For richer, for poorer, in sickness and in health: socioeconomic status and health among married couples.
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Biomedical subjects
D S Shinberg
Publications and source records attributed to D S Shinberg.
Socioeconomic status differences in hormone therapy.
Socioeconomic status (SES) is a significant sociodemographic correlate of noncontraceptive hormone therapy, yet multiple dimensions of SES have not been examined systematically in previous studies of hormone therapy. This study examined the lifetime incidence of noncontraceptive hormone therapy, how usage varied by type of reproductive organ surgery, and the bivariate and net associations between a large array of SES indicators and the likelihood of ever using hormones by age 53-54 years in a population sample (n = 3,612) of non-Hispanic white female participants in the Wisconsin Longitudinal Study (1957-1993). Approximately half of the women had ever used noncontraceptive hormones; 38.5% were current users. In multivariate logistic regression analyses, the most robust SES predictor of hormone therapy was a woman's husband's occupational status (higher status associated with higher rates of use), after adjustment for all other measured sociologic and biomedical factors (e.g., other SES measures, other health behaviors, menopausal symptoms, age at menopause, health insurance). The association of hormone therapy with education differed between women who underwent hysterectomy and/or oophorectomy (higher odds for less educated women) and those with intact reproductive organs (lower odds for less educated women). Additionally, a woman's own earnings and household net worth were positive net correlates of noncontraceptive hormone therapy.
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An event history analysis of age at last menstrual period: correlates of natural and surgical menopause among midlife Wisconsin women.
Population aging coupled with heightened consumerism among those using the health care system have increased public and research interest in menopause. Despite these trends, we know little about the process of menstrual cessation. This paper reviews previous claims regarding secular trends in menopausal age by considering how menstrual cessations differ by type: (1) that due to surgical intervention such as hysterectomy, and (2) that due to "natural" (non-surgical) menopause. Analyses of menopause that exclude hysterectomized women are flawed, because such women constitute a high proportion of American women at midlife. Competing risk survival analysis techniques are applied to model the shape of the underlying hazards for reproductive organ surgery versus "natural" menopause among 3506 midlife women from the Wisconsin Longitudinal Study. Weibull models are used to evaluate effects of a variety of possible correlates (including education, mental ability, occupation, family background, fertility experience, smoking behavior and hormone therapy). While socioeconomic parameters do contribute to observed differences in age at menstrual cessation, these factors operate through more proximate health-related behaviors (such as smoking in the case of natural menopause and fertility for surgical menopause).
Educational Status↗
Socioeconomic differences in hysterectomy: the Wisconsin Longitudinal Study.
OBJECTIVES: This study evaluated the relative gross and net predictive value of multiple socioeconomic status indicators for the likelihood of undergoing hysterectomy. METHODS: Data from a sample of Wisconsin Longitudinal Study women respondents (n = 3326) followed for 35 years were analyzed by means of multivariate logistic regression. RESULTS: Women's own higher occupational status and greater family net worth were significant net predictors of a lower likelihood of hysterectomy. Women's own education was a significant bivariate predictor. Mental ability did not account for the education effect. CONCLUSIONS: Higher education's association with a lower rate of hysterectomy is not due to ability, but to the opportunities that more-educated women have for higher-status employment and its health-related benefits. Measures of women's own occupational status should be included in future health surveys.
Educational Status↗