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PubMed2001

Self-report quality of life as a predictor of hospitalization for patients with LV dysfunction: a life course approach.

For this secondary data analysis of a large clinical drug study, researchers investigated the independent prognostic utility of self-report quality-of-life measures versus clinical measures for assessing patient risk for heart-failure-related hospitalization. The experience of heart failure varies over the life course; hence, four age groups were investigated. Quality-of-life measures, specifically health-related quality-of-life and psychosocial quality-of-life measures, were found to be independent and significant predictors of heart-failure-related hospitalizations, as compared to traditional clinical indicators. In addition, the psychosocial quality-of-life measure varied by age group in its importance as a predictor of hospitalization, suggesting differential relevance over the life course. Specifically, psychosocial quality of life was most strongly predictive of hospitalization for those ages 21-44, was less predictive for those ages 45-54, and was nonsignificant for those 55-64 years of age and those 65 and over. Including self-report quality-of-life measures provides a more complete picture of the factors associated with risk of hospitalization at different points in the life course for individuals with heart failure. These findings suggest that researchers and practitioners could use self-report quality-of-life measures as additional prognostic indicators of a patient's condition and risk for heart-failure-related hospitalization, especially for younger patients.

Activities of Daily Living↗

PubMed2005

Marital life course events and smoking behaviour in Sweden 1980-2000.

The protective effect of marriage on smoking has been extensively established in the literature. However, less is known about the dynamics of how smoking behaviour is connected to various marital life course events, and whether there are any gender discrepancies in this respect. In this article the connection between the marital life course and smoking is analysed from a stress-related perspective controlling for other socio-economic characteristics. We use information on 81,000 individuals from the Swedish longitudinal micro-level ULF (Survey of Living Conditions) database 1980-2000, which is randomly drawn from the sample population of all Swedes aged 16-84. Logistic regressions on current smoking status and changes in smoking behaviour of participants in the panel part of the data are estimated. The marital life course is strongly linked to smoking behaviour with being or getting married indicating low smoking risks and marital disruption indicating high risks. The divorced smoke to a higher extent than the widowed and there are signs that getting divorced implies higher risks than becoming widowed, both of taking up/relapsing and, for women, not being able to quit. Further, the results indicate that the connection between smoking cessation and living with a partner is stronger for men, whereas women are more affected by the propensity to start smoking after marital disruption. The protective effect of being married on smoking decreases with the age difference between spouses in households where the wife is older than the husband. Taken together, the results yield a rather complex pattern of smoking behaviour over the marital life course. Further, perceived financial stress is strongly connected to smoking and not being able to quit. Controlling for this effect still leaves a socio-economic status gradient in smoking.

Adolescent↗

PubMed2005

Marital coitus across the life course.

It remains unclear whether the frequency of marital coitus does in fact decline universally across the life course, what shape that decay normally takes, and what best accounts for it: increasing marriage duration, women's age or age of their partners. Using cross-sectional Demographic and Health Survey (DHS) data of 91,744 non-abstaining women in their first marriage, a generalized linear model is used to determine if there is a consistent pattern in the life course pattern of degradation in the frequency of marital coitus. Datasets were drawn from nineteen countries in Asia, Africa and the Americas. Use of very large samples allows proper disentangling of the effects of women's age, husband's age and marital duration, and use of samples from multiple countries allows consideration of the influence of varied prevailing fertility regimes and fertility-related practices on life course trajectories. It is found that declining coital frequency over time seems a shared demographic feature of human populations, but whether marriage duration, wife's age or husband's age is most responsible for that decline varies by country. In many cases, coital frequency actually increases with women's age into their thirties, once husband's age and marriage duration are taken into account, but in most cases coital frequency declines with husband's age and marital duration.

Adult↗

PubMed2002

Life-course perspective on socioeconomic differences in carotid atherosclerosis.

OBJECTIVE: Socioeconomic status (SES) in adulthood is known to be related to carotid atherosclerosis. However, few studies have tried to assess its association with SES from a life-course perspective. METHODS AND RESULTS: We examined the relationship between SES in childhood and in adulthood and carotid atherosclerosis in a general population of Swedish men and women. Carotid stenosis was determined by B-mode ultrasound. Results showed that women whose fathers' occupations involved unskilled manual labor had higher odds of carotid stenosis than did women whose fathers' occupations involved high- or medium-level nonmanual labor, even after adjustment for adult occupational status and risk factors (odds ratio 1.8, 95% CI 1.1 to 2.8). No such association appeared in men. Furthermore, the impact of life-course SES on atherosclerosis was examined by using an additive measure of one's combined SES during childhood and adulthood. Among women, the odds of carotid stenosis increased with a rise in exposure to low SES during the life-course (P for trend <0.001). In men, no such trend was found. CONCLUSIONS: The results indicate that the total life-course exposure to low SES, with contributions from childhood and adulthood, seems to play a role in atherogenesis in women. Such a pattern of association could not be shown in men.

Age Factors↗

PubMed1998

Drinking over the life course within gender and ethnic groups: a hyperparametric analysis.

OBJECTIVE: This study examines drinking patterns over the life course among males and females and among three ethnic groups (whites, blacks and Hispanics) in order to compare gender group and ethnic group differences in alcohol use as a continuous function of age. METHOD: Data are from a general population sample of 13,553 respondents aged 12 to 80 interviewed by telephone in 20 urban areas of the United States. Drinking measures include total consumption, drinking participation, drinking frequency and average drinks per occasion. RESULTS: In the total sample over age cohorts, total consumption, participation and average drinks per occasion rose rapidly before age 21, peaked in young adulthood and declined gradually thereafter. Drinking frequency rose rapidly before age 21, but generally showed no decline thereafter. As expected, compared to women, men consumed more total alcohol, were more likely to participate in drinking, drank more often and drank more per occasion. Men did not differ from women in the age at which peak drinking occurred. Relationships of drinking to ethnicity were more complex. Although white total consumption exceeded that of blacks and Hispanics over the entire life course, the other drinking measures involved interactions in which white participation and frequency exceeded that of blacks and Hispanics in later adulthood, but black and Hispanic average drinks per occasion exceeded that of whites in later adulthood. CONCLUSIONS: Differences in drinking patterns over the life course among gender groups and ethnic groups are largely a result of differences in rates of change over age cohorts in alcohol use, both in rates of increase in youth and of decrease thereafter.

Adolescent↗

PubMed2001

The EVA-study: nutrition behaviour in the life course of elderly women.

Which biographical factors are important for shaping present today eating behaviour. Is eating behaviour maintained throughout life, what are likely causes for changes. In a qualitative study on eating and drinking in the life course, 60 women aged 64 to 94 living independently in their homes were interviewed using semi-structured biographical methods focussing on eating and drinking in the life course. Socialisation of eating in childhood was in all participants either conservative/authoritarian or liberal. Following socialisation and life course 4 different "eating types" with common present nutrition behaviour were found. The eating type was changed only in case of marriage if the partner was another eating type, in case of illness or in case of fear of health implications. For improving current dietary practices, health and nutrition professionals should recognize the contribution of biographical factors as well as eating types for present nutrition behaviour.

Aged↗

PubMed1996

The precious and the precocious: understanding cumulative disadvantage and cumulative advantage over the life course.

The explanation of increasing heterogeneity and inequality within aging cohorts is a central concern of the life-course perspective and common ground for demographers, economists, historians, sociologists, and psychologists alike. Income and wealth inequality among the aged is one area of shared interest where cross-disciplinary fertilization is occurring. While indices of aged economic inequality applied across different data sets replicate the level of inequality among the elderly, theoretical and methodological concerns are focused more and more on identifying and specifying the long-term interactions between institutional and life-course processes producing this outcome. Institutional mechanisms incorporated in opportunity structures such as labor markets and pensions stratify the availability of resources and rewards, and they interact with life-course processes related to labor force history and job mobility to produce complex patterns of cumulative advantage and cumulative disadvantage. However, the examination of long-term mechanisms of stratification requires finer-grained observations of work, employer, and pension histories than current data-collection strategies afford. Two biases--the steady worker bias and the one pension bias--are inherent in most longitudinal data bases and hamper progress in our understanding of the production of aged inequality.

Aged↗

PubMed1991

[[Attitudes toward marriage and their effect on expected life course patterns of unmarried Japanese women]].

"The aim of this paper is to study the perspectives unmarried women [in Japan] hold towards marriage, and towards their life course. This paper will also attempt to determine how changing life course perspectives among unmarried women are influencing the trend towards later marrying ages. [Data are from a] sample of 2,605 unmarried women aged 18-34 derived from the 9th National Fertility Survey conducted...in 1987....[The author finds that] while still planning to marry eventually, more women are putting off marriage. In conclusion, the increase in the proportion of unmarried women...is not so much because they have chosen the unmarried life course in order to pursue their careers, but rather merely because they are putting off marriage until later." (SUMMARY IN ENG)

Asia↗

PubMed2003

The life course of severe obesity: does childhood overweight matter?

OBJECTIVES: A life course perspective is used to examine the epidemiology of severe obesity in adulthood, defined as a body mass index > or = 35 kg/m(2). METHODS: Data from adults in the National Health and Nutrition Examination Survey I: Epidemiologic Followup Study, including their reports of childhood overweight, were used to examine the risk of severe obesity and mortality over 20 years (N = 6,767). All multivariate models control for age, sex, race, smoking, and socioeconomic resources. RESULTS: Childhood overweight was significantly associated with severe obesity for both women and men, although the effect was stronger for men. The prevalence of severe obesity was highest between 45 and 64 years of age than for persons under 45 or over 65, and higher for African Americans than White Americans. Childhood overweight was associated with lower mortality risk for women, but not for men. Mortality risk was higher for persons with severe obesity (relative risk = 1.571, 95% confidence interval = 1.335-1.849, p <.001). DISCUSSION: The findings demonstrate the importance of childhood overweight as a risk factor for severe obesity over the life course. Nevertheless, overweight children who did not become severely obese were not at greater risk of mortality.

Adult↗

PubMed2006

Changing conceptions of health and life course concepts.

Health as a social concept is very important in medical sociology. More complicated conceptions of health as a multi-dimensional concept have emphasized not only physical health status, but aspects of overall well-being. This article continues in the tradition of a multi-dimensional concept of health, but adds in the complexity of variation over the life course. As people age, chronic health problems become more common. Mobility and sensory limitations also increase. How does this impact how people view their health? How do more complicated understandings of the life course and variation by social factors link to an expanded model of health. This literature review article covers material on concepts of health and life course concepts. The concluding portions of the article focus on the need to improve measurement, to incorporate diversity related to social factors such as gender and race, and to incorporate a broader understanding of health problems into conceptions of health across the life course.

Aging↗

PubMed1992

[[Demographic life courses of women in Japan: a reappraisal]].

The author examines the life courses of cohorts of Japanese women born from 1890 to 1940, and makes projections for those born in 1950 and later. "In [the] past hundred years, demographic changes in women's life courses in Japan were mainly characterized by rapid fall of mortality and fertility...[and] cohort by cohort, age at marriage of women in Japan has gradually been rising....[The author] suggests the intense needs for policies of social and economic welfare for family of mother and children and policies for equal wage between working men and women in contemporary Japan." (SUMMARY IN ENG)

Asia↗

PubMed1998

Gender, employment, and retirement quality: a life course approach to the differential experiences of men and women.

Using a life course perspective in integrating 2 theories of retirement satisfaction--role theory and continuity theory--this study draws on a sample of retired men (n = 244) and women (n = 214), ages 50-72, to investigate factors contributing to the quality of their retirement experience. Overall, we find that men report greater retirement satisfaction than women, although the difference is small. For women, increased retirement quality is associated with good health, a continuous career (fewer years spent in part-time employment), an early retirement (though not earlier than anticipated), and a good postretirement income. For men, the key correlates with retirement quality are good health, an enjoyable preretirement job, low work-role salience, substantial preretirement planning, and retiring for internally motivated reasons (e.g., to do other things). These results underscore the importance of a life course focus on gendered pathways to and through life transitions such as retirement.

Adaptation, Psychological↗

PubMed2003

Intergenerational relationships in young adulthood and their life course, mental health, and personality correlates.

To evaluate effects of life-course events and experiences of young adults, as well as personality and mental-health history on intergenerational relationships in young adulthood, the authors examined dyadic relationship data drawn from a sample of more than 900 New Zealand 26-year-olds and their mothers and fathers. Results indicated that intergenerational relations were more positive when young adults were childless, not unemployed, married, and living away from home, but these factors did not interact with family relationship history in predicting relationship outcomes. Intergenerational relationships were less positive when children scored low on positive emotionality and constraint and high on negative emotionality and mental disorders, though these attributes did not account for the effect of life-course factors. Results are discussed in terms of the openness of the parent-child relationship in adulthood to further development.

Adolescent↗

PubMed2006

Financial strain over the life course and health among older adults.

This paper focuses on financial strain across the life course as a condition underlying health inequalities observed in later life. The analysis is based on data from 1167 adults 65 years and older collected as part of the 'Aging, Stress and Health Study". Relying on retrospective data about hardship experienced over the life course, we find that long-term financial hardship is reflected in a range of health outcomes at late life, even after controlling for the effects of current financial circumstances. Moreover, the sheer persistence of hardship matters more than its episodic occurrence or timing, so that the health effects of early hardship may be obviated if followed by no further hardship. This pattern offindings is consistent with the notion of allostatic load, the cumulative damage done to health and well-being under the burden of an unrelenting stressor in a critically important life domain.

Aged↗

PubMed1993

Continuity after a stroke: implications of life-course disruption in old age.

Life-course disruption caused by a stroke and subsequent attempts on the part of stoke victims to restore continuity was explored through qualitative research with a sample of 216 persons. This research suggests: 1) that theory in gerontology could be deepened by framing continuity to include discontinuous experience in late life; and 2) that research on what elderly persons themselves make of continuity--how they perpetuate it or recreate it and the obstacles they perceive in doing so--may inform our understanding of the experience of old age and lead to applications in the practice of gerontology that address the disruption illness poses for people's lives.

Activities of Daily Living↗

PubMed2000

Continuity and change in women's weight orientations and lifestyle practices through pregnancy and the postpartum period: the influence of life course trajectories and transitional events.

The life course perspective offers a framework for understanding continuity and change in health and health practices. Body weight, and the diet and physical activity strategies used to manage weight in pregnancy and the postpartum period, are a focus of much study because of an association between parity and body weight. The motherhood transition offers an opportunity to study weight concerns and weight management strategies during a period of weight fluctuation that is part of a life transition for many women. Our aim was to develop an in-depth understanding of women's experiences of pregnancy and postpartum weight changes, the strategies that women used to deal with weight changes, and patterns in their attitudes and strategies across pregnancy and the postpartum period. A longitudinal design, using multiple, in-depth, qualitative interviews with 36 women from pregnancy through the postpartum period, was chosen for data collection. Prepregnancy orientations towards body weight emerged as the primary influence on women's pregnancy and postpartum attitudes towards weight, on patterns of physical activity and diet, and on postpartum weight outcomes among most study participants. Four different trajectories ("relaxed maintenance", "exercise", "determined", and "unhurried"), characterized by differences in women's orientations towards their body weight and their diet and physical activity patterns across pregnancy and the postpartum period, emerged from the data. Only a few women diverged from prepregnancy trajectories in weight orientation and diet and physical activity patterns postpartum. Delayed resumption of prepregnancy physical activity and dietary patterns contributed to postpartum weight retention for a subset of "exercisers". Stress and age- or role-related changes in perspective interrupted the continuity of weight orientations and behavioral patterns for three other women. These findings highlight the direction and momentum provided by trajectories in health attitudes and strategies as processes shaping responses to a life transition.

Adult↗

PubMed2006

Older women and sexuality: experiences in marital relationships across the life course.

Rates of sexual activity have been found to decline over the life course, as individuals experience marital transitions and the loss of partners, health problems, and decreased sexual interest. This article compares and contrasts earlier and later-life sexual experiences and examines the changing meanings that older women ascribe to sexuality over the life course. Qualitative data from a study involving 24 women aged 52 to 90 who were remarried after age 50 illuminate a shift, as individuals age, from an emphasis on the importance of sexual intercourse and passion to a greater valuing of companionship, cuddling, affection, and intimacy. Situating the discussion in the context of changing cultural norms and sexual scripts, the article investigates the impact of health conditions on the women's sexual relationships as well as the women's tendency to have later-life sexual experiences more positive than were their earlier sexual experiences.

Aged↗

PubMed1999

Adolescence-limited versus life-course-persistent criminal behaviour in adolescent psychiatric inpatients.

A nation-wide sample of 1072 Norwegian adolescent psychiatric inpatients were followed up 15-33 (mean 23.8) years after hospitalisation, by record linkage to the National Register of Criminality. Defining criminal behaviour as entry into the criminal registry, 481 patients (45%) had an adolescent criminal debut, entering the registry before the age of 21. Of these, 130 (27%) had no criminal record after the age of 21 and were consequently considered as adolescence-limited criminal offenders, as opposed to the remaining 351 (73%) individuals who continued their criminal behaviour beyond the age of 21 and were considered as life-course-persistent criminal offenders. On the basis of hospital records, all patients were rediagnosed according to DSM-IV and scored on factors hypothesised to have predictive power as to persistence of criminal behaviour. We found that 79.6% of the male, and 58.8% of the female adolescent delinquents went on to life-course-persistent criminality. In females, intravenous use of illegal drugs, and being discharged from the hospital elsewhere than to the family home, were strong and independent predictors of life-course-persistent criminal behaviour. In males, the following were significant and independent predictors of life-course-persistent criminality: a high number of conduct disorder criteria fulfilled, comorbidity of psychoactive substance use disorder, and having attended correctional school.

Adolescent↗