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To examine relationships among stressful life events (SLE), caregiver depression, and asthma symptom free days (SFDs) in publicly insured Black children aged 4–12 years with persistent asthma. Secondary analysis of longitudinal data from a clinical trial assessing the efficacy of a six-month parental stress management intervention. Using repeated measures Poisson regression, we constructed four models of SLE (Rochester Youth Development Stressful Life Events scale—Parent Items), caregiver depression (Center for Epidemiologic Studies Depression scale ≥ 11), and child asthma symptom-free days (SFDs) in the prior 14 days. There was no association between SLE and child SFDs, but there was for caregiver depression (Incidence Rate Ratio [IRR]: 0.904; 95% CI 0.86–0.95). The interaction between SLE and caregiver depression was not significant. A specific SLE (recent serious family accident or illness) predicted fewer child SFDs (IRR: 0.91, 95% CI: 0.85–0.98). In the interaction model between caregiver depression and recent accident/illness, caregiver depression was associated with fewer child SFDs (IRR: 0.95, 95% CI: 0.91–0.99) as was the interaction between caregiver depression and recent accident/illness (IRR: 0.77, 95% CI 0.66–0.91); but the relationship between recent accident/illness and child SFDs was not (IRR: 1.00, 95% CI, 0.92–1.09), meaning accident/illness was only associated with fewer child SFDs among depressed caregivers. In a sample of publicly insured Black children with persistent asthma, caregiver depression was negatively associated with child SFDs while overall SLE were not. A recent family accident or illness was negatively associated with child SFDs only when the caregiver was depressed. [ABSTRACT FROM AUTHOR]

Objectives We examine whether adults aged 45 and older lacking a partner and children are disadvantaged in terms of physical, mental, and social aspects of health. Then we test whether the importance of family structure for these outcomes varies by age, gender, and educational attainment. Methods We examine aging and social network modules from the Canadian General Social Survey to estimate associations between family structure and physical, mental, and social health, with the last measured as communication with relatives and friends, civic participation, and loneliness. Results Results show that middle-aged and older adults without partners have lower levels of physical and mental health and higher levels of loneliness than those with partners. Those without partners and children (the "kinless") interact less with relatives than those who have children but not partners, but more with friends, showing some substitution. In terms of civic participation, kinless middle-aged and older adults have significantly lower odds of this type of engagement than peers with close kin. Our interaction models find some differences by age, gender, and education, which vary by the outcome. Discussion Our results highlight some concerns about the well-being of kinless adults in Canada, especially as related to physical and mental health and two aspects of social health, loneliness, and civic participation. We find some substitution occurring, whereby middle-aged and older adults without family are interacting more with friends than comparable peers, but such substitution is marginal. [ABSTRACT FROM AUTHOR]

Objectives The coronavirus disease 2019 (COVID-19) pandemic has left older adults around the world bereaved by the sudden death of relatives and friends. We examine if COVID-19 bereavement corresponds with older adults' reporting depression in 27 countries and test for variations by gender and country context. Method We analyze the Survey of Health, Ageing and Retirement in Europe COVID-19 data collected between June and August 2020 from 51,383 older adults (age 50–104) living in 27 countries, of whom 1,363 reported the death of a relative or friend from COVID-19. We estimate pooled multilevel logit regression models to examine if COVID-19 bereavement is associated with self-reported depression and worsening depression, and we test whether national COVID-19 mortality rates moderate these associations. Results COVID-19 bereavement is associated with significantly higher probabilities of both reporting depression and reporting worsened depression among older adults. Net of one's own personal loss, living in a country with the highest COVID-19 mortality rate is associated with women's reports of worsened depression but not men's. However, the country's COVID-19 mortality rate does not moderate associations between COVID-19 bereavement and depression. Discussion COVID-19 deaths have lingering mental health implications for surviving older adults. Even as the collective toll of the crisis is apparent, bereaved older adults are in particular need of mental health support. [ABSTRACT FROM AUTHOR]

Accurately assessing asthma medication usage among low-income, urban, African American children is essential to reduce asthma health disparities. The purpose of this study was to examine the factor structure of the five-item Medication Adherence Report Scale (MARS), in a sample of caregivers of low-income, urban, African American youth with poorly controlled asthma. Using baseline data from a randomized clinical trial evaluating the efficacy of an environmental control educational intervention, confirmatory factor analysis (CFA) was conducted to ascertain the MARS factor structure. Construct validity was assessed using a regression model inclusive of caregiver-reported medication adherence, Asthma Medication Ratio (AMR), asthma control, and caregiver perception of asthma control as predictors of the MARS. Caregivers were female (97%) and 27.4% had an annual income under $10,000. The mean MARS score was 21.88 ± 3.33 out of a possible range of 5-25, representing high adherence. Confirmatory factor analysis indicated that a five-item one-factor model marginally fit the data based on the fit indices: χ 2 (5) = 31.71, p < 0.001; RMSEA ≤ 0.161; CFI = 0.986; TLI = 0.971; and WRMR = 0.979. The MARS was associated with another caregiver-reported measure of medication adherence but not associated with AMR, asthma control, or caregiver perception of asthma control. The MARS demonstrated marginal fit in CFA and may not be clinically indicated in light of the lack of associations with objective measures of asthma medication adherence and asthma control. [ABSTRACT FROM AUTHOR]

Objectives The topic of older adult loneliness commands increasing media and policy attention around the world. Are surveys of aging equipped to measure it? We assess the measurement of loneliness in large-scale aging studies in 31 countries by describing the available measures, testing correlations between them, and documenting their construct validity. Methods We use data from several "sister studies" of aging adults around the world. In each country, we document available loneliness measures, test for measurement reliability by examining correlations between different measures of loneliness, and assess how these correlations differ by gender and age group. We then evaluate construct validity by estimating correlations between loneliness measures and theoretically hypothesized constructs related to loneliness: living alone and not having a spouse. Results There is substantial heterogeneity in available measures of loneliness across countries. Within countries with multiple measures, the correlations between measures are high (range 0.384–0.777, median 0.636). Although we find several statistically significant differences in these correlations by gender and age, the differences are small (gender: range −0.098 to 0.081, median −0.026; age group: range −0.194 to 0.092, median −0.003). Correlations between loneliness measures and living alone and being without a spouse are all positive, almost universally statistically significant, and similar in magnitude across countries, supporting construct validity. Discussion This article establishes that even single-item measures of loneliness contribute meaningful information in diverse settings. Similar to the measurement of self-rated health, there are nuances to the measurement of older adult loneliness in different contexts, but it has reliable and consistent measurement properties within many countries. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to examine whether gender equality‐focused parental benefits affect the union stability of couples. Background: Generous, flexible, and gender equality‐focused parental benefits have been shown to increase fathers' use of parental leave and time with children. Even though these policies have no explicit aims regarding relationship stability, two longstanding theoretical perspectives (traditionalist and egalitarian) offer potential mechanisms through which this type of policy can shift relationship dynamics either to increase or to decrease union dissolution. Method: Using Canadian administrative data, we estimate difference‐in‐differences and local average treatment effects to examine the effects of the Québec Parental Insurance Plan (QPIP 2006) on union dissolution. Then we examine whether the policy had heterogenous effects on couples which are likely to be either traditional or egalitarian. Results: We find that QPIP decreased the separation rate by half of a percentage point overall, a 6% decrease. The greatest reductions in union dissolution are found among couples likely to be more egalitarian in orientation. Conclusion: The large negative effects of this family policy on union dissolution are significant, as they show one clear way in which family policies can encourage egalitarianism and stabilize families during the second phase of the gender revolution. [ABSTRACT FROM AUTHOR]

Background and Objectives Although individual age and preexisting health conditions are well-documented risk factors for coronavirus disease 2019 (COVID-19) mortality, it is unclear whether these 2 factors capture unique dimensions of risk for epidemic severity at the national level. In addition, no studies have examined whether national distributions of these factors are associated with epidemic experiences to date. Research Design and Methods Drawing on surveys of older adults from 42 countries and estimated case fatality ratios by age and preexisting health conditions, we document and compare national profiles of COVID-19 mortality risks among older adults. We develop 2 measures of national risk profiles: one based on age structures and another based on distributions of preexisting health conditions. Our analysis compares these constructs and documents their associations with national COVID-19 mortality rates. Results National profiles of COVID-19 mortality risk based on age structure and preexisting health conditions are moderately uncorrelated, capturing different aspects of risk. Both types of national risk profiles correlate meaningfully with countries' COVID-19 mortality experiences to date. Discussion and Implications Measures of population age structure are readily available for every country in the world, while cross-national measures of older adult population health are more limited. In the COVID-19 crisis, these factors give different pictures of the countries with high and low risks of COVID-19 mortality. Moreover, our results suggest that both types of national risk profiles based on population health reflect current COVID-19 mortality severity in several countries, highlighting the need for more cross-national comparative data on older adult population health. [ABSTRACT FROM AUTHOR]