171 results on '"Popham, Frank"'
Search Results
152. The increasing lifespan variation gradient by area-level deprivation: A decomposition analysis of Scotland 1981-2011.
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Seaman R, Riffe T, Leyland AH, Popham F, and van Raalte A
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- Adult, Age Distribution, Aged, Cause of Death, Female, Humans, Male, Middle Aged, Scotland, Socioeconomic Factors, Health Status Disparities, Life Expectancy trends, Longevity physiology, Mortality trends
- Abstract
Life expectancy inequalities are an established indicator of health inequalities. More recent attention has been given to lifespan variation, which measures the amount of heterogeneity in age at death across all individuals in a population. International studies have documented diverging socioeconomic trends in lifespan variation using individual level measures of income, education and occupation. Despite using different socioeconomic indicators and different indices of lifespan variation, studies reached the same conclusion: the most deprived experience the lowest life expectancy and highest lifespan variation, a double burden of mortality inequality. A finding of even greater concern is that relative differences in lifespan variation between socioeconomic group were growing at a faster rate than life expectancy differences. The magnitude of lifespan variation inequalities by area-level deprivation has received limited attention. Area-level measures of deprivation are actively used by governments for allocating resources to tackle health inequalities. Establishing if the same lifespan variation inequalities emerge for area-level deprivation will help to better inform governments about which dimension of mortality inequality should be targeted. We measure lifespan variation trends (1981-2011) stratified by an area-level measure of socioeconomic deprivation that is applicable to the entire population of Scotland, the country with the highest level of variation and one of the longest, sustained stagnating trends in Western Europe. We measure the gradient in variation using the slope and relative indices of inequality. The deprivation, age and cause specific components driving the increasing gradient are identified by decomposing the change in the slope index between 1981 and 2011. Our results support the finding that the most advantaged are dying within an ever narrower age range while the most deprived are facing greater and increasing uncertainty. The least deprived group show an increasing advantage, over the national average, in terms of deaths from circulatory disease and external causes., (Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2019
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153. Controlled Mediation as a Generalization of Interventional Mediation.
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Popham F
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- 2019
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154. Interpreting mutual adjustment for multiple indicators of socioeconomic position without committing mutual adjustment fallacies.
- Author
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Green MJ and Popham F
- Subjects
- Humans, Socioeconomic Factors, Research Design standards, Social Class, Social Determinants of Health
- Abstract
Research into the effects of Socioeconomic Position (SEP) on health will sometimes compare effects from multiple, different measures of SEP in "mutually adjusted" regression models. Interpreting each effect estimate from such models equivalently as the "independent" effect of each measure may be misleading, a mutual adjustment (or Table 2) fallacy. We use directed acyclic graphs (DAGs) to explain how interpretation of such models rests on assumptions about the causal relationships between those various SEP measures. We use an example DAG whereby education leads to occupation and both determine income, and explain implications for the interpretation of mutually adjusted coefficients for these three SEP indicators. Under this DAG, the mutually adjusted coefficient for education will represent the direct effect of education, not mediated via occupation or income. The coefficient for occupation represents the direct effect of occupation, not mediated via income, or confounded by education. The coefficient for income represents the effect of income, after adjusting for confounding by education and occupation. Direct comparisons of mutually adjusted coefficients are not comparing like with like. A theoretical understanding of how SEP measures relate to each other can influence conclusions as to which measures of SEP are most important. Additionally, in some situations adjustment for confounding from more distal SEP measures (like education and occupation) may be sufficient to block unmeasured socioeconomic confounding, allowing for greater causal confidence in adjusted effect estimates for more proximal measures of SEP (like income).
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- 2019
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155. Theorising social class and its application to the study of health inequalities.
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McCartney G, Bartley M, Dundas R, Katikireddi SV, Mitchell R, Popham F, Walsh D, and Wami W
- Abstract
The literature on health inequalities often uses measures of socio-economic position pragmatically to rank the population to describe inequalities in health rather than to understand social and economic relationships between groups. Theoretical considerations about the meaning of different measures, the social processes they describe, and how these might link to health are often limited. This paper builds upon Wright's synthesis of social class theories to propose a new integrated model for understanding social class as applied to health. This model incorporates several social class mechanisms: social background and early years' circumstances; Bourdieu's habitus and distinction; social closure and opportunity hoarding; Marxist conflict over production (domination and exploitation); and Weberian conflict over distribution. The importance of discrimination and prejudice in determining the opportunities for groups is also explicitly recognised, as is the relationship with health behaviours. In linking the different social class processes we have created an integrated theory of how and why social class causes inequalities in health. Further work is required to test this approach, to promote greater understanding of researchers of the social processes underlying different measures, and to understand how better and more comprehensive data on the range of social class processes these might be collected in the future.
- Published
- 2018
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156. Assessing Confounder Balance in Outcome Regressions.
- Author
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Popham F and Leyland AH
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- Humans, Probability, Causality, Confounding Factors, Epidemiologic, Regression Analysis, Statistics as Topic
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- 2018
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157. Synthetic control methodology as a tool for evaluating population-level health interventions.
- Author
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Bouttell J, Craig P, Lewsey J, Robinson M, and Popham F
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- Germany, Humans, Life Expectancy, Health Promotion standards, Population Health, Program Evaluation methods
- Abstract
Background: Many public health interventions cannot be evaluated using randomised controlled trials so they rely on the assessment of observational data. Techniques for evaluating public health interventions using observational data include interrupted time series analysis, panel data regression-based approaches, regression discontinuity and instrumental variable approaches. The inclusion of a counterfactual improves causal inference for approaches based on time series analysis, but the selection of a suitable counterfactual or control area can be problematic. The synthetic control method builds a counterfactual using a weighted combination of potential control units., Methods: We explain the synthetic control method, summarise its use in health research to date, set out its advantages, assumptions and limitations and describe its implementation through a case study of life expectancy following German reunification., Results: Advantages of the synthetic control method are that it offers an approach suitable when there is a small number of treated units and control units and it does not rely on parallel preimplementation trends like difference in difference methods. The credibility of the result relies on achieving a good preimplementation fit for the outcome of interest between treated unit and synthetic control. If a good preimplementation fit is established over an extended period of time, a discrepancy in the outcome variable following the intervention can be interpreted as an intervention effect. It is critical that the synthetic control is built from a pool of potential controls that are similar to the treated unit. There is currently no consensus on what constitutes a 'good fit' or how to judge similarity. Traditional statistical inference is not appropriate with this approach, although alternatives are available. From our review, we noted that the synthetic control method has been underused in public health., Conclusions: Synthetic control methods are a valuable addition to the range of approaches for evaluating public health interventions when randomisation is impractical. They deserve to be more widely applied, ideally in combination with other methods so that the dependence of findings on particular assumptions can be assessed., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
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- 2018
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158. How Healthy Are Survey Respondents Compared with the General Population?: Using Survey-linked Death Records to Compare Mortality Outcomes.
- Author
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Keyes KM, Rutherford C, Popham F, Martins SS, and Gray L
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- Adolescent, Adult, Censuses, Databases, Factual, Female, Health Surveys, Humans, Male, Middle Aged, Poisson Distribution, United States epidemiology, Young Adult, Mortality trends, Population Surveillance methods
- Abstract
Background: National surveys are used to capture US health trends and set clinical guidelines, yet the sampling frame often includes those in noninstitutional households, potentially missing those most vulnerable for poor health. Declining response rates in national surveys also represent a challenge, and existing inputs to survey weights have limitations. We compared mortality rates between those who respond to surveys and the general population over time., Methods: Survey respondents from 20 waves of the National Health Interview Survey from 1990 to 2009 who have been linked to death records through 31 December 2011 were included. For each cohort in the survey, we estimated their mortality rates along with that cohort's mortality rate in the census population using vital statistics records, and differences were examined using Poisson models., Results: In all years, survey respondents had lower mortality rates compared with the general population when data were both weighted and unweighted. Among men, survey respondents in the weighted sample had 0.86 (95% confidence interval = 0.853, 0.868) times the mortality rate of the general population (among women, RR = 0.887; 95% confidence interval, 0.879, 0.895). Differences in mortality are evident along all points of the life course. Differences have remained relatively stable over time., Conclusion: Survey respondents have lower death rates than the general US population, suggesting that they are a systematically healthier source population. Incorporating nonhousehold samples and revised weighting strategies to account for sample frame exclusion and nonresponse may allow for more rigorous estimation of the US population's health.
- Published
- 2018
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159. Associations of Successful Aging With Socioeconomic Position Across the Life-Course: The West of Scotland Twenty-07 Prospective Cohort Study.
- Author
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Whitley E, Benzeval M, and Popham F
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- Adult, Aged, Aging psychology, Child, Cohort Studies, Female, Humans, Male, Middle Aged, Prospective Studies, Scotland epidemiology, Socioeconomic Factors, Healthy Aging psychology, Life History Traits, Social Class
- Abstract
Objective: The aim of this study is to investigate how socioeconomic position (SEP) is associated with multidimensional measures of successful aging (SA), and how this varies and accumulates across the life-course., Method: Using data from 1,733 Scottish men and women from two cohorts aged around 57 and 76, respectively, we explored associations of SA, based on the Rowe-Kahn model, with 10 measures of SEP measured in childhood and, distally and proximally, in adulthood., Results: Individual SEP associations with SA score were generally consistent across different indicators and life stages: Respondents with the most versus least favorable SEP had two additional positive SA dimensions. There was also a strong association between SA and cumulative SEP based on all 10 measures combined; respondents with the most versus least favorable lifelong SEP had four additional positive SA dimensions., Conclusion: SEP advantages/disadvantages act and accumulate across the life-course, resulting in widening socioeconomic inequalities in SA in later life.
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- 2018
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160. Leaving the labour market later in life: how does it impact on mechanisms for health?
- Author
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Whitley E and Popham F
- Subjects
- Activities of Daily Living, Adult, Aged, Anxiety, Disabled Persons, Employment psychology, Female, Humans, Male, Middle Aged, Personal Autonomy, Scotland, Stress, Psychological, Surveys and Questionnaires, Aging, Health Status, Mental Health, Retirement psychology, Self Concept, Social Participation, Unemployment psychology
- Abstract
Objectives: Negative associations between non-employment and health among older people are well established and are potentially important for successful ageing. However, opportunities to improve health through re-employment or extending working lives are limited as later-life exits from employment are often unwanted and permanent. We aim to establish a greater understanding of the psychosocial mechanisms underlying non-employment and health associations in older people to identify modifiable pathways through which the negative impact of non-employment can be ameliorated., Methods: Using multilevel analysis of four waves of repeated panel data from a representative sample of 1551 older men and women reaching state retirement age in the West of Scotland from 1987/1988 to 2000/2004, we explored respondents' strength of agreement with 20 statements relating to their self-defined employment status, covering themes of functioning, social engagement, self-esteem, mental engagement, stress, and control and autonomy., Results: Compared with those in employment, respondents who were retired, unemployed, sick/disabled and home makers were more likely to agree that this resulted in poor social engagement, low self-esteem and, with the possible exception of retirees, reduced mental engagement. Associations were particularly marked among unemployed and sick/disabled respondents who also agreed that their status was a source of worry and prevented them from feeling in control., Conclusion: Older people who are not in employment are at higher risk of poor physical and mental health. Interventions targeting psychosocial mechanisms such as social and mental engagement and self-esteem offer potentially valuable opportunities to improve health outcomes and promote successful ageing., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2017
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161. Visualising and quantifying 'excess deaths' in Scotland compared with the rest of the UK and the rest of Western Europe.
- Author
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Minton J, Shaw R, Green MA, Vanderbloemen L, Popham F, and McCartney G
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- Aged, Aged, 80 and over, Cause of Death, Female, Humans, Male, Middle Aged, Morbidity trends, Scotland, Social Class, Socioeconomic Factors, United Kingdom, Attitude to Health, Health Status, Mortality trends, Vulnerable Populations statistics & numerical data
- Abstract
Background: Scotland has higher mortality rates than the rest of Western Europe (rWE), with more cardiovascular disease and cancer among older adults; and alcohol-related and drug-related deaths, suicide and violence among younger adults., Methods: We obtained sex, age-specific and year-specific all-cause mortality rates for Scotland and other populations, and explored differences in mortality both visually and numerically., Results: Scotland's age-specific mortality was higher than the rest of the UK (rUK) since 1950, and has increased. Between the 1950s and 2000s, 'excess deaths' by age 80 per 100 000 population associated with living in Scotland grew from 4341 to 7203 compared with rUK, and from 4132 to 8828 compared with rWE. UK-wide mortality risk compared with rWE also increased, from 240 'excess deaths' in the 1950s to 2320 in the 2000s. Cohorts born in the 1940s and 1950s throughout the UK including Scotland had lower mortality risk than comparable rWE populations, especially for males. Mortality rates were higher in Scotland than rUK and rWE among younger adults from the 1990s onwards suggesting an age-period interaction., Conclusions: Worsening mortality among young adults in the past 30 years reversed a relative advantage evident for those born between 1950 and 1960. Compared with rWE, Scotland and rUK have followed similar trends but Scotland has started from a worse position and had worse working age-period effects in the 1990s and 2000s., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)
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- 2017
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162. Insomnia symptoms as a cause of type 2 diabetes Incidence: a 20 year cohort study.
- Author
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Green MJ, Espie CA, Popham F, Robertson T, and Benzeval M
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- Adult, Aged, Cohort Studies, Female, Humans, Incidence, Male, Middle Aged, Obesity complications, Obesity epidemiology, Prospective Studies, Risk Factors, Scotland, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 etiology, Sleep Initiation and Maintenance Disorders complications, Sleep Initiation and Maintenance Disorders epidemiology
- Abstract
Background: Insomnia symptoms are associated with type 2 diabetes incidence but are also associated with a range of potential time-varying covariates which may confound and/or mediate associations. We aimed to assess whether cumulative exposure to insomnia symptoms has a causal effect on type 2 diabetes incidence., Methods: A prospective cohort study in the West of Scotland, following respondents for 20 years from age 36. 996 respondents were free of diabetes at baseline and had valid data from up to four follow-up visits. Type 2 diabetes was assessed at the final visit by self-report, taking diabetic medication, or blood-test (HbA
1c ≥ 6.5% or 48 mmol/mol). Effects of cumulative insomnia exposure on type 2 diabetes incidence were estimated with traditional regression and marginal structural models, adjusting for time-dependent confounding (smoking, diet, physical inactivity, obesity, heavy drinking, psychiatric distress) as well as for gender and baseline occupational class., Results: Traditional regression yielded an odds ratio (OR) of 1.34 (95% CI: 1.06-1.70) for type 2 diabetes incidence for each additional survey wave in which insomnia was reported. Marginal structural models adjusted for prior covariates (assuming concurrently measured covariates were potential mediators), reduced this OR to 1.20 (95% CI: 0.98-1.46), and when concurrent covariates were also included (viewing them as potential confounders) this dropped further to 1.08 (95% CI: 0.85-1.37)., Conclusions: The association between cumulative experience of insomnia and type 2 diabetes incidence appeared confounded. Evidence for a residual causal effect depended on assumptions as to whether concurrently measured covariates were confounders or mediators.- Published
- 2017
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163. Comparison of the Rowe-Kahn Model of Successful Aging With Self-rated Health and Life Satisfaction: The West of Scotland Twenty-07 Prospective Cohort Study.
- Author
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Whitley E, Popham F, and Benzeval M
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- Aged, Cohort Studies, Female, Humans, Logistic Models, Male, Middle Aged, Models, Theoretical, Prospective Studies, Scotland, Aging, Health Status, Mental Health, Personal Satisfaction
- Abstract
Purpose of the Study: With increasing longevity in industrialized populations, there is growing interest in what defines "successful aging" (SA). Various SA measures have been proposed but no consensus has been reached and many have been criticized for not representing the views and priorities of older people. We consider whether the Rowe-Kahn SA model captures older individual's perceptions of their own health and aging., Methods: Using two cohorts of 886 and 483 men and women from the West of Scotland Twenty-07 Study, aged around 57 and 76, respectively, we explored associations between Rowe-Kahn SA dimensions (absence of disease/disability; good physical/cognitive functioning; good interpersonal/productive social engagement) and four aspects of self-rated health and satisfaction (current general health; health for age; satisfaction with health; satisfaction with life)., Results: Respondents' self-rated health and satisfaction was generally good but few had all six Rowe-Kahn dimensions positive, the conventional definition of SA. All individual positive SA dimensions were associated with better self-rated health and satisfaction. This was consistent across age, gender, manual/nonmanual occupations, and personality. The prevalence of good self-rated health and satisfaction increased with increasing numbers of positive SA dimensions., Implications: The Rowe-Kahn model provides a functional definition of SA. Future work on ageing should include all Rowe-Kahn dimensions and consider SA as a continuum., (© The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America.)
- Published
- 2016
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164. Increasing inequality in age of death at shared levels of life expectancy: A comparative study of Scotland and England and Wales.
- Author
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Seaman R, Leyland AH, and Popham F
- Abstract
There is a strong negative correlation between increasing life expectancy and decreasing lifespan variation, a measure of inequality. Previous research suggests that countries achieving a high level of life expectancy later in time generally do so with lower lifespan variation than forerunner countries. This may be because they are able to capitalise on lessons already learnt. However, a few countries achieve a high level of life expectancy later in time with higher inequality. Scotland appears to be such a country and presents an interesting case study because it previously experienced lower inequality when reaching the same level of life expectancy as its closest comparator England and Wales. We calculated life expectancy and lifespan variation for Scotland and England and Wales for the years 1950 to 2012, comparing Scotland to England and Wales when it reached the same level of life expectancy later on in time, and assessed the difference in the level of lifespan variation. The lifespan variation difference between the two countries was then decomposed into age-specific components. Analysis was carried out for males and females separately. Since the 1950s Scotland has achieved the same level of life expectancy at least ten years later in time than England and Wales. Initially it did so with lower lifespan variation. Following the 1980s Scotland has been achieving the same level of life expectancy later in time than England and Wales and with higher inequality, particularly for males. Decomposition revealed that higher inequality is partly explained by lower older age mortality rates but primarily by higher premature adult age mortality rates when life expectancy is the same. Existing studies suggest that premature adult mortality rates are strongly associated with the social determinants of health and may be amenable to social and economic policies. So addressing these policy areas may have benefits for both inequality and population health in Scotland.
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- 2016
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165. The impact on health of employment and welfare transitions for those receiving out-of-work disability benefits in the UK.
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Curnock E, Leyland AH, and Popham F
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- Adult, Disabled Persons statistics & numerical data, Female, Humans, Male, Return to Work statistics & numerical data, Social Welfare statistics & numerical data, Surveys and Questionnaires, United Kingdom, Workforce, Disabled Persons psychology, Employment statistics & numerical data, Return to Work psychology, Social Welfare psychology
- Abstract
Employment status has a dynamic relationship with health and disability. There has been a striking increase in the working age population receiving out-of-work disability benefits in many countries, including the UK. In response, recent UK welfare reforms have tightened eligibility criteria and introduced new conditions for benefit receipt linked to participation in return-to-work activities. Positive and negative impacts have been suggested but there is a lack of high quality evidence of the health impact when those receiving disability benefits move towards labour market participation. Using four waves of the UK's Understanding Society panel survey (2009-2013) three different types of employment and welfare transition were analysed in order to identify their impact on health. A difference-in-difference approach was used to compare change between treatment and control groups in mental and physical health using the SF-12. To strengthen causal inference, sensitivity checks for common trends used pre-baseline data and propensity score matching. Transitions from disability benefits to employment (n = 124) were associated on average with an improvement in the SF12 mental health score of 5.94 points (95% CI = 3.52-8.36), and an improvement in the physical health score of 2.83 points (95% CI = 0.85-4.81) compared with those remaining on disability benefits (n = 1545). Transitions to unemployed status (n = 153) were associated with a significant improvement in mental health (3.14, 95% CI = 1.17-5.11) but not physical health. No health differences were detected for those who moved on to the new out-of-work disability benefit. It remains rare for disability benefit recipients to return to the labour market, but our results indicate that for those that do, such transitions may improve health, particularly mental health. Understanding the mechanisms behind this relationship will be important for informing policies to ensure both work and welfare are 'good for health' for this group., (Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2016
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166. Re: Lies, Damned Lies, and Health Inequality Measurements: Understanding the Value Judgments.
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Popham F
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- Humans, Health Status Disparities, Judgment, Social Values
- Published
- 2016
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167. Converting between marginal effect measures from binomial models.
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Popham F
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- Binomial Distribution, Humans, Computer Simulation, Models, Statistical
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- 2016
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168. Deprivation is a relative concept? Absolutely!
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Popham F
- Subjects
- Female, Humans, Male, Coronary Disease mortality, Health Status Disparities, Health Status Indicators, Mental Health, Poverty statistics & numerical data, Psychosocial Deprivation, Residence Characteristics
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- 2015
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169. Is changing status through housing tenure associated with changes in mental health? Results from the British Household Panel Survey.
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Popham F, Williamson L, and Whitley E
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- Adult, Female, Housing economics, Housing legislation & jurisprudence, Humans, Male, Middle Aged, Ownership legislation & jurisprudence, Stress, Psychological psychology, Surveys and Questionnaires, United Kingdom, Health Status, Housing classification, Mental Health, Ownership economics, Social Class, Stress, Psychological economics
- Abstract
Background: Actual or perceived status, such as housing tenure, may impact on health through stress-inducing social comparisons. Studies of how status change impacts mental health change are rare but important because they are less prone to confounding., Methods: We used data from the British Household Panel Survey to compare psychological distress in local authority renters who opted to buy their home under the UK's Right to Buy (RTB) policy versus those who continued to rent the same (social non-mover (SNM)) or a different (social mover (SM)) local authority property or who bought privately (owner mover (OM)). General Health Questionnaire (GHQ-12) scores before and after any change in tenure and/or address were compared across groups using a difference-in-difference approach., Results: Individuals who moved house (bought or rented) were younger while those who bought (the same or different house) were better off, more likely to be employed, and had higher educational qualifications. Individuals who bought their home (under RTB or privately) had lower distress scores from the outset. Individuals who moved house (bought or rented) experienced a rise in distress prior to moving that was no longer evident 1 year after the move. There was no evidence that changing tenure reduced psychological distress comparing (difference (95% CI)) average GHQ score 2 years preaddress and 1 year postaddress/tenure change in RTB vs SNM, SM, OM: -0.08 (-0.68 to 0.51), 0.16 (-0.70 to 1.01) and -0.17 (-1.28 to 0.94), respectively)., Conclusions: Changing tenure under RTB did not, on average, impact psychological distress, suggesting that this status change did not change mental health., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)
- Published
- 2015
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170. To what extent do financial strain and labour force status explain social class inequalities in self-rated health? Analysis of 20 countries in the European Social Survey.
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Shaw RJ, Benzeval M, and Popham F
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- Adult, Europe, Female, Humans, Male, Middle Aged, Self Report, Socioeconomic Factors, Employment, Health Status Disparities, Population Surveillance, Social Class
- Abstract
Introduction: Nordic countries do not have the smallest health inequalities despite egalitarian social policies. A possible explanation for this is that drivers of class differences in health such as financial strain and labour force status remain socially patterned in Nordic countries., Methods: Our analyses used data for working age (25-59) men (n = 48,249) and women (n = 52,654) for 20 countries from five rounds (2002-2010) of the European Social Survey. The outcome was self-rated health in 5 categories. Stratified by gender we used fixed effects linear regression models and marginal standardisation to instigate how countries varied in the degree to which class inequalities were attenuated by financial strain and labour force status., Results and Discussion: Before adjustment, Nordic countries had large inequalities in self-rated health relative to other European countries. For example the regression coefficient for the difference in health between working class and professional men living in Norway was 0.34 (95% CI 0.26 to 0.42), while the comparable figure for Spain was 0.15 (95% CI 0.08 to 0.22). Adjusting for financial strain and labour force status led to attenuation of health inequalities in all countries. However, unlike some countries such as Spain, where after adjustment the regression coefficient for working class men was only 0.02 (95% CI -0.05 to 0.10), health inequalities persisted after adjustment for Nordic countries. For Norway the adjusted coefficient was 0.17 (95% CI 0.10 to 0.25). Results for women and men were similar. However, in comparison to men, class inequalities tended to be stronger for women and more persistent after adjustment., Conclusions: Adjusting for financial security and labour force status attenuates a high proportion of health inequalities in some counties, particularly Southern European countries, but attenuation in Nordic countries was modest and did not improve their relative position.
- Published
- 2014
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171. Differences in adiposity trajectories by birth cohort and childhood social class: evidence from cohorts born in the 1930s, 1950s and 1970s in the west of Scotland.
- Author
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Shaw RJ, Green MJ, Popham F, and Benzeval M
- Subjects
- Adolescent, Adult, Aged, Body Mass Index, Cohort Studies, Female, Humans, Longitudinal Studies, Male, Middle Aged, Multilevel Analysis, Scotland, Young Adult, Body Fat Distribution economics, Obesity economics, Social Class, Social Determinants of Health
- Abstract
Background: Since the 1930s, the environment has become increasingly obesogenic, leading to rising rates of adiposity and socioeconomic inequalities in adiposity. Building on studies comparing body mass index (BMI) for cohorts born over a period of 20 years, we examine the social patterning of BMI and central adiposity for three cohorts born over a 40-year period., Methods: Using data from the West of Scotland Twenty-07 study (n=4510), we investigate 20-year trajectories of adiposity for three cohorts born in the 1930s, 1950s and 1970s, allowing us to study 60 years of the lifecourse. Stratified by gender, we employed multilevel models to generate trajectories for BMI and waist-to-height ratio (WHtR) and explored how these trajectories varied by childhood social class., Results: Adiposity increased most quickly with age in the youngest cohort, and cohort differences were greater than socioeconomic differences. For example, the smallest cohort difference for BMI, a comparison of men in the 1930s and 1950s cohorts at age 55, was 2.66 (95% CI 2.11 to 3.20) kg/m(2), while the largest socioeconomic difference, a comparison of manual and non-manual women at age 64, was 1.18 (95% CI 0.37 to 1.98) kg/m(2). Socioeconomic inequalities in adiposity increased with age and were greater for women than for men. The results for WHtR differed in that increases in WHtR accelerated with age while increases in BMI slowed., Conclusions: Socioeconomic differences in adiposity accumulate slowly across the lifecourse and are approximately only a third of the adiposity differences between cohorts.
- Published
- 2014
- Full Text
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