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Objectives: To investigate whether the timing and nature of women's transitions out of full-time (FT) education are related to later-life subjective well-being and the life-course experiences that might explain any associations seen., Methods: Data are from women in Wave 3 of the English Longitudinal Study of Ageing who have participated in the life history interview and were aged 50+ at the interview (n = 3,889). Using multichannel sequence analysis, we identified 6 types of transition out of FT education (ages 14-26). Regression models were used to examine associations between transition types and life satisfaction, quality of life, and depressive symptoms at age 50+., Results: Women who made early transitions to married parenthood and FT domestic labor had lower levels of well-being on all 3 later-life well-being outcomes (p < .01), compared to women who made later transitions to family life and remained employed. Women who remained single up to age 26 also had lower life satisfaction (p < .05) and quality of life (p < .01) in later life than their counterparts who married and had children. These associations were explained by the life-course socioeconomic and relationship pathways. Advantaged childhood socioeconomic circumstances and higher educational qualifications set "Later Marriage and Later employment" women apart onto advantaged trajectories and a better quality of life later (p < .01)., Discussion: The timing and nature of exits from FT education played a pivotal role in setting people onto life-course trajectories that influence well-being in later life for this older generation of women., (© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Explanations for health inequalities include material, behavioural and psychosocial pathways. Social relationships are an important determinant of health, and research has consistently found that a lack of support networks may diminish favourable health outcomes. There is some evidence that social network structures, partly shaped by socioeconomic factors, contribute to health inequalities. This protocol will summarise the systematic review process. Methods and analyses: The Systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic database search of MEDLINE, Embase Classic + Embase and PsychINFO using the OvidSP platform will be undertaken. Databases will be searched from the earliest date of entry until 10 June 2022. Articles that have quantitatively assessed the role of social relationships in mediating or moderating health inequalities will be included and any health outcome (mental/physical) will be considered. The database search will be supplemented by reference list screening of all relevant full-text articles identified through the search. Two independent reviewers will be responsible for screening of articles, data extraction and assessment of bias. Observational studies will be risk assessed for bias using a modified version of the Newcastle-Ottawa Quality Assessment Scale, and intervention studies will be assessed using the revised Cochrane risk-of-bias tool. It is anticipated that the eligible studies will be highly variable; therefore, a meta-analysis will only be considered if the available data of the selected studies are similar. If the studies are too heterogeneous, a narrative synthesis of the extracted data will be presented. Conclusion: The results of the systematic review will examine the link between social relationships and health inequalities. The findings of the review will identify gaps in knowledge where further research is needed. Systematic review registration: PROSPERO CRD42020181706 [ABSTRACT FROM AUTHOR]

Background: Urban greening may reduce loneliness by offering opportunities for solace, social reconnection and supporting processes such as stress relief. We (i) assessed associations between residential green space and cumulative incidence of, and relief from, loneliness over 4 years; and (ii) explored contingencies by age, sex, disability and cohabitation status.Methods: Multilevel logistic regressions of change in loneliness status in 8049 city-dwellers between 2013 (baseline) and 2017 (follow-up) in the Household, Income and Labour Dynamics in Australia study. Associations with objectively measured discrete green-space buffers (e.g. parks) (<400, <800 and <1600 m) were adjusted for age, sex, disability, cohabitation status, children and socio-economic variables. Results were translated into absolute risk reductions in loneliness per 10% increase in urban greening.Results: The absolute risk of loneliness rose from 15.9% to 16.9% over the 4 years; however, a 10% increase in urban greening within 1.6 km was associated with lower cumulative incident loneliness [odds ratio (OR) = 0.927, 95% confidence interval (CI) = 0.862 to 0.996; absolute risk reduction = 0.66%]. Stronger association was observed for people living alone (OR = 0.828, 95% CI = 0.725 to 0.944). In comparison to people with <10% green space, the ORs for cumulative incident loneliness were 0.833 (95% CI = 0.695 to 0.997), 0.790 (95% CI = 0.624 to 1.000) and 0.736 (95% CI = 0.549 to 0.986) for 10-20%, 20-30% and >30% green space, respectively. Compared with the <10% green-space reference group with 13.78% incident loneliness over 4 years and conservatively assuming no impact on incident loneliness, associations translated into absolute risk reductions of 1.70%, 2.26% and 2.72% within populations with 10-20%, 20-30% and >30% green space, respectively. These associations were stronger again for people living alone, with 10-20% (OR = 0.608, 95% CI = 0.448 to 0.826), 20-30% (OR = 0.649, 95% CI = 0.436 to 0.966) and >30% (OR = 0.480, 95% CI = 0.278 to 0.829) green space within 1600 m. No age, sex or disability-related contingencies, associations with green space within 400 or 800 m or relief from loneliness reported at baseline were observed.Conclusions: A lower cumulative incidence of loneliness was observed among people with more green space within 1600 m of home, especially for people living alone. Potential biopsychosocial mechanisms warrant investigation. [ABSTRACT FROM AUTHOR]

Objectives To investigate whether the timing and nature of women's transitions out of full-time (FT) education are related to later-life subjective well-being and the life-course experiences that might explain any associations seen. Methods Data are from women in Wave 3 of the English Longitudinal Study of Ageing who have participated in the life history interview and were aged 50+ at the interview (n = 3,889). Using multichannel sequence analysis, we identified 6 types of transition out of FT education (ages 14–26). Regression models were used to examine associations between transition types and life satisfaction, quality of life, and depressive symptoms at age 50+. Results Women who made early transitions to married parenthood and FT domestic labor had lower levels of well-being on all 3 later-life well-being outcomes (p <.01), compared to women who made later transitions to family life and remained employed. Women who remained single up to age 26 also had lower life satisfaction (p <.05) and quality of life (p <.01) in later life than their counterparts who married and had children. These associations were explained by the life-course socioeconomic and relationship pathways. Advantaged childhood socioeconomic circumstances and higher educational qualifications set "Later Marriage and Later employment" women apart onto advantaged trajectories and a better quality of life later (p <.01). Discussion The timing and nature of exits from FT education played a pivotal role in setting people onto life-course trajectories that influence well-being in later life for this older generation of women. [ABSTRACT FROM AUTHOR]

Background: Approximately seven million people in the UK are engaged in informal caregiving. Informal caregivers are at risk of poorer mental and physical health. However, less is known about how the relationship between the informal caregiving and psychological distress changes over time. The aim of this study was to investigate longitudinal associations between the informal caregiving and psychological distress amongst UK men and women aged 16+. Methods: Data were analysed from the UK Household Longitudinal Study (UKHLS, n = 9368), a nationally representative study of UK households. Longitudinal linear mixed modelling was used to estimate associations between the longitudinal patterns of informal caregiving (non-caregiver/one episode of 1–2 years/intermittent caregiving/3+ years caregiving) and trajectories of psychological distress across seven waves of UKHLS data. Results: Informal caregiving was not associated with psychological distress for men. Women engaged in long-term (⩾3 years) or intermittent caregiving had higher levels of psychological distress at the point of initiation, compared with women who were not caregivers throughout the study period (3+ years caregiver: regression coefficient 0.48, 95% confidence interval (CI) 0.07–0.89; intermittent caregiver: regression coefficient 0.47, 95% CI 0.02–0.92). Trajectories of psychological distress changed little over time, suggesting a plateau effect for these caregiving women. Conclusions: Women engaged in long-term or repeated shorter episodes of informal caregiving reported more symptoms of psychological distress than non-caregiving women. Given the increased risk of reporting psychological distress and the increasing importance of the informal care sector, the risk of poorer mental health of informal caregivers should be a priority for public health. [ABSTRACT FROM AUTHOR]

Objective: The present study investigates whether the reversal of the social gradient in obesity, defined as a cross-over to higher obesity prevalence among groups with lower education level, has occurred among men and women in urban and rural areas of Mexico.Design: Cross-sectional series of nationally representative surveys (1988, 1999, 2006, 2012 and 2016). The association between education and obesity was investigated over the period 1988-2016. Effect modification of the education-obesity association by household wealth was tested.Setting: Mexico.Subjects: Women (n 54 816) and men (n 20 589) aged 20-49 years.Results: In both urban and rural areas, the association between education and obesity in women varied by level of household wealth in the earlier surveys (1988, 1999 and 2006; interaction P<0·001). In urban areas in 1988, one level lower education was associated (prevalence ratio; 95 % CI) with 45 % higher obesity prevalence among the richest women (1·45; 1·24, 1·69), whereas among the poorest the same education difference was protective (0·84; 0·72, 0·99). In the latest surveys (2012, 2016), higher education was protective across all wealth groups. Among men, education level was not associated with obesity in urban areas; there was a direct association in rural areas. Wealth did not modify the association between education and obesity.Conclusion: The reversal of the educational gradient in obesity among women occurred once a threshold level of household wealth was reached. Among men, there was no evidence of a reversal of the gradient. Policies must not lose sight of the populations most vulnerable to the obesogenic environment. [ABSTRACT FROM AUTHOR]

Background There is raised risk of mortality following unemployment, and reviews have consistently found worse psychological health among the unemployed. Inflammation is increasingly implicated as a mediating factor relating stress to physical disease and is strongly linked to depression. Inflammation may, therefore, be implicated in processes associated with excess mortality and morbidity during unemployment. This study examined associations of unemployment with inflammatory markers among working-age men and women from England and Scotland. Methods Cross-sectional analyses using data from the Health Survey for England and the Scottish Health Survey collected between 1998 and 2010. Systemic inflammation was indexed by serum concentrations of C reactive protein (CRP) and fibrinogen, and compared between participants currently employed/self-employed, currently unemployed and other groups. Results CRP, fibrinogen and odds of CRP >3 mg/L were all significantly raised for the unemployed, as compared to the employed participants (eg, OR for CRP >3 mg/L=1.43, CI 1.15 to 1.78 N=23 025), following adjustment for age, gender, occupational social class, housing tenure, smoking, alcohol consumption, body mass index, long-term illness and depressive/anxiety symptoms. Strengths of associations varied considerably by both age and country/region, with effects mainly driven by participants aged ≥48 and participants from Scotland, which had comparatively high unemployment during this time. Conclusions Current unemployment is associated with elevated inflammatory markers using data from two large-scale, nationally representative UK studies. Effect modification by age suggests inflammation may be particularly involved in processes leading to ill-health among the older unemployed. Country/regional effects may suggest the relationship of unemployment with inflammation is strongly influenced by contextual factors, and/or reflect life course accumulation processes. [ABSTRACT FROM AUTHOR]

Objective To investigate whether changes in health, social and economic circumstances predict change in quality of life (QoL) at older ages. Design Secondary analysis, using multiple regression analyses, of waves 1 and 3 of the English Longitudinal Study of Ageing. Setting England, 2002-6. Participants A nationally representative sample of noninstitutionalised adults aged over 50 years living in England with non-missing data for the variables of interest (N=4848). Main Outcome Measure QoL in 2006, with reference to QoL in 2002, both measured using the CASP-19 score. Results Mean QoL decreased over the 4 years, with becoming depressed (β -0.12) and developing difficulties with activities of daily living (β -0.08) contributing to this decrease. Improvements in family relationships (β 0.10), the neighbourhood (β 0.08) and perceived financial position (β 0.07) each counteracted the decline in QoL. Initial QoL strongly predicted QoL at follow-up (β 0.46). Regression models explained 59% of variation in QoL, and there were small differences between age and gender groups. Conclusions The maintenance of good QoL in older aged people is enabled by the avoidance of depression, maintenance of physical function, good neighbourhood standards, family relationships and financial circumstances. [ABSTRACT FROM AUTHOR]

Background: previous studies have suggested a decline in the relationship between socioeconomic circumstances and health or functioning in later life, but this may be due to survival effects. Objective: to examine whether wealth gradients in the incidence of illness decline with age, and, if so, whether this decline is explained by differential mortality. Methods: the study included participants in the first two waves of the English Longitudinal Study of Ageing (ELSA), a large national longitudinal study of the population aged 50+ in England, who reported good health, no functional impairment, or no heart disease at baseline. Wealth inequalities in onset of illness over 2 years were examined across age groups, with and without the inclusion of mortality. Outcome measured were functional impairment, heart disease, self-reported health, and all-cause mortality (in conjunction with self-reported health and disability) or circulatory-related mortality (in relation to heart disease). Results: wealth predicted onset of functional impairment equally across age groups. For self-reported health and heart disease, wealth gradients in the onset of illness declined with age. Selective mortality contributed to this decline in the oldest age groups. Conclusions: socioeconomic inequality in developing new health problems persist into old age for certain illnesses, particularly functional impairment, but not for heart disease. Selective mortality explains only some of the decline in health inequalities with age. [ABSTRACT FROM AUTHOR]

A large body of literature has shown marked differences in the average levels of resources and child well-being across different family structures. Studies have examined cognitive, educational and behavioural outcomes; less is known about differentials in physical health, and about dynamics in early childhood. Furthermore, up to the present time, less emphasis has been placed on describing the underlying mechanisms relating childhood experiences of family structure to health. In this paper, we hypothesize that socio-economic characteristics and family structure trajectories will affect every-day, more proximal processes (material, behavioural and family stress pathways) directly experienced by the child, which will in turn affect child health. Using the UK Millennium Cohort Study, a nationally representative cohort of over 19 000 children born in 2001 and living in the UK shortly thereafter, we employ Graphical Chain Models to map the processes linking family structure trajectories to three physical health outcomes at age 5: overweight/obesity, respiratory health, and accidental injury. We construct family trajectories to highlight two components: status (distinguishing between married, cohabiting and single parents), and (in)stability. We show that both status, the (in)stability of that status, and their interplay, are important components of family structure trajectories which correlate to children's early physical health. Analyses highlight the relative importance of distinct pathways across different health outcomes. As well as some outcome-specific paths, we find that "family stress" variables appeared to underscore the relationship between family structure and child physical health, pointing to the importance of such variables in understanding how family structure relates to early child health. • Family structure trajectories are correlated to early child physical health. • Both status (married, cohabiting, single) and instability were important features. • We know little about the mechanisms relating family structure to early child health. • Family stress appeared to be an important mechanisms across all family trajectories. • Housing quality was important for cohabitors; daily routines for separating parents. [ABSTRACT FROM AUTHOR]