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A number of studies demonstrates a relationship between neighbourhood concentration of affluence and disadvantage and the health and development of its residents. We contribute to this literature by testing hypotheses about the relationship between neighbourhood-level concentrated affluence/disadvantage and child-level developmental outcomes in a study population of 37,798 Kindergarten children residing in 433 neighbourhoods throughout the province of British Columbia, Canada. We utilise a previously-validated measure of neighbourhood socioeconomic composition—the Index of Concentration at the Extremes (ICE) —which not only allows for more precise estimation of the competing influences of concentrated affluence and disadvantage, but also facilitates examination of the potential impact of neighbourhood-level income inequality. Our findings show that increases in neighbourhood affluence are associated with increases in children's scores on the Early Development Instrument (EDI) , a holistic measure of Kindergarteners' readiness for school. Particularly noteworthy is that, for four of the five EDI scales (physical, social, emotional, and communication) and the total score, results indicate a significant curvilinear relationship – whereby the highest average child-level outcomes are not found in locations with the highest concentrations of affluence, but rather in locations with relatively equal proportions of affluent and disadvantaged families. This finding suggests, first, that concentrated affluence may have diminishing rates of return on contributing to enhanced child development, and, second, that children residing in mixed-income neighbourhoods may benefit both from the presence of affluent residents and from the presence of services and institutions aimed at assisting lower-income residents. Implications and future directions are discussed.

Early child development (ECD) – the development of physical, social–emotional, and language–cognitive capacities in the early years – is a foundation of health, well-being, learning, and behaviour across the life course. Consequently, the capacity to monitor ECD is an important facet of a modern society. This capacity is achieved by having in place an ongoing flow of high-quality information on the state of early child development, its determinants, and long-term developmental outcomes. Accordingly, there remains a considerable need for research that merges community-centred, longitudinal, and linked-data approaches to monitoring child development. The current paper addresses this need by introducing one method of summarising and quantifying the developmental trajectories of British Columbian children at the neighbourhood- or district-level: computing the Community Index of Child Development (CICD) for each geographic area. A simple index that describes change in children's developmental trajectories at the aggregate level, the CICD is computable because of our capacity to conduct individual-level linkage of two population data sets: the Early Development Instrument (EDI), a holistic measure of children's readiness for school which is administered at Kindergarten, and the British Columbia Ministry of Education's Foundation Skills Assessment (FSA), a Grade 4 measure of academic skills. In this paper, we demonstrate: (a) wide variation in the CICDs according to the children's district of residence in Kindergarten; (b) an association of the CICDs with an indicator of the socioeconomic character of the neighbourhoods; and (c) contrasting patterns of neighbourhood convergence and divergence in two different school districts – such that, in some areas, children from high vulnerability neighbourhoods tend to catch up between Kindergarten and Grade 4 whereas, in other areas, they tend to fall further behind.

This paper presents an integrated model of the determinants of adult health combining lifecourse factors and contemporary circumstances. Using the 1958 British Birth Cohort, it operationalises lifecourse influences in terms of factors from birth to age 33, which might act through latent, pathway, or cumulative effects. Contemporary circumstances are represented by variables at different levels of social aggregation: macro (socio-economic circumstances); meso (involvement in civil society functions); micro (personal social support); and intersecting (job insecurity and life control). Multiple regression models were fitted, using self-rated health at age 33 as the health outcome. To allow for temporal ordering of events, early life factors were entered first in the final model, followed by later childhood factors and, finally current factors. Self-rated health was predicted by variables representing both early and later stage of the lifecourse and also contemporary societal-level factors. The effects of childhood factors were not removed by including contemporary factors, and conversely, contemporary factors contributed to the prediction of self-rated health over and above lifecourse factors. The factors were not collinear; supporting the notion that each dimension was distinct from the others. Although the model accounted for only 9% of the variance in self-rated health, the general conclusion is that both lifecourse and contemporary circumstances should be considered together in explaining adult health.

This study examined the association between perceived control and several socioeconomic variables and self-rated health in seven post-communist countries (Russia, Estonia, Lithuania, Latvia, Hungary, Poland, Czech Republic). Questionnaire interviews were used to collect data on self-rated health in the last 12 months, education, marital status, perceived control based on nine questions, and material deprivation based on availability of food, clothing and heating. For each population, two ecological measures of material inequalities were available: an inequality score estimated from the survey data as the distance between the 90th and 10th percentiles of material deprivation, and Gini coefficient from published sources. Data on 5330 men and women aged 20-60 were analysed. Prevalence of poor health (worse than average) varied between 8% in Czechs and 19% in Hungarians. The age-sex-adjusted odds ratio for university vs primary education was 0.36 (0.26-0.49); odds ratios per 1 standard deviation increase in perceived control and in material deprivation were 0.58 (95% CI 0.48-0.69) and 1.51 (1.40-1.63), respectively. The odds ratio for an increase in inequality equivalent to the difference between the most and the least unequal populations was 1.49 (0.88-2.52) using the material inequality score and 1.41 (0.91-2.20) using the Gini coefficient. No indication of an effect of either inequality measure was seen after adjustment for individuals' deprivation or perceived control. The results suggest that, as in western populations, education and material deprivation are strongly related to self-rated health. Perceived control appeared statistically to mediate some of the effects of material deprivation. The non-significant effects of both ecological measures of inequality were eliminated by controlling for individuals' characteristics.

This paper aims to identify gender similarities and differences in psychosocial work characteristics for those in and out of paid employment, to inform research on possible health-related effects. Specifically five questions are addressed: do women report poorer work characteristics than men; are gender differences related to specific characteristics; do work characteristics differ between full- and part-time women workers and between those in paid and unpaid work; are socio-economic gradients in work characteristics similar for men and women; and, if there are gradients, do they differ between women in paid and unpaid work? Analyses are based on the 33 year follow-up of the 1958 British birth cohort. Four psychosocial work characteristics were examined: learning opportunities, monotony, pace of work, and flexibility of breaks. Women reported more negative work characteristics than men, primarily because of differences in learning opportunities (26% lacked opportunity compared with 13% of men) and monotonous work (47 and 31% respectively). Women in full-time employment reported fewer negative characteristics (27%) than part-time (39%) or home-workers (36%). Home-workers had fewer opportunities for learning (36%) and greater monotony (49%) than paid workers (21 and 22% respectively), however fewer home-workers reported inability to control the work pace (11% compared to 23%) and inflexibility of breaks (21% compared to 47%). Socio-economic gradients in work characteristics were similar among men and women, except for flexibility of break times. A socio-economic gradient in work characteristics was found for full- and part-time workers, but not among home-workers. Differences in self reported health were also examined: a social gradient was found for all employment status groups, being strongest for home-workers despite the absence of a gradient in negative work characteristics. In conclusion, these marked gender differences in psychosocial work characteristics need to be considered in future research on work and health.

Studies of socioeconomic gradients in mortality in wealthy societies reveal that they have been persistent, and included most of the principal causes of death, even during the era when these principal causes of death have entirely changed. This observation has led to an interest in the ways in which the diversity of conditions of life, unfolding over the life cycle, can become embedded in human biology and subsequently affect health status and vitality. There is evidence that childhood experiences affect subsequent health status (as well as well-being and competence) in profound and long-lasting ways. Conflicting explanatory models of the impact of childhood experiences have been advanced, whose conflicts are political in nature, in that they reflect divergent beliefs about how human potential expresses itself, and, also, about the nature of the obligations which members of society have to one another. Notwithstanding these conflicts, a body of evidence derived from intervention studies in the post-neonatal, preschool, and school age periods suggest that performance in two basic domains of child development, the cognitive and the social-emotional, can be modified in ways which improve health, well-being, and competence in the long-term.

The proportion of the population in the older age groups will increase dramatically over the next four decades. Furthermore, current per capita rates of hospital and medical care utilization rise sharply with age beyond the age of about 55. However, demographic trends alone do not imply health care cost increases in excess of what is supportable by normal economic growth. A 'cost crisis' will only occur if per capita rates of utilization among the elderly increase faster than for the general population. In this paper we present some descriptive data from published sources suggesting that this has been the case over the recent past in one Canadian province. The implications for the policy debate over the effects of an aging population are discussed.