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Higher education has been shown to have neuroprotective effects, reducing the risk of Alzheimer's and Parkinson's diseases, slowing the rate of age-related cognitive decline, and is associated with lower rates of early mortality. In the present study, the association between higher education, fragile X messenger ribonucleoprotein 1 (FMR1) cytosine–guanine–guanine (CGG) repeat number, and mortality before life expectancy was investigated in a population cohort of women born in 1939. The findings revealed a significant interaction between years of higher education and CGG repeat number. Counter to the study's hypothesis, the effects of higher education became more pronounced as the number of CGG repeats increased. There was no effect of years of higher education on early mortality for women who had 25 repeats, while each year of higher education decreased the hazard of early mortality by 8% for women who had 30 repeats. For women with 41 repeats, the hazard was decreased by 14% for each additional year of higher education. The interaction remained significant after controlling for IQ and family socioeconomic status (SES) measured during high school, as well as factors measured during adulthood (family, psychosocial, health, and financial factors). The results are interpreted in the context of differential sensitivity to the environment, a conceptualization that posits that some people are more reactive to both negative and positive environmental conditions. Expansions in CGG repeats have been shown in previous FMR1 research to manifest such a differential sensitivity pattern. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine the physical and mental health impact of violence against youth with and without disabilities. We analyzed data from the National Crime Victimization Survey (2008–2016), a nationally representative survey on crime in the United States. Respondents included 729 adolescents (12–17 years) and 953 young adults (18–24 years) who experienced violence in the previous 6 months. Disability status was determined using a six-item screener. Outcome measures included several physical and mental health symptoms experienced for at least one month following violence. Data were analyzed using multivariable logistic, Poisson, and negative binomial regression models. The results indicated that, for at least one month following a violent incident, adolescents and young adults with disabilities were more likely to experience headaches, sleep difficulty, changes in eating or drinking habits, fatigue, muscle pain, and severe distress compared to peers without disabilities. Young adults with disabilities were also more likely to experience stomach problems, depression, and anxiety. Adolescents and young adults with disabilities experienced a greater number of concurrent physical and mental health symptoms compared to peers without disabilities. The results suggest that the health effects of violence are worse for youth with disabilities compared to their nondisabled peers. These findings emphasize the importance of screening young people with disabilities for violence exposure and ensuring that trauma and health services are universally accessible. [ABSTRACT FROM AUTHOR]

Students with disabilities with unmet health care needs are vulnerable to adverse educational outcomes, including exclusionary discipline. We examined the association between schools' spatial proximity to health care providers and their use of suspension to discipline students with disabilities. The study sample included the 398 public secondary schools in the Boston Metropolitan Statistical Area. We merged census-tract and school-level data from several sources, including the American Community Survey, the Health Resources and Services Administration, the Massachusetts Department of Public Health, and the U.S. Department of Education. Zero-inflated beta regression models were used to examine the association between schools' locations in medically underserved areas (MUAs) and the out-of-school suspension rates of students qualifying for special education services in the 2013–14 school year. Nested models and mediation analysis were used to parse the effects of medical underservice and neighborhood poverty on suspension rates. The suspension rate of students with disabilities was about 5 percentage points higher in schools located in medically underserved areas compared to schools that are not in MUAs, controlling for school- and neighborhood-level characteristics (z = 1.97, p <.05). Medical underservice significantly mediated the effect of neighborhood poverty on suspensions of students with disabilities (indirect effect, p <.05), accounting for 44% of the total effect of poverty. The findings indicate that schools with limited geographic access to health care services may more likely to use suspension as a tool to manage the behavior of students with disabilities. • The spatial distribution of health resources is unequal in the Boston area. • Local health contexts impact schools' inclusion of students with disabilities. • Schools in medically underserved areas suspend more students with disabilities. • Local health contexts impact suspension rates above and beyond neighborhood poverty. [ABSTRACT FROM AUTHOR]

There is increasing interest in the role of contextual factors in promoting well-being among parents of children with developmental disabilities. This study aimed to examine whether social network types moderate the impacts of having a child with a developmental disability on parents' health. Using cross-sectional data from the Midlife in the United States survey (MIDUS 2 and Refresher cohorts), we analyzed a sample of 363 parents of children with developmental disabilities and 4,919 parents of children without developmental disabilities. K-means cluster analysis was implemented to identify a social network typology. Modified Poisson and negative binomial regression models estimated the effect of having a child with a developmental disability and the typology on parents' physical health (self-rated health, number of chronic conditions) and mental health (self-rated mental health, major depression). The cluster analysis revealed two social network types. Parents of children with developmental disabilities were more likely to have "restricted/unsupported" networks, whereas parents in the comparison group were more likely to have "diverse/supported" networks. Social support was more important for differentiating the network types of parents of children with developmental disabilities, while social integration was more salient for the comparison group. Parents of children with developmental disabilities fared worse on all outcomes relative to parents of children without disabilities. However, the typology had a compensatory psychological effect; the diverse/supported network type conferred greater mental health benefits to parents of children with developmental disabilities than to those in the comparison group. The diverse/supported network type was also associated with better physical health, but the associations did not differ between the two parent groups. The results of this study emphasize the importance of social determinants of well-being for those with exceptional parenting responsibilities. Strengthening social networks may have a particularly positive impact on such parents' mental health. • Parents in midlife can be classified into two social network types. • Social support is paramount for parents of children with developmental disabilities. • Social integration matters more for other parents. • Diverse and supported network type is beneficial for parents' health. • Network type buffers the effects of having a child with developmental disabilities. [ABSTRACT FROM AUTHOR]

Objective: To compare female sterilization among three mutually exclusive groups of females: 1) those without any self-reported disability, 2) those with noncognitive disabilities (sensory or physical disabilities), and 3) those with cognitive disabilities.Methods: We conducted a secondary analysis of nationally representative data from the National Survey of Family Growth 2011-2015, which surveyed individuals aged 15-44 years in the U.S. civilian population. Disability status (self-reported) was ascertained using a standard set of questions about hearing, vision, cognitive, ambulatory, self-care, and independent living difficulties. Regression models were used to calculate odds of female sterilization, hysterectomies, and age of sterilization while accounting for sociodemographic differences.Results: Female sterilization rates were higher among females with cognitive (22.1% [n=272]) and noncognitive disabilities (24.7% [n=150]) than among those without disabilities (14.8% [n=1,132]). After adjusting for sociodemographic covariates, females with cognitive disabilities had significantly higher odds of female sterilization (adjusted odds ratio [OR] 1.54, 95% CI 1.19-1.98, P<.01) and hysterectomy (adjusted OR 2.64, 95% CI 1.53-4.56, P<.001) than those without cognitive disabilities. Females with cognitive disabilities also underwent sterilization at significantly younger ages (27.3 years, 95% CI 27.0-27.6) than those with noncognitive disabilities (28.3 years, 95% CI 27.9-28.8) and those without any disability (29.8 years, 95% CI 29.5-30.0).Conclusion: U.S. females with cognitive disabilities were more likely to have undergone female sterilizations and hysterectomies and at younger ages than those with other disabilities or without disabilities. Drivers of these disability-related differences in female sterilization patterns must be explored. [ABSTRACT FROM AUTHOR]