particularly detrimental for CHD. CONCLUSIONS: The health effects of socioeconomic disadvantage accumulate over the life course. In addition to accumulation effects, analysis stratified by adult SEP also provided support for the critical period and the pathway model.

Adult↗
PubMed2004

The effect of control at home on CHD events in the Whitehall II study: Gender differences in psychosocial domestic pathways to social inequalities in CHD.

Although there has been considerable research on psychosocial working conditions and their effect on physical and mental health, there has been little research into the effects of psychosocial domestic conditions on health. The association between psychosocial working conditions (and control at work in particular) and coronary heart disease (CHD) is not as strong for women compared to men. Other research suggests that household and domestic factors may have an important effect on women's health. Some studies have shown that low control at home affects psychological well being. However, there has been little research into its effects on physical health. Furthermore, similar to results analysing low control at work, low control at home may form part of the pathways underlying social inequalities in health. The study investigates the meaning of control at home, the effect of control at home on incident CHD events and whether this explains some of the social inequalities in CHD events in men and women. Data from phases 3-5 of the Whitehall II study, London, UK, were analysed (N = 7470). The results indicate that low control at home predicts CHD among women but not among men. Furthermore, low control at home may explain part of the association between household social position and CHD among women. There is some evidence suggesting that low control at home among women results from a lack of material and psychological resources to cope with excessive household and family demands. Psychosocial domestic conditions may have a greater effect on the health of women compared with men.

Adult↗
PubMed2003

Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study.

The purpose of this study was twofold-(1) investigate the role of subjective social status as a predictor of ill-health, with a further exploration of the extent to which this relationship could be accounted for by conventional measures of socioeconomic position; (2) examine the determinants of a relatively new measure of subjective social status used in this study. A 10 rung self-anchoring scale was used to measure subjective social status in the Whitehall II study, a prospective cohort study of London-based civil service employees. Results indicate that subjective status is a strong predictor of ill-health, and that education, occupation and income do not explain this relationship fully for all the health measures examined. The results provide further support for the multidimensional nature of both social inequality and health. Multiple regression shows subjective status to be determined by occupational position, education, household income, satisfaction with standard of living, and feeling of financial security regarding the future. The results suggest that subjective social status reflects the cognitive averaging of standard markers of socioeconomic situation and is free of psychological biases.

Adult↗
PubMed2003

Vascular disease and cognitive function: evidence from the Whitehall II Study.

OBJECTIVES: : To test the hypothesis of an inverse association between indicators of vascular disease and cognitive function in the general, stroke-free population. DESIGN: : A longitudinal, British civil service-based cohort study. Measures of vascular disease examined were prevalent at baseline or traced over a median of 11 years, between Phases 1 (1985-1988) and 5 (1997-1999) of data collection. Cognitive function was assessed at Phase 5 of data collection. SETTING: : Twenty London-based Civil Service departments. PARTICIPANTS: : Four thousand one hundred forty-one men and 1,681 women, aged 46 to 68 when tested for cognitive function. MEASUREMENTS: : A battery of cognitive tests consisting of: memory test, Alice Heim 4, Mill-Hill, phonemic, and semantic fluency. RESULTS: : The occurrence of angina pectoris (P<.001), myocardial infarction (P=.02), all coronary heart disease (P<.001), and intermittent claudication (P=.004) was associated with poor cognitive function. These effects were independent of age and socioeconomic status. The association between indicators of vascular disease and cognitive function applied to the entire range of cognitive function measures examined in the study. CONCLUSION: : The findings support the view that vascular disease is predictive of poor cognitive function in the general population. The fact that presence of vascular disease was associated with diminished cognitive function even in a relatively young cohort has implications for the management of vascular disease.

Adult↗
PubMed2002

Multiple measures of socio-economic position and psychosocial health: proximal and distal measures.

BACKGROUND: The aim of this paper is to compare three models for exploring the links between different measures of adult socioeconomic position (SEP)-education, occupation, income-and psychosocial health. Model I is a basic univariate regression model with psychosocial health as the outcome and a measure of SEP as the predictor. Model II is a multiple regression model with psychosocial health as the outcome with all three measures of SEP allocated the same temporal position as predictors. Model III treats education, a distal measure of SEP, as antecedent to the proximal measures of SEP in the prediction equations linking SEP to health. METHODS: Participants were drawn from the Whitehall II study, a prospective cohort study of British civil servants. Data analysed here are from Phase 5 (1997-1999) of data collection, 7830 individuals in all. The measures of SEP and psychosocial health were assessed via a self-administered questionnaire. RESULTS: The three models can lead to completely different conclusions. Model III, our preferred model, shows education to have a stronger indirect effect on psychosocial health when compared to its direct effect. The indirect effect is due to the effect of education on proximal measures of social position, occupation, and income in this case. CONCLUSIONS: Results reported here support the hypothesis that a comparison of the relative importance of the different measures of social position in predicting health is meaningless if the causal relationships among these measures are not accounted for.

Adult↗
PubMedDate not supplied

Does subjective social status predict health and change in health status better than objective status?

OBJECTIVE: To examine, among middle-aged individuals, if subjective socioeconomic status (SES) predicts health status and change in health status over time better than objective SES. METHODS: Data are from the Whitehall II study, a prospective study of British civil servants. SES data are drawn from Phase 5 (1997-1999) of the study and health data from Phases 5 and 6 (2000-2001). Physical and mental component scores from the Short Form 36, the General Health Questionnaire, and self-rated health were used to assess health status. Multiple linear regressions were used to examine the relationship between SES and health and change in health status. RESULTS: Complete data were available on 5486 people. Results show both measures of SES to be global measures of SES. Both measures of SES were significantly associated with health outcomes and with decline in health status over time. However, when both objective and subjective measures of SES are entered simultaneously in the model to predict change in health status, it was only the latter that continues to be significantly associated with health and changes in health. CONCLUSIONS: Subjective SES is a better predictor of health status and decline in health status over time in middle-aged adults. These results are discussed in terms of three possible explanations: subjective SES is a more precise measure of social position, the results provide support for the hierarchy-health hypothesis, and the results could be an artifact of common method variance.

Adult↗