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This paper provides novel evidence on how a sharp increase in labor force participation among older women affects the provision of informal care to their older parents. Based on data from Understanding Society -- The UK Household Longitudinal Study, we use an instrumental variable approach that exploits a unique reform that increased the female State Pension age by up to six years. Our results provide evidence of a trade-off between the intensive margin of work and informal care provided outside the household: an increase of 10 hours of work per week reduces the provision of informal care by 2.1 hours a week, which amounts to roughly £2,100 of yearly care-hours lost. This reduction in caregiving is largest among women working in physically or psychosocially demanding jobs, and "sandwich generation" women who have both a living grandchild and a parent alive. Using data from the English Longitudinal Study of Ageing, we show that older parents whose daughters became ineligible to claim their pensions experienced a significant reduction in the amount of care they receive from their daughters, which was not compensated by an increase in formal care or other sources of support. Our results suggest that policies that increase older workers' labor supply require changes in long-term care policy that compensate for the loss of informal care.

BackgroundSingle motherhood is associated with poorer health, but whether this association varies between countries is not known. We examine associations between single motherhood and poor later-life health in the USA, England and 13 European countries.MethodsData came from 25 125 women aged 50+ who participated in the US Health and Retirement Study, the English Longitudinal Study of Ageing and Survey of Health, Ageing and Retirement in Europe. We tested whether single motherhood at ages 16-49 was associated with increased risk of limitations with activities of daily living (ADL), instrumental ADL and fair/poor self-rated health in later life.Results33% of American mothers had experienced single motherhood before age 50, versus 22% in England, 38% in Scandinavia, 22% in Western Europe and 10% in Southern Europe. Single mothers had higher risk of poorer health and disability in later life than married mothers, but associations varied between countries. For example, risk ratios for ADL limitations were 1.51 (95% CI 1.29 to 1.98) in England, 1.50 (1.10 to 2.05) in Scandinavia and 1.27 (1.17 to 1.40) in the USA, versus 1.09 (0.80 to 1.47) in Western Europe, 1.13 (0.80 to 1.60) in Southern Europe and 0.93 (0.66 to 1.31) in Eastern Europe. Women who were single mothers before age 20, for 8+ years, or resulting from divorce or non-marital childbearing, were at particular risk.ConclusionsSingle motherhood during early-adulthood or mid-adulthood is associated with poorer health in later life. Risks were greatest in England, the USA and Scandinavia. Selection and causation mechanisms might both explain between-country variation.

The recent economic recession has led to increases in suicide, but whether US state unemployment insurance programs ameliorate this association has not been examined. Exploiting US state variations in the generosity of benefit programs between 1968 and 2008, we tested the hypothesis that more generous unemployment benefit programs reduce the impact of economic downturns on suicide. Using state linear fixed-effect models, we found a negative additive interaction between unemployment rates and benefits among the US working-age (20-64 years) population (β = -0.57, 95% confidence interval: -0.86, -0.27; P < 0.001). The finding of a negative additive interaction was robust across multiple model specifications. Our results suggest that the impact of unemployment rates on suicide is offset by the presence of generous state unemployment benefit programs, though estimated effects are small in magnitude.

Background Neighborhood deprivation and depression have been linked to epigenetic age acceleration. The next-generation epigenetic clocks including the DNA methylation (DNAm) GrimAge, and PhenoAge have incorporated clinical biomarkers of physiological dysregulation by selecting cytosine–phosphate–guanine sites that are associated with risk factors for disease, and have shown improved accuracy in predicting morbidity and time-to-mortality compared to the first-generation clocks. The aim of this study is to examine the association between neighborhood deprivation and DNAm GrimAge and PhenoAge acceleration in adults, and assess interaction with depressive symptoms. Methods The Canadian Longitudinal Study on Aging recruited 51 338 participants aged 45–85 years across provinces in Canada. This cross-sectional analysis is based on a subsample of 1 445 participants at baseline (2011–2015) for whom epigenetic data were available. Epigenetic age acceleration (years) was assessed using the DNAm GrimAge and PhenoAge, and measured as residuals from regression of the biological age on chronological age. Results A greater neighborhood material and/or social deprivation compared to lower deprivation (b  = 0.66; 95% confidence interval [CI] = 0.21, 1.12) and depressive symptoms scores (b  = 0.07; 95% CI = 0.01, 0.13) were associated with higher DNAm GrimAge acceleration. The regression estimates for these associations were higher but not statistically significant when epigenetic age acceleration was estimated using DNAm PhenoAge. There was no evidence of a statistical interaction between neighborhood deprivation and depressive symptoms. Conclusions Depressive symptoms and neighborhood deprivation are independently associated with premature biological aging. Policies that improve neighborhood environments and address depression in older age may contribute to healthy aging among older adults living in predominantly urban areas. [ABSTRACT FROM AUTHOR]

PurposeWe sought to examine how different activities performed during employment gaps are associated with later cognitive function and change.MethodsFive cognitive measures were used to indicate cognitive impairment of 18,259 respondents to the Survey of Health, Ageing, and Retirement in Europe (ages 50-73) in 2004/5 or 2006/7. Using complete employment histories, employment gaps of ≥6 months between ages 25 and 65 were identified.ResultsControlling for early life socioeconomic status, school performance, and education, higher risk of cognitive impairment was associated with employment gaps described as unemployment (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.04-1.35) and sickness (OR, 1.78; 95% CI, 1.52-2.09). In contrast, lower risk of cognitive impairment was associated with employment gaps described as training (OR, 0.73; 95% CI, 0.52-1.01) or maternity leave (OR, 0.65; 95% CI, 0.57-0.79). In longitudinal mixed effects models, training and maternity leave were associated with lower 2-year aging-related cognitive decline.DiscussionPeriods away from work described as unemployment or sickness are associated with lower cognitive function, whereas maternity and training leaves are associated with better late-life cognitive function. Both causation and selection mechanisms may explain these findings.

In this commentary, invited for the 100th anniversary of the Journal , we discuss the addition of randomized experiments, along with natural experiments that emulate randomized trials using observational data, as designs in the social epidemiologist's toolbox. These approaches transform the way we define and ask questions about social exposures. They compel us to ask questions about how well-defined interventions change a social exposure that might lead to changes in health. As such, experiments are of unique public health and policy significance. We argue that they are a powerful approach to advance our understanding of how well-defined changes in social exposures impact health, and how credible social policy reforms may be instrumental to address health inequalities. We focus on two research designs. The first is a "pure" randomized controlled trial (RCT) in which the investigator defines and randomly assigns the intervention. The second is a natural experiment, which exploits the fact that policies or interventions in the real world often involve an element of random assignment, emulating an RCT. To give the reader our bottom line: While acknowledging their limits, we continue to be very excited about the promise of RCTs and natural experiments to advance social epidemiology. [ABSTRACT FROM AUTHOR]