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Several countries are expanding their paternity leave policies, which can have positive effects on parental mental health. We examined whether 2 weeks of paid paternity leave are associated with post-partum depression in mothers and fathers at 2 months after the birth of their child.We used data from the Etude Longitudinale Française depuis l'Enfance (ELFE) cohort study. Participating mothers gave birth in 2011 in a representative sample of 320 maternity hospitals in mainland France. Inclusion criteria were single or twin livebirths born after at least 33 weeks' gestation; mother's age at least 18 years; no plans to leave metropolitan France within 3 years. Mothers were interviewed face-to-face shortly after the child's birth. Fathers and mothers were both interviewed by telephone 2 months after the child's birth, reporting whether the father had the right to paternity leave and if yes, if he had taken or intended to take it. We used the Edinburgh Postnatal Depression Scale to assess post-partum depression among fathers and mothers at 2 months. Logistic regression models, using survey-weighted data and adjusted for confounders using inverse probability weights, yielded odds ratios (ORs).We included 10 975 fathers and 13 075 mothers with reported information on paternity leave and post-partum depression at 2 months in the statistical analyses. Fathers had a median age of 32·6 years (IQR 36·9-22·6) and mothers had a median age of 30·5 years (34·0-27·1) at the time of the ELFE child's birth. The prevalence of depression in fathers according to paternity leave status was 4·5% among those who used paternity leave, 4·8% among those who intended to use paternity leave, and 5·7% among those who did not use paternity leave. For mothers, the prevalence of post-partum depression was 16·1% among those whose partner used paternity leave, 15·1% among those whose partner intended to use paternity leave, and 15·3% among those whose partner did not use paternity leave. Fathers who took paternity leave had reduced odds of post-partum depression (OR 0·74 [95% CI 0·70-0·78]) as did fathers who intended to take paternity leave (0·76 [0·70-0·82]) compared with fathers who did not take paternity leave. However, we did not find such beneficial effects for mothers whose partners took (1·13 [1·05-1·20]) or intended to take paternity leave (1·02 [0·96-1·08]).Taking and intending to take 2-weeks' paid paternity leave was associated with a reduced likelihood of reporting post-partum depression in fathers. However, offering 2-weeks' paternity leave might place mothers at a greater risk of post-partum depression, suggesting that optimal length and timing of the leave, among other factors, need further investigation.The French National Research Agency.

A growing body of research suggests that adult child educational attainment benefits older parents’ cognitive outcomes via financial (e.g., direct monetary transfers) and nonfinancial (e.g., psychosocial) mechanisms. Quasi-experimental studies are needed to circumvent confounding bias. No such quasi-experimental studies have been completed in higher-income countries, where financial transfers from adult children to aging parents are rare. Using data on 8,159 adults aged ≥50 years in the Survey for Health, Aging and Retirement in Europe (2004/2005), we leveraged changes in compulsory schooling laws as quasi-experiments. Each year of increased schooling among respondents’ oldest children was associated with better verbal fluency (β = 0.07, 95% CI: 0.02, 0.12) scores; overall associations with verbal memory scores were null, with mixed and imprecise evidence of association in models stratified by parent gender. We also evaluated associations with psychosocial outcomes as potentially important mechanisms. Increased schooling among respondents’ oldest children was associated with higher quality-of-life scores and fewer depressive symptoms. Our findings present modest albeit inconsistent evidence that increases in schooling may have an “upward” influence on older parents’ cognitive performance even in settings where financial transfers from adult children to their parents are uncommon. Associations with parents’ psychosocial outcomes were more robust.

BACKGROUND Low birthweight and preterm birth are associated with an increased risk of neonatal death and chronic conditions across the life course. Reducing these adverse birth outcomes is a global public health priority and requires strategies to improve health care during pregnancy. We aimed to assess the effect of a Swiss health policy expansion fully covering illness-related costs during pregnancy on health outcomes in newborn babies. METHODS We implemented a quasi-experimental difference in regression discontinuity design to assess the effect of expansion of Swiss health insurance (on March 1, 2014), to fully cover health-care costs during pregnancy and 8 weeks postpartum, on neonatal outcomes. Before this reform, only costs specific to the standard monitoring of a normal pregnancy were covered. Babies born before March 1, 2014, and their mothers were assigned to the unexposed group, and babies born on or after March 1, 2014, and their mothers were assigned to the exposed group. We included nearly all children born 2011-19 in Switzerland within a period of 9 months around the date March 1, 2014, and control years 2012, 2016, and 2018. Outcomes were birthweight, low birthweight, very low birthweight, gestational age, preterm or extremely preterm birth, and neonatal death. We estimated the intention-to-treat effect of the policy using parametric regression models. FINDINGS 61 910 children were born 9 months before and 63 991 were born 9 months after March 1, 2014. 382 861 children were born in the same time period around the three control dates. In the period before policy implementation, mean birthweight was 3289 g, gestational age was 275 days, and 6·5% of children had low birthweight, 1·0% very low birthweight, 7·1% were preterm, 0·4% were extremely preterm, and 0·3% died within the first 28 days of life. After initiation of the policy (vs before) mean birthweight increased by 23 g (95% CI 5 to 40) and the predicted proportion of low birthweight births decreased by 0·81% (0·14 to 1·48) and of very low birthweight births decreased by 0·41% (0·17 to 0·65). The effect on very low birthweight was not robust in sensitivity analyses. The policy had a negligible effect on gestational age (mean difference 1 day, 95% CI 0 to 1) and no clear effects on the other examined outcomes. The change in predicted proportion for preterm births was -0·39% (95% CI -1·2 to 0·38), for extremely preterm births was -0·09% (-0·27 to 0·08), and for neonatal death was -0·07% (-0·2 to 0·07). INTERPRETATION Free access to prenatal care in Switzerland reduced the risk of some adverse health outcomes in newborn babies. Expanding health-care coverage is a relevant health system intervention to reduce the risk of adverse health outcomes in the newborn baby and, potentially, across the life course. FUNDING Swiss National Science Foundation.

Income, schooling, and healthcare are key ingredients for health, but most government programs that are designed to provide these social benefits are difficult to access. While many Americans struggle to pay taxes, few understand how difficult it can be for needy Americans to enroll in public social benefits such as Temporary Assistance for Needy Families (one of many income support programs), Pell grants (one of many tuition assistance programs), or Medicaid (one of many public health insurance programs). Perhaps because such programs are difficult to enroll in, only a fraction of needy families receive the social benefits to which they are entitled. That percentage is smaller for those most in need (e.g., those with disabilities or caregiving responsibilities). In this editorial, we discuss a novel method for improving health while also improving privacy, reducing fraud, and improving data system compatibility. Specifically, we propose a digital identity card that allows for the creation of a “digital republic” in which enrollment in social benefits can be automated, and the benefits can be targeted to those most in need. While there are large potential population health and health disparities benefits that could arise from a digital republic, more empirical work is needed to understand the extent to which nations have benefited from digital identity programs in the past and the political economy associated with implementing such programs.

In this commentary invited for the 100th anniversary of AJE, 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 one 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.

IntroductionThe UK private rental housing market has poorer quality housing compared with other sectors and is subjected to calls for better regulation. Poor quality housing poses risks to mental and physical health, and housing improvement can potentially benefit health and well-being. Local authorities have powers to implement selective licencing (SL) schemes in specific localities. Such schemes involve landlord registration, payment of licence fees, local authority inspection and requirements that landlords conduct any necessary renovation works to ensure housing standards are met. We aim to evaluate SL in Greater London and to test the feasibility of a national evaluation.Methods and analysisWe will measure individual-level and area-level impacts of SL in Greater London between 2011 and 2019. A difference-in-differences approach with propensity score-matched controls will be used. We propose to exploit data from the Annual Population Survey (APS) and health and social benefit registers to measure mental health and well-being at individual (self-reported anxiety) and area (Small Area Mental Health Index) level. We estimate 633 APS participants in our intervention groups compared with 1899 participants in control areas (1:3 ratio of intervention to control). Secondary outcomes will be self-reported well-being and residential stability at the individual level and incidence of police-recorded antisocial behaviour calls and population turnover at the area level. The study size of the area-level analyses will be 3684 lower layer super output areas (including controls). Qualitative semistructured interviews with lead implementers in several London boroughs will produce insights into variations and commonalities between schemes.Ethics and disseminationEthical approval was obtained from London School of Hygiene and Tropical Medicine’s Ethics Committee (reference number 26481) and London Borough of Hackney. All interviewees will be asked for informed written consent. Study findings will be published in a peer-reviewed journal.

Antipoverty policies may hold promise as tools to improve health and reduce mortality rates among low-income Americans. We examined the health effects of the New York City Paycheck Plus randomized controlled trial. Paycheck Plus tests the impact of a potential fourfold increase in the Earned Income Tax Credit for low-income Americans without dependent children. Starting in 2015, Paycheck Plus offered 5,968 study participants a credit of up to $2,000 at tax time (treatment) or the standard credit of about $500 (control). Health-related quality of life and other outcomes for a representative subset of these participants (n = 3,289) were compared to those of a control group thirty-two months after randomization. The intervention had a modest positive effect on employment and earnings, particularly among women. It had no effect on health-related quality of life for the overall sample, but women realized significant improvements.

Policy Points Social policies might not only improve economic well-being, but also health. Health policy experts have therefore advocated for investments in social policies both to improve population health and potentially reduce health system costs. Since the 1960s, a large number of social policies have been experimentally evaluated in the United States. Some of these experiments include health outcomes, providing a unique opportunity to inform evidence-based policymaking. Our comprehensive review and meta-analysis of these experiments find suggestive evidence of health benefits associated with investments in early life, income support, and health insurance interventions. However, most studies were underpowered to detect health outcomes. CONTEXT: Insurers and health care providers are investing heavily in nonmedical social interventions in an effort to improve health and potentially reduce health care costs. METHODS: We performed a systematic review and meta-analysis of all known randomized social experiments in the United States that included health outcomes. We reviewed 5,880 papers, reports, and data sources, ultimately including 61 publications from 38 randomized social experiments. After synthesizing the main findings narratively, we conducted risk of bias analyses, power analyses, and random-effects meta-analyses where possible. Finally, we used multivariate regressions to determine which study characteristics were associated with statistically significant improvements in health outcomes. FINDINGS: The risk of bias was low in 17 studies, moderate in 11, and high in 33. Of the 451 parameter estimates reported, 77% were underpowered to detect health outcomes. Among adequately powered parameters, 49% demonstrated a significant health improvement, 44% had no effect on health, and 7% were associated with significant worsening of health. In meta-analyses, early life and education interventions were associated with a reduction in smoking (odds ratio [OR] = 0.92, 95% confidence interval [CI] 0.86-0.99). Income maintenance and health insurance interventions were associated with significant improvements in self-rated health (OR = 1.20, 95% CI 1.06-1.36, and OR = 1.38, 95% CI 1.10-1.73, respectively), whereas some welfare-to-work interventions had a negative impact on self-rated health (OR = 0.77, 95% CI 0.66-0.90). Housing and neighborhood trials had no effect on the outcomes included in the meta-analyses. A positive effect of the trial on its primary socioeconomic outcome was associated with higher odds of reporting health improvements. We found evidence of publication bias for studies with null findings. CONCLUSIONS: Early life, income, and health insurance interventions have the potential to improve health. However, many of the included studies were underpowered to detect health effects and were at high or moderate risk of bias. Future social policy experiments should be better designed to measure the association between interventions and health outcomes.

Publisher Copyright: Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. BACKGROUND: Few studies have examined the interactions between individual socioeconomic position and neighbourhood deprivation and the findings so far are heterogeneous. Using a large sample of diverse cohorts, we investigated the interaction effect of neighbourhood socioeconomic deprivation and individual socioeconomic position, assessed using education, on mortality. METHODS: We did a longitudinal multicohort analysis that included six cohort studies participating in the European LIFEPATH consortium: the CoLaus (Lausanne, Switzerland), E3N (France), EPIC-Turin (Turin, Italy), EPIPorto (Porto, Portugal), Melbourne Collaborative Cohort Study (Melbourne, VIC, Australia), and Whitehall II (London, UK) cohorts. All participants with data on mortality, educational attainment, and neighbourhood deprivation were included in the present study. The data sources were the databases of each cohort study. Poisson regression was used to estimate the mortality rates and associations (relative risk, 95% CIs) with neighbourhood deprivation (Q1 being least deprived to Q5 being the most deprived). Baseline educational attainment was used as an indicator of individual socioeconomic position. Estimates were combined using pooled analysis and the relative excess risk due to the interaction was computed to identify additive interactions. FINDINGS: The cohorts comprised a total population of 168 801 individuals. The recruitment dates were 2003-06 for CoLaus, 1989-91 for E3N, 1992-98 for EPIC-Turin, 1999-2003 for EPIPorto, 1990-94 for MCCS, and 1991-94 for Whitehall II. We use baseline data only and mortality data obtained using record linkage. Age-adjusted mortality rates were higher among participants residing in more deprived neighbourhoods than those in the least deprived neighbourhoods (Q1 least deprived neighbourhoods, 369·7 per 100 000 person-years [95% CI 356·4-383·2] vs Q5-most deprived neighbourhoods 445·7 per 100 000 person-years [430·2-461·7]), but the magnitude of the association varied according to educational attainment (relative excess risk due to interaction=0·18, 95% CI 0·08-0·28). The relative risk for Q5 versus Q1 was 1·31 (1·23-1·40) among individuals with primary education or less, but less pronounced among those with secondary education (1·12; 1·04-1·21) and tertiary education (1·16; 1·07-1·27). Associations remained after adjustment for individual-level factors, such as smoking, physical activity, and alcohol intake, among others. INTERPRETATION: Our study suggests that the detrimental health effect of living in disadvantaged neighbourhoods is more pronounced among individuals with low education attainment, amplifying social inequalities in health. This finding is relevant to policies aimed at reducing health inequalities, suggesting that these issues should be addressed at both the individual level and the community level. FUNDING: The European Commission, European Regional Development Fund, the Portugese Foundation for Science and Technology.

ObjectivesTo assess primary impact of selective Licensing (SL), an area-based intervention in the private rented housing market, on individual self-reported anxiety and neighbourhood mental health (MHI—Mental Healthcare Index) and secondary impacts on antisocial behaviour (ASB), population turnover and self-reported well-being.DesignDifference-in-difference (DiD) was used to evaluate effects of SL schemes initiated 2012–2018. 921 intervention areas (lower super output areas) were matched 3:1 using propensity scores derived from sociodemographic and housing variables (N=3.684 including controls). Average treatment effect on treated (ATT) was calculated for multiple time period DiD in area-level analyses. Canonical DiD was used for individual-level analysis by year of treatment initiation while adjusting for age, sex, native birth and occupational class.SettingIntervention neighbourhoods and control areas in Greater London, UK, 2011–2019.ParticipantsWe sampled 4474 respondents renting privately in intervention areas (N=17 347 including controls) in Annual Population Survey and obtained area-level MHI population data.InterventionsPrivate landlords in SL areas must obtain a licence from the local authority, allow inspection and maintain minimum housing standards.ResultsATT after 5 years was significantly lower for MHI (−7.5%, 95% CI −5.6% to −8.8%) than controls. Antidepressant treatment days per population reduced by −5.4% (95% CI −3.7% to −7.3), mental health benefit receipt by −9.6% (95% CI −14% to −5.5%) and proportion with depression by −12% (95% CI −7.7% to −16.3%). ASB reduced by −15% (95% CI −21% to −8.2%). Population turnover increased by 26.5% (95% CI 22.1% to 30.8%). Sensitivity analysis suggests overlap with effects of London 2012 Olympic regeneration. No clear patterns were observed for self-reported anxiety.ConclusionsWe found associations between SL and reductions in area-based mental healthcare outcomes and ASB, while population turnover increased. A national evaluation of SL is feasible and necessary.

A Perspective on 'A Machine-Generated View of the Role of Blood Glucose Levels in the Severity of COVID-19' by Logette E, Lorin C, Favreau C, Oshurko E, Coggan JS, Casalegno F, Sy MF, Monney C, Bertschy M, Delattre E, Fonta P-A, Krepl J, Schmidt S, Keller D, Kerrien S, Scantamburlo E, Kaufmann A-K and Markram H (2021). Front. Public Health. 2:27. doi: 10.3389/fpubh.2021.695139

Adverse childhood experiences (ACE) are associated with key risk factors for adult morbidity and mortality. Most interventions to date target proximal risk factors and do not account for the structural determinants shaping the risk of childhood adversity. This review summarizes recent findings regarding the impact of socioeconomic interventions on ACE. Thirty-five percent of reviewed socioeconomic interventions reported reductions in exposure to ACE. Effect sizes were modest for family financial problems, adverse parenting, household mental illness, child maltreatment and neglect; moderate to high for exposure to domestic violence, Home score, parental separation, childhood physical abuse and household criminality; and strongest for childhood victimization and substance abuse. Housing, conditional cash transfer and income supplementation interventions were the most promising interventions. Current evidence suggests that upstream interventions can contribute to the reduction of ACE. Future research should expand this work beyond developed countries using robust evaluation designs.

Antipoverty policies have the potential to improve mental health. We conducted a randomized trial (Paycheck Plus Health Study Randomized Controlled Trial, New York, New York) to investigate whether a 4-fold increase in the Earned Income Tax Credit for low-income Americans without dependent children would reduce psychological distress relative to the current federal credit. Between 2013 and 2014, a total of 5,968 participants were recruited; 2,997 were randomly assigned to the treatment group and 2,971 were assigned to the control group. Survey data were collected 32 months postrandomization (n = 4,749). Eligibility for the program increased employment by 1.9 percentage points and after-bonus earnings by 6% ($635/year), on average, over the 3 years of the study. Treatment was associated with a marginally statistically significant decline in psychological distress, as measured by the 6-item Kessler Psychological Distress Scale, relative to the control group (score change = −0.30 points, 95% confidence interval (CI): −0.63, 0.03; P = 0.072). Women in the treated group experienced a half-point reduction in psychological distress (score change = −0.55 points, 95% CI: −0.97, −0.13; P = 0.032), and noncustodial parents had a 1.36-point reduction (95% CI: −2.24, −0.49; P = 0.011). Expansion of a large antipoverty program to individuals without dependent children reduced psychological distress for women and noncustodial parents—the groups that benefitted the most in terms of increased after-bonus earnings.

Background Parental leave policies have been hypothesized to benefit mothers’ mental health. We assessed the impact of a 6-week extension of parental leave in Denmark on maternal mental health. Methods We linked individual-level data from Danish national registries on maternal sociodemographic characteristics and psychiatric diagnoses. A regression discontinuity design was applied to study the increase in parental leave duration after 26 March 1984. We included women who had given birth between 1 January 1981 and 31 December 1987. Our outcome was a first psychiatric diagnosis following the child’s birth, ascertained as the first day of inpatient hospital admission for any psychiatric disorder. We presented cumulative incidences for the 30-year follow-up period and reported absolute risk differences between women eligible for the reform vs not, in 5-year intervals. Results In all, 291 152 women were followed up until 2017, death, emigration or date of first psychiatric diagnosis. The median follow-up time was 29.99 years, corresponding to 10 277 547 person-years at risk. The cumulative incidence of psychiatric diagnoses at 30 years of follow-up was 59.5 (95% CI: 57.4 to 61.6) per 1000 women in the ineligible group and 57.5 (95% CI: 55.6 to 59.4) in the eligible group. Eligible women took on average 32.85 additional days of parental leave (95% CI: 29.20 to 36.49) and had a lower probability of having a psychiatric diagnosis within 5 years [risk difference (RD): 2.4 fewer diagnoses per 1000 women, 95% CI: 1.5 to 3.2] and up to 20 years after the birth (RD: 2.3, 95% CI: 0.4 to 4.2). In subgroup analyses, the risk reduction was concentrated among low-educated, low-income and single women. Conclusions Longer parental leave may confer mental health benefits to women, in particular to those from disadvantaged backgrounds.

In this quasiexperimental study, we examined whether the introduction of an age-friendly transportation policy-free bus passes for older adults-increased public transport use and in turn affected cognitive function among older people in England. Data came from 7 waves (2002-2014) of the English Longitudinal Study of Ageing (n = 17,953), which measured total cognitive function, memory, executive function, and processing speed before and after the bus pass was introduced in 2006. The analytical strategy was an instrumental-variable approach with fixed effects, which made use of the age-eligibility criteria for free bus passes and addressed bias due to reverse causality, measurement error, and time-invariant confounding. Eligibility for the bus pass was associated with a 7% increase in public transport use. The increase in public transportation use was associated with a 0.346 (95% confidence interval: 0.017, 0.674) increase in the total cognitive function z score and with a 0.546 (95% confidence interval: 0.111, 0.982) increase in memory z score. Free bus passes were associated with an increase in public transport use and, in turn, benefits to cognitive function in older age. Public transport use might promote cognitive health through encouraging intellectually, socially, and physically active lifestyles. Transport policies could serve as public health tools to promote cognitive health in aging populations. © The Author(s) 2019. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Less schooling is associated with increased biological risks for chronic disease, but whether increasing years of schooling through policy interventions reduces these risks remains unclear. We examine the effect of a major education reform introduced in 1959 that raised the minimum school leaving age from 14 to 16 years in France, offering a unique natural experiment. We assess the causal impact of increased schooling duration on 16 biomarkers of cardiovascular, metabolic, organ and immune function in a large cohort of men and women born around 1953. Using a Regression Discontinuity Design, we find that the reform led to a significant increase in schooling duration among children from disadvantaged families; but longer schooling did not translate into better biomarker profiles in adulthood. Eligibility to the reform had no impact on the biomarker profile of respondents from intermediate or high social class families, while it led to increased blood pressure and white cells counts in adulthood among those from low parental social class. These findings were robust across several sensitivity analyses. They emphasize the importance of considering the institutional context and the respondents' social origins when evaluating the health effects of compulsory schooling reforms. Our results do not necessarily question the premise that education leads to better health, but they suggest that law-mandated increases in schooling alone may not improve the health of disadvantaged groups.

BackgroundLonger schooling is associated with better physical, mental and cognitive functioning, but there is controversy as to whether these associations are causal. We examine the long-term health impact of a policy that increased compulsory schooling by 2 years in France for cohorts born on or after January 1953, offering a natural experiment.MethodsData came from Constances, a randomly selected cohort of the French population assessed for cognition, depressive symptoms and physical functioning at ages 45 and older (n=18 929). We use a Regression Discontinuity Design to estimate the impact of increased schooling duration on health. Cognition was measured based on five validated neuropsychological tests and combined into an overall score. The Center for Epidemiological Studies Depression scale was used to assess depressive symptoms levels. Physical functioning was included as finger tapping, hand grip strength and walking speed.ResultsThe reform increased average schooling, particularly among participants from disadvantaged families. Estimates suggest that for men, this reform improved cognitive scores (β=0.15, 95% CI 0.02 to 0.27), but had no impact on physical functioning. Among women, the reform did not increase cognitive scores or physical functioning but led to higher levels of depressive symptoms (β=1.52, 95% CI 0.32 to 2.72). Results were robust to a range of sensitivity analyses.ConclusionThese findings highlight the need to carefully consider the potential limits of policies that increase the length of compulsory schooling as strategies to improve population health.

Opportunity NYC-Family Rewards was the first conditional cash transfer, randomized controlled trial for low-income families in the United States. From 2007 to 2010, Family Rewards offered 2,377 New York City families cash transfers that were conditional upon their investments in education, preventive health care, and parental employment. Their health and other outcomes were compared to those of a control group of 2,372 families. The experiment led to a modest improvement in health insurance coverage and a large increase in the use of preventive dental care. It improved parents' perception of their own health and levels of hope, mainly through improvements in reported financial well-being. While the program's impacts on physical health were weaker, our study might not have captured effects on chronic disease risk that take longer to accrue. In the context of New York City's operating social-safety-net programs, conditional cash transfers may have led to positive, albeit modest, improvements in the health of poor families.

Homeownership is consistently associated with better mental health, but whether becoming a homeowner in later in life has positive psychological benefits has not, to our knowledge, been examined. We assessed whether acquiring a home after age 50 years was associated with depression in a representative sample of older US adults. We used individual fixed-effects models based on data from 20,524 respondents aged ≥50 years from the Health and Retirement Study, who were interviewed biennially during 1993-2010. Depressive symptoms were measured using the 8-item Center for Epidemiologic Studies Depression Scale. Controlling for confounders, becoming a homeowner in later life predicted a decline in depressive symptoms in the same year (β = -0.0768, 95% confidence interval (CI): -0.152, -0.007). The association remained significant after 2 years (β = -0.0556, 95% CI: -0.134, -0.001) but weakened afterward. Buying a home for reasons associated with positive characteristics of the new house or neighborhood drove this association (β = -0.426, 95% CI: -0.786, -0.066), while acquiring a home for reasons associated with characteristics of the previous home or neighborhood, the desire to be closer to relatives, downsizing, or upsizing did not predict mental health improvements. Findings suggest that there are small but significant benefits for mental health associated with acquiring a home in older age.

Background Urbanization and ageing have important implications for public mental health and well-being. Cities pose major challenges for older citizens, but also offer opportunities to develop, test, and implement policies, services, infrastructure, and interventions that promote mental well-being. The MINDMAP project aims to identify the opportunities and challenges posed by urban environmental characteristics for the promotion and management of mental well-being and cognitive function of older individuals. Methods MINDMAP aims to achieve its research objectives by bringing together longitudinal studies from 11 countries covering over 35 cities linked to databases of area-level environmental exposures and social and urban policy indicators. The infrastructure supporting integration of this data will allow multiple MINDMAP investigators to safely and remotely co-analyse individual-level and area-level data. Individual-level data is derived from baseline and follow-up measurements of ten participating cohort studies and provides information on mental well-being outcomes, sociodemographic variables, health behaviour characteristics, social factors, measures of frailty, physical function indicators, and chronic conditions, as well as blood derived clinical biochemistry-based biomarkers and genetic biomarkers. Area-level information on physical environment characteristics (e.g. green spaces, transportation), socioeconomic and sociodemographic characteristics (e.g. neighbourhood income, residential segregation, residential density), and social environment characteristics (e.g. social cohesion, criminality) and national and urban social policies is derived from publically available sources such as geoportals and administrative databases. The linkage, harmonization, and analysis of data from different sources are being carried out using piloted tools to optimize the validity of the research results and transparency of the methodology. Discussion MINDMAP is a novel research collaboration that is combining population-based cohort data with publicly available datasets not typically used for ageing and mental well-being research. Integration of various data sources and observational units into a single platform will help to explain the differences in ageing-related mental and cognitive disorders both within as well as between cities in Europe, the US, Canada, and Russia and to assess the causal pathways and interactions between the urban environment and the individual determinants of mental well-being and cognitive ageing in older adults. © The Author(s). 2018 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

The health and well-being consequences of social isolation and loneliness in old age are increasingly being recognised. The purpose of this scoping review was to take stock of the available evidence and to highlight gaps and areas for future research. We searched nine databases for empirical papers investigating the impact of social isolation and/or loneliness on a range of health outcomes in old age. Our search, conducted between July and September 2013 yielded 11,736 articles, of which 128 items from 15 countries were included in the scoping review. Papers were reviewed, with a focus on the definitions and measurements of the two concepts, associations and causal mechanisms, differences across population groups and interventions. The evidence is largely US-focused, and loneliness is more researched than social isolation. A recent trend is the investigation of the comparative effects of social isolation and loneliness. Depression and cardiovascular health are the most often researched outcomes, followed by well-being. Almost all (but two) studies found a detrimental effect of isolation or loneliness on health. However, causal links and mechanisms are difficult to demonstrate, and further investigation is warranted. We found a paucity of research focusing on at-risk sub-groups and in the area of interventions. Future research should aim to better link the evidence on the risk factors for loneliness and social isolation and the evidence on their impact on health.

The Centre for Epidemiologic Studies of Depression (CES-D) and the Euro-D are commonly used depressive symptom scales but their comparability has not been assessed to date. This article aims to contribute to the literature comparing the drivers of depression in old age across countries by examining whether CES-D (in its eight-item short version) and Euro-D are comparable. Data from the Survey of Health, Ageing and Retirement in Europe (SHARE, N = 15,487) covering 13 countries was used to examine the scales' distributional properties, systematic differences between population subgroups, sensitivity and specificity, and associations with established risk factors for depression in old age. CES-D and Euro-D were strongly correlated (r = 0.6819, p

Using data from the nationally representative Consultants des Centres d'Examens de Santé (CONSTANCES) study in France (2012-2014; n = 67,057), we assessed the relationship between intergenerational socioeconomic mobility and adult depression (Center for Epidemiological Studies-Depression Scale scores of ≥16 in men or ≥20 in women) and antidepressant use. Socioeconomic position was ascertained by occupational grade (childhood: maternal and paternal measures prior to age 15 years combined; adulthood: participant's own). We used logistic regression models adjusted for sociodemographic characteristics, parental history of psychiatric disorders and suicide, health behaviors, and chronic health problems. Compared with the reference group (persistently high socioeconomic circumstances), participants in other groups had elevated levels of depression (for upward mobility, multivariate odds ratios (OR) = 1.21; intermediate socioeconomic position, 1.28; downward mobility, 1.66; persistently low socioeconomic position, 1.82). Downward mobility and persistently low socioeconomic position were also associated with elevated odds of antidepressant use (for downward mobility, multivariate OR = 1.24; for persistently low socioeconomic position, 1.36). In supplementary analyses, the association of socioeconomic mobility with depression was stronger in women than in men and among younger participants (aged 18-29 years) than among older participants. Factors that contribute to depression risk and socioeconomic inequalities in this area appeared to be at play already in childhood; this should be acknowledged by clinicians and policymakers.

Les etudes disponibles dans plusieurs pays et les quelques donnees obtenues recemment en France suggerent que les consequences du chomage sur la sante vont bien au-dela de l’augmentation de la frequence des suicides. L’incidence des pathologies chroniques, maladies cardiovasculaires et cancers en premier lieu, semble egalement fortement augmentee chez les chomeurs par rapport aux travailleurs. Les mecanismes par lesquels le chomage est susceptible de degrader l’etat de sante sur le long terme sont encore a eclaircir : exposition accrue a des facteurs de risque comportementaux, acces reduit au systeme de soins, effets organiques plus directs sont autant de pistes possibles. D’ores et deja, il serait souhaitable que le corps medical soit sensibilise sur les risques encourus par les chomeurs afin de les aider a les reduire autant que faire se peut.

Background At a time when health and social care services in European countries are under pressure to contain or cut costs, informal carers are relied upon as the main providers of long-term care. However, still little is known about the availability of direct and indirect support for informal carers across the European Union. Methods Primary data collection in all EU member states was supplemented with an extensive review of the available literature. Results Various forms and levels of support have been implemented across Europe to facilitate the role of informal caregivers. Financial support is the most common type of support provided, followed by respite care and training. Most countries do not have a process in place to systematically identify informal carers and to assess their needs. Policies are often at an early stage of development and the breadth of support varies significantly across the EU. Conclusions Policy developments are uneven across the member states, with some countries having mechanisms in place to assess the needs and support informal carers while others are only starting to take an interest in developing support services. Given the unprecedented challenges posed by population ageing, further research and better data are needed to capture and monitor information on informal carers, to help design adequate support policies and eventually to evaluate their impact across the EU.

Aim: To examine whether late-career job loss increased depression among older workers approaching retirement in the USA and Europe. Methods: Longitudinal data came from the Health and Retirement Survey and the Survey of Health, Ageing, and Retirement in Europe. Workers aged 50 to 64 years in 13 European countries and the USA were assessed biennially from 2006 to 2010. Individual fixed effects models were used to test the effect of job loss on depressive symptoms, controlling for age, sex, physical health, initial wealth and socio-demographic factors. Results: Job loss was associated with a 4.78% [95% confidence interval (CI): 0.823% to 8.74%] increase in depressive symptoms in the USA compared with a 3.35% (95% CI: 0.486% to 6.22%) increase in Europe. Job loss due to a worker’s unexpected firm closure increased depression scores in both the USA (beta ¼28.2%, 95% CI: 8.55% to 47.8%) and Europe (beta ¼7.50%, 95% CI: 1.25% to 13.70%), but pooled models suggested significantly stronger effects for US workers (P

Studies have linked home ownership with health at older ages, but few studies have summarized entire housing histories and tested their links to health at older ages. This paper uses residential life history data from the Survey of Health, Ageing and Retirement in Europe (SHARE) with annual housing information from age 15 up until age 60 (renting or owning in a rural or urban region) for more than 10,000 older men and women. We use sequence analyses to identify types of previous housing histories and investigate their links to health functioning (physical, affective and cognitive functioning). Findings suggest that the positive association between home ownership and health is restricted to urban regions, and that it is more pronounced for individuals who acquired a home after an episode of renting. We discuss potential explanations, specifically, the role of housing histories for later socioeconomic circumstances.

Background Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs). We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs. Methods We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review. Results Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors. Conclusions This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed quantitative and qualitative approaches. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1853-0) contains supplementary material, which is available to authorized users.

Housing quality has a positive impact on older people’s physical health. However, few studies have examined how specific national-level policies to improve the quality of housing for older people influence their mental health. The Winter Fuel Payment (WFP) is a universal, unconditional cash transfer ranging from £200 to £300. The policy was introduced in 1997 to fight excess winter mortality in old age by providing people aged 60 and over financial support towards the cost of fuel during winter months. Over 12 million people received the benefit in 2017. This paper uses six waves of the English Longitudinal Study of Ageing (ELSA – 2002 to 2015, N=17,235) to examine the mental health effect of the subsidy. Applying individual fixed-effects models, we show that the WFP subsidy leads to a significant reduction in depressive symptoms among older people in the UK. In particular, becoming eligible to WFP is associated with a significant decrease in depressive symptoms levels (beta = -0.07; 95% CI: -0.12, -0.02). Our findings indicate that policies providing financial support to older people to maintain their housing quality have the potential to improve mental health.

Several approaches based on the sol-gel process have been developed to synthesize YSZ (ZrO2-8%Y2O3) films with controlled porosities and thickness. Thick monolayer (> 10 µm) was obtained from a powder charged polymeric sol using the dip-coating process. This film exhibited porosities after a heat treatment at 1300{degree sign}C during 4 hours in air. These porosities are related to the decomposition of carbonate species formed during the heat-treatment. Dense films with a thickness ranging from 1 to 5 μm were synthesized via the deposition (spin-coating and dip-coating) of a solution containing YSZ nanoparticles. The calcinations temperature influences the films' density and porosity. YSZ films were synthesized on anode support (Ni-YSZ/YSZ) in order to evaluate the microstructure of these films in real fuel cell.

The Centre for Epidemiologic Studies of Depression (CES‐D) and the Euro‐D are commonly used depressive symptom scales but their comparability has not been assessed to date. This article aims to contribute to the literature comparing the drivers of depression in old age across countries by examining whether CES‐D (in its eight‐item short version) and Euro‐D are comparable. Data from the Survey of Health, Ageing and Retirement in Europe (SHARE, N = 15,487) covering 13 countries was used to examine the scales’ distributional properties, systematic differences between population subgroups, sensitivity and specificity, and associations with established risk factors for depression in old age. CES‐D and Euro‐D were strongly correlated (r = 0.6819, p

Stigma and social exclusion related to mental health are of substantial public health importance for Europe. As part of ROAMER (ROAdmap for MEntal health Research in Europe), we used systematic mapping techniques to describe the current state of research on stigma and social exclusion across Europe. Findings demonstrate growing interest in this field between 2007 and 2012. Most studies were descriptive (60%), focused on adults of working age (60%) and were performed in Northwest Europe—primarily in the UK (32%), Finland (8%), Sweden (8%) and Germany (7%). In terms of mental health characteristics, the largest proportion of studies investigated general mental health (20%), common mental disorders (16%), schizophrenia (16%) or depression (14%). There is a paucity of research looking at mechanisms to reduce stigma and promote social inclusion, or at factors that might promote resilience or protect against stigma/social exclusion across the life course. Evidence is also limited in relation to evaluations of interventions. Increasing incentives for cross-country research collaborations, especially with new EU Member States and collaboration across European professional organizations and disciplines, could improve understanding of the range of underpinning social and cultural factors which promote inclusion or contribute toward lower levels of stigma, especially during times of hardship.

International audience; Sol–gel strategies are carefully evaluated and compared to synthesize electrolyte materials for Intermediate Temperature SOFCs (Solid Oxide Fuel Cells). Robust 10–20 μm thick cubic Yttria-Stabilized Zirconia (YSZ), (Y2O3)0.08(ZrO2)0.92, films have been prepared by using nanocomposite stable sols composed with “sol–gel made” YSZ binders and YSZ powder. Two different strategies have been investigated for the synthesis of 8YSZ binders: a mixed alkoxide-nitrate route in alcoholic media, and an environment-friendly hydrothermal route, in water media. Ionic conductivities of ∼2.5 × 10–2 S cm–1 are obtained at 800 °C for powders made by the hydrothermal and the alkoxide routes. Films synthesized from composite sols that contain commercial YSZ powder and the organic binder or the water-based binder, have been deposited on YSZ-NiO cermets and integrated in an entire single fuel cell. The two optimized routes yield to gastight YSZ electrolytes. In particular with the organic-based binder, a maximum power density of 250 mW cm–2 at 850 °C has been achieved. The proposed route can be extended to other materials for different applications such as ferroelectric and dielectric materials.

Background and objectives Policies to expand the traditional role of community pharmacists have been implemented or at least considered in a number of countries, as advocated by academics, professional organizations, and governments. Such reforms come on the heel of pressing system-wide challenges. At a time of growing interest in evidence-based policymaking, what is the policy-relevant evidence base in support of this new expanded role for community pharmacists? Methods An umbrella review was conducted to identify published systematic reviews of evidence on the effectiveness of community pharmacist interventions. Findings of the identified reviews were documented according to Pharmaceutical Care and Total Pharmacy Care models, and evaluated on the basis of internal and external validity. The internal validity of identified reviews was evaluated in terms of the comparability of populations, interventions, and outcomes. External validity was based on the reproducibility and generalizability of review findings. Results Thirty-three systematic reviews published since 2000 evaluated the evidentiary support for the expanded role of community pharmacists, which focuses on two primary objectives: (1) to encourage the effective, safe and appropriate use of medicines and (2) to promote the prevention and management of chronic diseases. The results of most systematic reviews were mixed, with unclear policy relevance. Important methodological drawbacks were found in terms of study identification and selection, and comparability of interventions and outcomes. In addition, the external validity of the findings was inconclusive on the basis of reproducibility and generalizability. Conclusions There is inconclusive evidence in support of expanding the role of community pharmacists. This raises an important question: should the pharmacy profession only undertake tasks for which there is strong policy relevance with evidence of economic and public health benefits? In spite of this tension between the necessity to formulate new policies during a period of economic constraints and the level of corresponding evidence, several countries have begun entertaining policies to equip community pharmacists with patient-centered responsibilities. As implementing such expanded roles requires significant changes in the wider health care system, further research is needed to evaluate country-level policy developments.

International audience; ZrO2–8% Y2O3 (YSZ) thick film was deposited on a YSZ–NiO anode and co-sintered to obtain a gas-tight electrolyte for an application as Solid Oxide Fuel Cell. A YSZ sol–gel composite sol is synthesized from a YSZ colloidal binder and a YSZ commercial powder and deposited as a thick (>10 μm) monolayer by the dip-coating process. The evolution of the composite sol viscosity with time and its influence on the deposited film thickness is studied. The influence of the composite sol composition, the film sintering on the films microstructure is also studied in order to achieve dense films. The interest of co-sintering the electrolyte with the anodic support is demonstrated. Ionic conductivity and activation energy are measured on pellets obtained from pressed-powder obtained from (a) the calcination of composite sol and (b) the commercial powder. Conductivity of 0.03 S cm−1 at 800 °C and activation energy of 0.9 eV were measured through impedance spectroscopy. Finally, an entire cell is processed with the developed electrolyte and polarization curves (I–V) were measured at 850 °C. OCV of 1.23 V was achieved, indicating the quality of the synthesized YSZ electrolyte.