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Introduction: Mental health problems increased during the COVID-19 pandemic. The knowledge that one is less at risk after being vaccinated may alleviate distress, but this hypothesis remains unexplored. This study tests whether psychological distress declined in those vaccinated against COVID-19 in the U.S. and whether changes in anticipatory fears mediated any association., Methods: A nationally representative cohort of U.S. adults (N=8,090) in the Understanding America Study were interviewed regularly from March 2020 to June 2021 (28 waves). Difference-in-differences regression tested whether vaccination reduced distress (Patient Health Questionnaire 4 scores), with mediation analysis used to identify potential mechanisms, including perceived risks of infection, hospitalization, and death., Results: Vaccination was associated with a 0.04-SD decline in distress (95% CI= -0.07, -0.02). Vaccination was associated with a 7.77-percentage point reduction in perceived risk of infection (95% CI= -8.62, -6.92), a 6.91-point reduction in perceived risk of hospitalization (95% CI= -7.72, -6.10), and a 4.68-point reduction in perceived risk of death (95% CI= -5.32, -4.04). Including risk perceptions decreased the vaccination-distress association by 25%. Event study models suggest that vaccinated and never vaccinated respondents followed similar Patient Health Questionnaire 4 trends before vaccination, diverging significantly after vaccination. Analyses were robust to individual and wave fixed effects and time-varying controls. The effect of vaccination on distress varied by race/ethnicity, with the largest declines observed among American Indian and Alaska Native individuals (β= -0.20, p<0.05, 95% CI= -0.36, -0.03)., Conclusions: COVID-19 vaccination was associated with declines in distress and perceived risks of infection, hospitalization, and death. Vaccination campaigns could promote these additional benefits of receiving the COVID-19 vaccine., (Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Job loss is a well-established social determinant of health. Recent research has taken an 'institutional turn', asking whether unemployment support could buffer the health consequences of job loss. Here, we exploit a quasi-natural experiment based on the Fornero reforms in Italy, which increased wage replacement rates from 60% to 75% on 1 January 2013., Methods: We employed difference-in-difference models using longitudinal data covering 202 incidents of job loss from the EU-Survey on Income and Living Conditions to quantify the impact of job loss on changes in self-reported health prior to and after the Fornero reforms (2011-14)., Results: Job loss pre-Fornero was associated with health declines -0.342 [95% confidence interval (CI): -0.588 to -0.096] but did not significantly influence health post-Fornero 0.031 (95% CI: -0.101 to 0.164). The difference-in-difference estimate was 0.373 (95% CI: 0.107-0.639), or a -0.51 standard deviation in self-reported health, consistent with the buffering hypothesis. To put the magnitude of this estimate in perspective, the incidence of a chronic illness, such as diabetes, results in a similar magnitude decline in self-reported health., Conclusions: Our analysis contributes to a growing body of evidence that the impact of job loss on health depends critically on the strength of social protection systems and, in some cases, could be eliminated completely., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Background: Drug-related mortality in the UK rose markedly after 2012. Here we test the hypothesis that cuts to disability-related spending were associated with increased drug-related mortality across local governments in Great Britain., Methods: We regressed changes in drug-related death rates (years 2010-12 versus 2015-17) on local government disability-related budget reductions, adjusting for a range of regional, demographic, and economic factors. Budget reductions are captured with a combined measure of financial losses due to Incapacity Benefit and Disability Living Allowance reforms, expressed in pounds sterling per capita, per year. 364 local authorities across England, Scotland, and Wales were included in the study., Findings: Greater budget reductions were associated with greater increases in drug-related death rates. In the unadjusted model, each £100 per capita budget reduction was associated with an increase in drug-related death rates of 3.30 per 100 000 population (95% CI: 2.43 to 4.17). The magnitude of the association increased after adjusting for region and demographic factors (b = 4.84; 95% CI: 3.26 to 6.43). The association remained statistically significant after adjusting for a full set of controls, including baseline and trends in unemployment rates, median hourly pay, and gross disposable household income per capita (b = 4.41; 95% CI: 2.57 to 6.24)., Conclusion: Deeper cuts to local government spending in Great Britain in the 2010s were associated with larger increases in drug-related deaths., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The contemporaneous association between higher socioeconomic position and better health is well established. Life course research has also demonstrated a lasting effect of childhood socioeconomic conditions on adult health and well-being. Yet, little is known about the separate health effects of intergenerational mobility-moving into a different socioeconomic position than one's parents-among early adults in the United States. Most studies on the health implications of mobility rely on cross-sectional datasets, which makes it impossible to differentiate between health selection and social causation effects. In addition, understanding the effects of social mobility on health at a relatively young age has been hampered by the paucity of health measures that reliably predict disease onset. Analysing 4,713 respondents aged 25 to 32 from the National Longitudinal Study of Adolescent Health's Waves I and IV, we use diagonal reference models to separately identify the effects of socioeconomic origin and destination, as well as social mobility on allostatic load among individuals in the United States. Using a combined measure of educational and occupational attainment, and accounting for individuals' initial health, we demonstrate that in addition to health gradient among the socially immobile, individuals' socioeconomic origin and destination are equally important for multi-system physiological dysregulation. Short-range upward mobility also has a positive and significant association with health. After mitigating health selection concerns in our observational data, this effect is observed only among those reporting poor health before experiencing social mobility. Our findings move towards the reconciliation of two theoretical perspectives, confirming the positive effect of upward mobility as predicted by the "rags to riches" perspective, while not contradicting potential costs associated with more extensive upward mobility experiences as predicted by the dissociative thesis., Competing Interests: The authors have declared that no competing interests exist.

Do populist leaders contribute to the spread of coronavirus disease 2019 (COVID-19)? While all governments have struggled to respond to the pandemic, it is now becoming clear that some political leaders have performed much better than others. Among the worst performing are those that have risen to power on populist agendas, such as in the United States, Brazil, Russia, India, and the United Kingdom. Populist leaders have tended to: blame "others" for the pandemic, such as immigrants and the Chinese government; deny evidence and show contempt for institutions that generate it; and portray themselves as the voice of the common people against an out-of-touch 'elite.' In our short commentary, focusing on those countries with the most cases, we find that populist leaders appear to be undermining an effective response to COVID-19. Perversely, they may also gain politically from doing so, as historically populist leaders benefit from suffering and ill health. Clearly more research is needed on the curious correlation of populism and public health. Notwithstanding gaps in the evidence, health professionals have a duty to speak out against these practices to prevent avoidable loss of life., (© 2021 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Objectives. To test the hypothesis that deaths of despair, a marker of social suffering, were associated with greater support for Brexit in the United Kingdom's 2016 European Union referendum. Methods. We used cross-local authority regression models of Brexit vote shares on changes in suicide and drug-related death rates before (2005-2007) and after the recession (2014-2016), adjusting for sociodemographic factors. The population comprised 345 local authorities in England and Wales. Results. Mortality rates were associated with voting patterns. An increase of 10 drug-related deaths per 100 000 was associated with a 15.25-percentage-point increase in Brexit votes (95% confidence interval [CI] = 10.27, 20.24), while an increase of 10 suicides per 100 000 was associated with a 9.97-percentage-point increase in vote shares for Brexit (95% CI = 6.25, 13.70). These results were substantially attenuated after we adjusted for education, and reduced to nonsignificance for drug mortality (b = 2.18; 95% CI = -0.21, 4.57) and suicide (b = 0.94; 95% CI = -0.32, 2.21) upon inclusion of other sociodemographic factors. Conclusions. Worsening mortality correlated with Brexit votes. These phenomena appear to share similar antecedents. A rise in such deaths may point to deeper social problems that could have political consequences.

Recessions pose risks to mental health, yet the psychosocial mechanisms involved are less clear. One critical factor may be people's perceived control when faced with multiple recession hardships. Here we test a structural amplification hypothesis by assessing the role of perceived control as a mediator and moderator of the relation between recession shocks and psychological distress. We draw on waves 2 (2004-2006) and 3 (2013-2014) of the Midlife in the United States study (MIDUS), covering 1,739 US adults under age 75 from before and after the Great Recession. Our statistical models reveal that perceived control declines while distress rises in association with a greater accumulation of recession-related hardships. Perceived control partially mediated the recession hardships-distress association,attenuating it by about one-fifth. Further, perceived control modified the association between recession hardships and distress; individuals who reported larger declines in personal control had greater increases in distress, whereas those who experienced hardships but increased their perceived control did not exhibit significant changes in distress levels. Taken together, our findings support the structural amplification hypothesis, whereby an accumulation of recession hardships erode coping resources that would otherwise protect individuals from the mental health effects of stress exposure. Future research is needed to better understand sources of resilience at individual, community, and societal levels to help ameliorate sentiments of powerlessness and lack of perceived control during economic recessions., Competing Interests: None., (© 2019 The Authors. Published by Elsevier Ltd.)

This paper examines whether low income and subjective financial strain are associated with mental health, as well as whether mastery weakens this association. We analyze three waves of a large sample of Canadians and utilize random and fixed effects regression strategies to assess bias introduced by unobserved time-stable confounders. In random effects models, both low income and subjective financial strain are associated with distress and anger. In fixed effects models that control for all time-stable confounders, the effect of low income is reduced to non-significance for both outcomes. The effect of subjective strain is also reduced in fixed effects models, but remained statistically significant. Sobel tests indicated that the effect of subjective strain on mental health is transmitted through mastery, but this indirect path is modest in magnitude. When interactions are tested, mastery weakens the association between subjective strain and distress, and this effect is robust to the influence of time-stable controls, but mastery does not buffer the subjective strain-anger relationship in either random or fixed-effects models. Finally, moving below the low income threshold increases anger for low mastery individuals, but seems to reduce anger when moving below the low income threshold is coupled with increases in mastery. Collectively, our findings demonstrate the importance of assessing the influence of unobserved time-stable confounders in stress research. Further, discrepancies in the moderating role of mastery reinforce calls for the assessment of multiple outcomes in mental health research., (Copyright © 2018. Published by Elsevier Ltd.)

Prior research evaluates the health effects of higher status attainment by analyzing highly similar individuals whose circumstances differ after some experience a "status boost." Advancing that research, we assess health differences across organizational contexts among two national samples of lawyers who were admitted to the bar in the same year in their respective countries. We find that higher-status lawyers in large firms report more depression than lower-status lawyers, poorer health in the American survey, and no health advantage in Canada. Adjusting for income exacerbates these patterns-were it not for their higher incomes, large-firm lawyers would have a greater health disadvantage. Last, we identify two stressors in the legal profession, overwork and work-life conflict, that are more prevalent in the private sector and increase with firm size. Adjusting for these stressors explains well-being differences across organizational contexts. This study documents the role of countervailing mechanisms in health inequality research.

One of the most pervasive statements about stratification and health identifies the strong inverse relationship-or gradient-between socioeconomic status (SES) and poor health. We elaborate on the ways that the SES-based gradient in stress exposure contributes to nuances in the SES-health association. In analyses of the 2008 National Study of the Changing Workforce, we find some evidence that the inverse association between SES and health outcomes is finely graded-but several 'pockets of complexity' emerge. First, education and income have different associations with health and well-being. Second, those associations depend on the outcome being assessed. Education is more influential for predicting anxiety and poor health than for depression or life dissatisfaction, while income is more influential for predicting depression and, to a lesser extent, life dissatisfaction. Third, different patterns of explanation or suppression reflect resource advantage or stress of higher status dynamics. Some impactful stressors that people encounter-especially job pressure and work-family conflict-are not neatly graded in ways that corroborate the conventional SES-health narrative. Instead, these mask the size of the overall health differences between lower versus higher SES groups. Our mapping of the SES gradient in stressors extends that story and complicates the conventional view of the association between SES and health/well-being., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objectives: This study considers the association between personal network density and risk of elder mistreatment among American adults., Method: Using egocentric network data from the National Social Life, Health, and Aging Project, we employ logistic and negative binomial regression to predict recent experience of elder mistreatment. We further unpack the density mistreatment association by linking perpetrators to the victim's network and by assessing their position within its structure., Results: As hypothesized, older adults with dense networks had a lower risk of elder mistreatment. Interestingly, the perpetrators of these harmful acts were often found within seniors' close networks-though there was little evidence to suggest that perpetrators themselves were poorly embedded in the network., Discussion: Results highlight how network-level phenomena can operate distinctively from dyadic mistreatment processes. Dense personal networks seem to provide structural protection against elder mistreatment, even as many offensive acts are committed by those that are close to the victim and relatively well embedded in their network., (© The Author 2014. 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.)

Analyses of the 2008 National Study of the Changing Workforce demonstrate that job pressure is associated with greater anxiety and job dissatisfaction. In this paper we ask, What conditions protect workers? The conventional buffering hypothesis in the Job-Demands Resource (JD-R) model predicts that job resources should attenuate the relationship. We test whether the conventional buffering hypothesis depends on socioeconomic status (SES). Support for conventional buffering is evident only for job dissatisfaction--and that generalizes across SES. When anxiety is assessed, however, we observe an SES contingency: Job resources attenuate the positive association between job pressure and anxiety among workers with lower SES, but exacerbate it among those with higher SES. We discuss the implications of this SES-contingent pattern for theoretical scenarios about "resource reinforcement," "resource substitution," and the "stress of higher status." Future research should consider SES indicators as potential contingencies in the relationship between job conditions and mental health., (© American Sociological Association 2015.)