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Background: In developed countries with old age structures most deaths occur at older ages and older people account for the majority of those in poor health, which suggests a particular need to investigate health inequalities in the older population.Methods: We empirically compared the materialist, psychosocial and lifestyle/behavioural theoretical mechanisms of explanation for socio-economic variation in health using data from two waves of the English Longitudinal Study of Ageing (ELSA), a nationally representative multi-purpose sample of the population aged 50 and over living in England. Three dimensions of health were examined: somatic health, depression and well-being.Results: The materialist and lifestyle/behavioural paths had the most prominent mediating role in the association between socio-economic position and health in the older population, whereas the psychosocial pathway was less influential and exerted most of its influence on depression and well-being, with part of its effect being due to the availability of material resources.Conclusions: From a policy perspective there is therefore an indication that population interventions to reduce health differentials and thus improve the overall health of the older population should focus on material circumstances and population based interventions to promote healthy lifestyles. [ABSTRACT FROM AUTHOR]

Our primary aim is to develop and validate a population health metric for survey-based health assessment that combines information from both self-reported and observer-measured health indicators. A secondary objective is to use this index to examine gender and socioeconomic differentials in the health status of older people. We use data from the second wave of the English Longitudinal Study of Ageing (ELSA) conducted in 2004 (N = 8,870). Information from three observer-measured and three self-reported health indicators was combined, using a latent variable modeling approach. A model that decomposed the manifest health indicators to valid health, systematic error, and random error was found to fit the data best. The latent health dimension represented somatic health, and was tested against three external criteria: height, waist-hip ratio, and smoking status. We present the Latent Index of Somatic Health (LISH), as well as a procedure for deriving the LISH in surveys employing both self- and observer-measured health indicators. Observer-measured and self-reported indicators were found to be equally biased in indexing population somatic health, with the exception of self-reports of functional limitations, which was the most reliable somatic health indicator. As expected, results showed that women had worse health than men and that socioeconomic advantage is associated with better somatic health. [ABSTRACT FROM AUTHOR]

Maternal heavy alcohol use during pregnancy is harmful to offspring's health and adjustment. However, findings from studies on lower levels of prenatal drinking are mixed; a few even predict positive cognitive and psychosocial outcomes. Given that alcohol is a neurotoxin and teratogen, scholars question developmental benefits and point to residual confounding as a potential explanation, particularly as light drinkers are positively selected with respect to health and socioeconomic status. Using prospective, intergenerational data from the nationally-representative Millennium Cohort Study (MCS) in the United Kingdom, we studied associations between mother's drinking during pregnancy and children's cognitive and psychosocial outcomes at ages 3, 5, 7, 11, and 14 years (n = 10,454). We included early life confounders (e.g., maternal education, health, smoking) and mother's cognitive ability, and assessed robustness of relationships across outcomes and alternate drinking classifications. Results of a series of multivariable regression models found no association between light drinking and cognitive and psychosocial outcomes up to and including the age of 14, after controlling for key confounders. Light drinking during pregnancy was linked to higher socioeconomic advantages (e.g., mothers' higher education, professional/managerial occupation, home ownership, cognitive scores), which together accounted for positive associations between light drinking and children's outcomes. Mother's cognitive ability was an especially important confounder. [ABSTRACT FROM AUTHOR]

Purpose To examine the associations between social class at ages 0, 5, 10, 30, and 34 years and physical activity at age 34 years using a novel approach to analysis of life course data. Methods We used structural equation modeling to compare three competing models in life course epidemiology: the accumulation of risk model with additive effects, the accumulation of risk model with trigger effect, and the critical period model. Data were from a nationally representative prospective cohort of 16,571 British men and women born in 1970. Outcomes were physical activity during leisure time, during transports, and at work. Results For all three domains of physical activity, for men and women, the accumulation of risk model with additive effects fit the data best. In this model, social class at ages 0, 5, 10, 30, and 34 years were associated with physical activity at age 34 years, although the magnitude and the direction of the associations for social class at each age varied by physical activity outcome and by sex. Conclusions Structural equation modeling appears to be a helpful tool in selecting among competing models in life course epidemiology. [ABSTRACT FROM AUTHOR]