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Background frailty is a condition of reduced function and health due to ageing processes and is associated with a higher risk of falls, hospitalisation, disability and mortality. Objective to determine the relationship between household wealth and neighbourhood deprivation with frailty status, independently of demographic factors, educational attainment and health behaviours. Design population-based cohort study. Setting communities in England. Subjects in total 17,438 adults aged 50+ from the English Longitudinal Study of Ageing. Methods multilevel mixed-effects ordered logistic regression was used in this study. Frailty was measured using a frailty index. We defined small geographic areas (neighbourhoods) using English Lower layer Super Output Areas. Neighbourhood deprivation was measured by the English Index of Multiple Deprivation, grouped into quintiles. Health behaviours included in this study are smoking and frequency of alcohol consumption. Results the proportion of respondents who were prefrail and frail were 33.8% [95% confidence interval (CI) 33.0–34.6%] and 11.7 (11.1–12.2)%, respectively. Participants in the lowest wealth quintile and living in the most deprived neighbourhood quintile had 1.3 (95% CI = 1.2–1.3) and 2.2 (95% CI = 2.1–2.4) times higher odds of being prefrail and frail, respectively, than the wealthiest participants living in the least deprived neighbourhoods Living in more deprived neighbourhood and poorer wealth was associated with an increased risk of becoming frail. Those inequalities did not change over time. Conclusions in this population-based sample, living in a deprived area or having low wealth was associated with frailty in middle-aged and older adults. This relationship was independent of the effects of individual demographic characteristics and health behaviours.

The COVID-19 pandemic has given the global e-commerce market a strong boost and concerns have been raised about intensified work stress and its consequences on health and safety. China has soon become the market leader and the rapid adoption of last-mile technology and app-based work models means that work stress associated with the use of technology (“technostress”) is under-researched. This study set out to explore what work stressors couriers in China experience and how techno-stressors interacted with other work stressors, following the Job Demands-Resources (JD-R) framework. We conducted 14 semi-structured interviews with frontline couriers in May-June 2021 in China. Five major themes were identified: general (working conditions), algorithmic management, customer sovereignty, economic precarity and networked support. A novel contribution of the study is the identification of a new stressor: techno-dominance that we define as technology-induced worker vulnerability when labour relations and managerial functions traditionally fulfilled by humans are replaced by technology systems. It can be characterised as algorithmic controls, opaque system logic, extended social controls and lack of organizational (human) support. Technology associated benefits were categorised as techno-resource, including flexible hours, intelligent systems and app-based information & trainings. Some benefits were conditional, e.g. gamification where participants became motivated or frustrated depending on their job skills, suggesting potential moderators for the demands-stress relationship. Interactions between techno-stressors and other working conditions were also found, as techno-overload, techno-invasion, techno-complexity and techno-dominance intensified work stress.

Objectives: Understanding longitudinal patterns of rural–urban mental health disparities is vital for effective intervention and policy development in China. However, few studies have estimated separate effects of birth-cohort and ageing and examined the role of community resources on health inequalities. Methods: Drawing data from the China Health and Retirement Longitudinal Study (2011–2018), this study employed multilevel modelling to identify the mental health trajectories of rural, peri-urban, urban older adults by cohort and the community effects. Results: The changes in the mental health gap between rural, peri-urban and urban older adults over time varied by birth cohorts. Among younger cohorts aged under 65, the mental health disparities between rural, peri-urban and urban residents increased as they got older. Underdeveloped community infrastructure greatly explained the rural health disadvantage. Conclusion: The study indicates increasing rural–urban health disparities at the onset of later life. Improving community infrastructure in rural and peri-urban areas is vital to minimise rural–urban health gaps.

Life-course theories on how social relationships affect mental health are limited in causal claims. The restrictions in social contact during the coronavirus pandemic provided a natural experiment that modified the frequency of in-person contact and allowed us to estimate the effect of changes in in-person social contact frequency on mental health in four large nationally representative age-cohorts of adults living in the UK. There was consistent evidence of a small but statistically significant effect of less frequent social contact on anxiety-depression. Online modes of social contact did not compensate for the restrictions in in-person social contact during the pandemic. Young adults who increased their online social media frequency during the pandemic experienced a deterioration in mental health. Life-course theories cannot ignore the importance of the mode of social contact for social relationships, especially during young adulthood.

This paper investigated the extent to which parental socioeconomic status was associated with life course socioeconomic status heterogeneity between adult cohort members of the 1958 National Child Development Study and how this association differed depending on methods used to address longitudinal missing data. We compared three variants of the full information maximum likelihood approach, namely available case, complete case and partially observed case and two methods designed to compensate for missing at random data, namely multilevel multiple imputation and multiple imputation chained equations. Our results highlighted the important contribution of parental socioeconomic status in explaining the divergence in achieved socioeconomic status over the adult life course, how the available case approach increasingly overestimated socioeconomic attainment as age increased and survey sample size decreased and how the complete case approach downwardly biased the effect of parental socioeconomic status on adult socioeconomic status.

Education is associated with improved baseline cognitive performance in older adults, but the association with maintenance of cognitive function is less clear. Education may be associated with different types of active cognitive reserve in those following different cognitive trajectories. We used data on n = 5642 adults aged60 from the English Longitudinal Study of Aging (ELSA) over 5 waves (8 years). We used growth mixture models to test if the association between educational attainment and rate of change in verbal fluency or immediate recall varied by latent class trajectory. For recall, 91.5% (n = 5164) of participants were in a gradual decline class and 8.5% (n = 478) in a rapid decline class. For fluency, 90.0% (n = 4907) were in a gradual decline class and 10.0% (n = 561) were in a rapid decline class. Educational attainment was associated with improved baseline performance for both verbal fluency and recall. In the rapidly declining classes, educational attainment was not associated with rate of change for either outcome. In the verbal fluency gradual decline class, education was associated with higher (an additional 0.05-0.38 words per 2 years) or degree level education (an additional 0.04-0.42 words per 2 years) when compared to those with no formal qualifications. We identified no evidence of a protective effect of education against rapid cognitive decline. There was some evidence of active cognitive reserve for verbal fluency but not recall, which may reflect a small degree of domain-specific protection against age-related cognitive decline.

Introduction Ten percent of over 65 s and between a quarter and half of over 85 s are frail. Loneliness and social isolation are associated with increased falls, rates of hospitalisation and mortality. Lonely and socially isolated older adults may also be at risk of frailty. We examined the relationship between loneliness, social isolation and incident frailty among older adults in England longitudinally over 12 years. Methods The study sample are 9,171 older adults aged ≥50 years participating in a population representative longitudinal panel survey, the English Longitudinal Study of Ageing Waves 2–8. To define frailty across the biannual waves, we used the Frailty Index (FI), analysed continuously and into categories (FI ≤0.08 non-frail, 0.08–0.25 pre-frail and ≥ 0.25–1 frail). We used baseline (Wave 2): loneliness measure using the UCLA 3-item loneliness scale; social isolation measure using previously reported method (Banks et al. The Institute for Fiscal Studies. 2006.). Both were categorised into low/medium/high. To examine relationships, we used linear mixed methods modelling (for the continuous FI), and Cox proportional hazard model (for the categorical FI). Results Loneliness (β = 0.023; 95% CI = 0.022, 0.025) and social isolation (β = 0.007; 95% CI = 0.003, 0.010) were significantly associated with increased FI, after adjusting for cofounders (gender, age, marital status, smoking status and wealth). There was a 60% greater relative risk of belonging to the frail class with a medium loneliness score compared to low (HR = 1.570; 95% CI 1.492, 1.652) and a 160% greater relative risk with high loneliness score compared to low (HR = 2.621; 95% CI 2.488, 2.761). Although less pronounced, there was a 1% greater relative risk of developing frailty with a medium social isolation score compared to low (HR = 1.010, 95% CI 1.010, 1.197) and a 30% greater relative risk with high social isolation score compared to low (HR = 1.267; 95% CI 1.154, 1.390). Conclusions Our research indicates both loneliness and social isolation increase risk of developing frailty, expanding on previous evidence. This provides further support to the importance of understanding approaches to promote social inclusion of older adults.

Summary: Background: It is estimated that about 10% of people aged 65 and older are frail. Loneliness and social isolation are linked to increased mortality and poorer functional capacity. We assessed trends in frailty status associated with loneliness and social isolation over 14 years in a representative sample of English older adults. Methods: In this longitudinal study, we used data from the English Longitudinal Study of Ageing (ELSA), which was designed to recruit a representative sample of adults aged 50 years and older living in private households in England. We analysed Waves 2–8 (covering June, 2004, to June, 2017). Frailty was defined using the frailty index, analysed continuously and as pre-specified categories, to categorise individuals as being non-frail (≤0·08), pre-frail (>0·08 to

Aim: To determine the extent to which change in (i.e., start and end of) workplace bullying can be predicted by employee responses to standard workplace surveys. Methods: Responses to an 87-item survey from 48,537 Finnish public sector employees at T1 (2017-2018) and T2 (2019-2020) were analyzed with least-absolute-shrinkage-and-selection-operator (LASSO) regression. The predictors were modelled both at the individual- and the work unit level. Outcomes included both the start and the end of bullying. Predictive performance was evaluated with C-indices and density plots.Results: The model with best predictive ability predicted the start of bullying with individual-level predictors, had a C-index of 0.68 and included 25 variables, of which 6 remained in a more parsimonious model: discrimination at work unit, unreasonably high workload, threat that some work tasks will be terminated, working in a work unit where everyone did not feel they are understood and accepted, having a supervisor who was not highly trusted, and a shorter time in current position. Other models performed even worse, either from the point of view of predictive performance, or practical useability.Discussion: While many bivariate associations between socioeconomic characteristics, work characteristics, leadership, team climate, and job satisfaction were observed, reliable individualized detection of individuals at risk of becoming bullied at workplace was not successful. The predictive performance of the developed risk scores was suboptimal, and we do not recommend their use as an individual-level risk prediction tool. However, they might be useful tool to inform decision-making when planning the contents of interventions to prevent bullying at an organizational level.

ObjectivesCourier jobs are characterised as high demand, low control with lack of support, meaning that job burnout is a serious concern. Burnout could have negative influences on safety, performance, turnover and work engagement. This paper aims to review existing evidence about the level of and risk factors for burnout among couriers. DesignSystematic review and narrative synthesis Primary and secondary outcome measuresBurnout, risk factors The review followed PRISMA to search studies published in English and Chinese. English databases included MEDLINE, EMBASE, PsycINFO, Cochrane Library, Web of Science (Core Collection), Open Science Framework and Google Scholar. Chinese databases included CNKI, WANFANG data, Sino Med and CQVIP. ResultsThe search yielded nine papers, of which eight studied Chinese couriers and one Malaysian. Two of them were published in English language and seven were published in Chinese. Seven studies reported moderate to high levels of burnout, such as mean scores of 2.45 on a 1-5 scale, 4.02 on a 0-7 scale, and 49 where the total score is between 15 and 75. The included studies demonstrated that burnout is associated with low income, work stress, physical demands, emotional demands and organizational constraints. Some of them also measured factors that ameliorate the negative effect of work stress on burnout, such as job resources, decision latitude, social support and organizational support. Individual psychological processes, such as emotional regulation and psychological empowerment also play a role in ameliorating or exacerbating burnout. Level of burnout also varies significantly among different socio-demographic groups, such as age, income and marital status. ConclusionsJob burnout is moderate to high among couriers, but there is a dearth of literature in the English language. Interventions to prevent or reduce burnout are currently lacking but could include increasing job autonomy and offering more organizational support. PROSPEROregistration number: CRD42021247644 Strengths and limitations of this study{blacktriangleright} Given the importance of China in global e-commerce, comprehensive search strategies were employed to review publications in both English and Chinese languages {blacktriangleright}Outcome measures investigated have been clearly defined and referenced. {blacktriangleright}This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. {blacktriangleright}However, due to the heterogeneity of included studies, it was not meaningful to perform meta-analysis.

BackgroundMost studies on the health impact of occupational stress use single-point measures of stress at work. This study analyses the associations of properties of entire employment trajectories over an extended time period with a composite score of allostatic load (AL).MethodsData come from the French CONSTANCES cohort, with information on adverse employment histories between ages 25 and 45 and a composite score of AL (based on 10 biomarkers, range 0–10) among people aged 45 or older (47 680 women and 45 035 men). Data were collected by questionnaires (including retrospective employment histories) or by health examinations (including blood-based biomarkers). We distinguish six career characteristics: number of temporary jobs, number of job changes, number of unemployment periods, years out of work, mode occupational position and lack of job promotion.ResultsFor both men and women, results of negative binomial regressions indicate that adverse employment histories are related to higher levels of AL, particularly histories that are characterised by a continued disadvantaged occupational position, repeated periods of unemployment or years out of work. Findings are adjusted for partnership, age and education, and respondents with a health-related career interruption or early retirement are excluded.ConclusionsOur study highlights physiological responses as a mechanism through which chronic stress during working life is linked to poor health and calls for intervention efforts among more disadvantaged groups at early stages of labour market participation.

Objective To explore national and socioeconomic differences in overall job satisfaction, we examined whether those differences can be explained by what job-related factors. Methods Our datasets for this study are from the Whitehall II study and the Japan Civil Servant Study. Of the participants who were 5540 cases, with 3250 people from Great Britain and 2290 from Japan. Results The odds ratio for job dissatisfaction was more than double in Japan compared with Britain. However, after adjusting the related factors-especially the facets of job satisfaction variables-the difference was reversed. Also, regarding the occupational differences, lower occupational grades had lower risks of overall job dissatisfaction, after adjusting for related factors. Conclusions The national and socioeconomic differences in overall job satisfaction were strongly related to facets of job satisfaction rather than job stress factors.

Despite numerous studies on social relationships and health, the empirical focus has often been on middle-aged or older adults, even though young adulthood is a period of considerable change in social networks. We investigated whether the associations between social relationships and allostatic load, a multisystem physiological dysregulation index that reflects chronic stress responses, vary by type of relationship and stages of the lifecourse. Relationships with spouse/partner, immediate family and friends were assessed in terms of emotional support and social strain. Poisson regression models on multiple imputed data sets from waves 2-3 (2010-2012) of the UK Household Longitudinal Study (N = 10,380) were estimated. Social strain, particularly from partners and immediate family, appeared to elicit greater stress related dysregulation during early adulthood (age 21-34 years), corresponding to a predicted difference in the allostatic load index (range 0-12) between high and low strained relationships of 1.1 (95% CI: 0.5-1.6) among young women and 0.6 (95% CI: -0.04 to 1.2) among young men. There was little evidence of an association between allostatic load and any of the social relationships among older men and women. Models of social relationships over the lifecourse need to take account of how stressful social relationships become biologically embedded in early adulthood.

There is limited evidence on the protective effect of housing modifications on disability outcomes among older adults. We examined whether external and internal housing modifications reduce the risk of a range of disability outcomes among older adults living in England.We analysed adults aged 60 and over from the English Longitudinal Study of Ageing, initially recruited in 2002/03. The longitudinal sample consisted of 32,126 repeated observations from 10,459 individuals across 6 waves with an average follow-up of 11·3 years. Participants were asked if their homes had external (widened doorways, ramps, automatic doors, parking and lift) and internal (rails, bathroom/kitchen modifications, chair lift) housing modifications. Mobility impairment was measured through reported difficulties in 10 activities including walking, climbing, getting up, reaching and lifting. Five disability outcomes were analysed (falls in the previous two years, pain, poor self-rated health, no social activities, and moving home within next two years) using two-way fixed effect models, controlling for key risk factors for disability.Greater mobility impairments increased the probability of falls, pain and poor self-rated health although this effect was significantly moderated by external housing modifications. Among older adults with severe mobility impairments, external housing modifications reduced the probability of falls by 3% (1%-6%), pain by 6% (4%-8%), and poor health by 4% (2%-5%). Moreover, external housing modifications reduced the probability of no social activities by 6% (5%-7%) and moving home by 4% (2%-5%) even among those without any mobility impairments. Internal housing modifications had similar, but less consistent effects on the disability outcomes.There was strong evidence that external housing modifications protected against a range of disability outcomes. Studies on reducing disability in ageing populations need to consider the role of housing modifications as key interventions to promote healthy ageing in place.Economic and Social Research Council ES/R008930/1 and ES/S012567/1.

Background: In the UK, in March 2020, those at high risk for adverse outcomes following coronavirus disease (COVID-19), identified as ‘clinically extremely vulnerable’, were sent a notification to shield themselves for 12 weeks. This study examines the effect of this targeted shielding on reporting of coronavirus symptoms and testing positive, common mental disorder and loneliness. Methods: Data from 13,750 adult participants (aged 16+), who participated each month from April to July 2020 in the COVID-19 surveys of Understanding Society (UKHLS), were used to examine the association of receipt of a shielding communication with coronavirus symptoms reporting or a positive test, common mental disorder, loneliness. Findings: The prevalence of coronavirus symptom reporting or testing positive was around 4.2% (95% CI: 1.4%-7.2%) lower among individuals living in households that received a shielding letter compared to those in households which did not. This difference was 10.7% (95% CI: 3.1%-18.2%) among individuals in the highest COVID-19 risk group. Poor mental health was associated with the receipt of a shielding letter, but was accounted for by COVID-19 risk level. Similar patterns were apparent for loneliness. Interpretation: In the context of the lockdown when the general population was staying at home, the shielding policy further reduced the risk of coronavirus symptoms and infections.

There has been limited theoretical and empirical research into the role of workplace accommodations in enabling workers with and without impairments to remain in work. This study used the International Classification of Functioning, Disability and Health (ICF) model to examine (a) whether workplace accommodations enable workers, particularly those with different impairments, to remain economically active; and (b) the predictors of the onset of work accommodations. Data from two waves of a large-scale longitudinal survey of disability in Great Britain, the Life Opportunities Survey (2009-2012) were analysed. 2307 workers with an impairment and 4308 workers without an impairment were followed up for a year. Work accommodations appear to enable workers with impairments to remain economically active, especially those with mental impairments. There was no difference in the employment rates of workers with and without mental impairments who had two or more work accommodations, in contrast to the 10% employment gap between workers with and without mental impairments who did not have any work accommodations. While there was no gender difference in the disability employment gap, barriers to employment related to caregiving were much greater for women compared to men. Moreover, only workers with incident pain impairments were associated with an increase in their work accommodations, not workers with incident mental impairments. Despite the evidence that workers with mental impairments could benefit considerably from workplace accommodations, they are less likely to have their workplace adjusted. The ICF model is particularly useful in analysing the role of work accommodations because it considers a much wider range of factors that are relevant not just to workers with different types of impairments, but are also relevant to the wider group of workers who use workplace accommodations.

Although the diurnal rhythms of affect influence people’s health and behavior, there is a lack of evidence from rural China, where the types and timing of social activities may differ from Western contexts. In this study, a total of 2847 Chinese rural residents from three provinces of China are interviewed using the abbreviated Day Reconstruction Method (DRM) questionnaire. Diurnal rhythms of three affective subjective wellbeing (SWB) indicators—positive affect (PoA), negative affect (NeA), and net affect are analyzed by multilevel models. Our results show PoA and net affect generally increase in magnitude throughout the day with two peaks around noon and in the evening, respectively; whereas, there is an overall decline in NeA as the day passes with two troughs occurring at lunchtime and in the evening. These patterns, however, flatten considerably, with the lunchtime peaks in PoA and net affect (and trough in NeA) disappearing entirely, after further controlling for two social environmental factors—activity type and the quality of social interaction. This study, set in rural China, corroborates the diurnal rhythms of affect from prior Western research to some extent, and highlights that social environmental factors have a significant effect on diurnal rhythms of affect in the rural Chinese context. It is possible that the diurnal rhythms of affect could change in response to stimulation from the environment. Improving some social environmental factors, such as organizing pleasant activities and creating a friendly interactive environment, could contribute to the increase in positive affect and decline in negative affect, thereby enhancing the quality of life., SCOPUS: ar.j, info:eu-repo/semantics/published

BackgroundThe COVID-19 pandemic in the UK and subsequent lockdown may have affected the mental health of the population. This study examines whether there was an increase in the prevalence and incidence of common mental disorders (CMD) in the UK adult population during the first months of lockdown and whether changes in CMD were associated with stressors related to the pandemic and lockdown.MethodsLongitudinal data from the UK Household Longitudinal Study waves 10–11: 2019–2020 and waves 1–4 of the COVID-19 monthly surveys in April (n = 17 761) to July 2020 (n = 13 754), a representative sample of UK adult population, were analysed. CMD was measured using the 12-item General Health Questionnaire (GHQ-12) (cut-off >2). Changes in CMD were analysed in relation to COVID-19 and social stressors.ResultsAround 29% of adults without CMD less than a year earlier had a CMD in April 2020. However, by July 2020, monthly incidence of CMD had reduced to 9%. Most employment, financial and psychological ‘shocks’ were at their highest levels in April and reduced steadily in later months. Despite the lifting of some lockdown conditions by July, stressors related to loneliness, unemployment, financial problems and domestic work continued to influence CMD.ConclusionSome COVID-19 policy responses such as furloughing may have been effective in mitigating the increase in CMD for some groups of employees. Despite some reduction in levels of pandemic and lockdown-related stressors by the middle of 2020, loneliness and financial stressors remained key determinants of incidence in CMD among the UK adult population.

Collecting biological data in representative surveys is becoming more common due to their potential to inform research and policy. Nevertheless, using nurses to collect these data can lead to unintended effects. In this paper, we investigate how nurses influence the non-response process by looking at five waves of data coming from two surveys in the UK: Understanding Society and the English Longitudinal Study of Ageing. We find that nurses explain between 5 and 14 percent of the variance in non-response to biological data collection. We also find that older nurses are more successful in obtaining cooperation and consent to biological data collection and nurses with more survey experience are more likely to successfully collect blood samples. Finally, we show that including nurse characteristics in non-response weighting models leads to modest changes in population estimates of biological markers.

BackgroundThe coronavirus pandemic has resulted in a wide range of social and economic changes that could, in turn, have affected the mental health of the UK adult population. Previous research has not been able to measure the broad range of potential stressors, nor examine whether recent changes in those stressors have positively or negatively impacted on common mental disorders. Furthermore, it is unclear whether the stressful impact of the lockdown on mental health has accumulated over time or whether people have adapted to the new conditions of lockdown. This study examines whether there was an increase in the prevalence and incidence of Common Mental Disorders (CMD) in the UK adult population during the first few months of lockdown related to the coronavirus pandemic and whether changes in CMD were associated with an increase in stressors related to lockdown and the pandemic.MethodsLongitudinal data from the UK Household Longitudinal Study (wave 9: 2017-2019 and waves 1 and 2 of the Coronavirus survey in April and May 2020 respectively), a representative sample of UK population, were analysed. Common mental disorders (CMD) were measured using the GHQ-12 (cut off >2) at all waves. The difference in the GHQ-12 (using Likert scores) between waves measured changes in psychological well-being. The incidence of CMD and changes in psychological well-being were analysed in relation to pandemic specific stressors and changes in economic, financial, household and psychosocial stressors.FindingsAround 30% of UKHLS adults without CMD in 2017/9 had a CMD in April 2020. However from April to May 2020, the incidence reduced considerably to below 13%. Much of the increase in incident CMD between April and May was associated with an increase in feelings of loneliness, but some of this increase was also associated with increasing domestic work demands (arising out of childcare and home-schooling), working from home, and the receipt of care from outside the home. The reduction in the incidence of many of these stressors in May (compared to April) coincided with a reduction in the incidence of CMD in May.ConclusionThe pandemic and resultant lockdown were associated with an increase in the incidence of CMD in the UK adult population initially in April 2020. These changes were associated with increases in feelings of loneliness and stressors related to work and domestic life and receipt of care. There was some evidence of adaptation to many of these stressors over the lockdown period by May 2020. However, if levels of unemployment and redundancy increase in the near future, the implications for the mental health of the population need careful thought and monitoring.

AimTo explore whether there are social inequalities in non‐diabetic hyperglycaemia (NDH) and in transitions to type 2 diabetes mellitus and NDH low‐risk status in England.MethodsSome 9143 men and women aged over 50 years were analysed from waves 2, 4, 6 and 8 (2004–2016) of the English Longitudinal Study of Ageing (ELSA). Participants were categorized as: NDH ‘low‐risk’ [HbA1c < 42 mmol/mol (< 6.0%)], NDH [HbA1c 42–47 mmol/mol (6.0–6.4%)] and type 2 diabetes [HbA1c > 47 mmol/mol )> 6.4%)]. Logistic regression models estimated the association between sociodemographic characteristics and NDH, and the transitions from NDH to diagnosed or undiagnosed type 2 diabetes andlow‐risk status in future waves.ResultsNDH was more prevalent in older participants, those reporting a disability, those living in deprived areas and in more disadvantaged social classes. Older participants with NDH were less likely to progress to undiagnosed type 2 diabetes [odds ratio (OR) 0.27, 95% confidence interval (CI) 0.08, 0.96]. NDH individuals with limiting long‐standing illness (OR 1.72, 95% CI 1.16, 2.53), who were economically inactive (OR 1.60, 95% CI 1.02, 2.51) or from disadvantaged social classes (OR 1.63, 95% CI 1.02, 2.61) were more likely to progress to type 2 diabetes. Socially disadvantaged individuals were less likely (OR 0.64, 95% CI 0.41, 0.98) to progress to NDH low‐risk status.ConclusionsThere were socio‐economic differences in NDH prevalence, transition to type 2 diabetes and transition to NDH low‐risk status. Disparities in transitions included the greater likelihood of disadvantaged social groups with NDH developing type 2 diabetes and greater likelihood of advantaged social groups with NDH becoming low‐risk. These socio‐economic differences should be taken into account when targeting prevention initiatives.

Supplemental material, SDI906358_Appendices for The Influence of Household Pension Wealth, Partner’s Health and Spousal Employment Status on Heterogeneous Early Retirement Transitions among Women in England by Jennifer Prattley and Tarani Chandola in Work, Employment and Society

Global ageing poses a substantial economic burden on health and social care costs. Enabling a greater proportion of older people to stay healthy for longer is key to the future sustainability of health, social and economic policy. Frailty and associated decrease in resilience plays a central role in poor health in later life. In this study, we present a population level assessment of the metabolic phenotype associated with frailty. Analysis of serum from 1191 older individuals (aged between 56 and 84 years old) and subsequent longitudinal validation (on 786 subjects) was carried out using liquid and gas chromatography-mass spectrometry metabolomics and stratified across a frailty index designed to quantitatively summarize vulnerability. Through multivariate regression and network modelling and mROC modeling we identified 12 significant metabolites (including three tocotrienols and six carnitines) that differentiate frail and non-frail phenotypes. Our study provides evidence that the dysregulation of carnitine shuttle and vitamin E pathways play a role in the risk of frailty., info:eu-repo/semantics/published

Background Prior analyses of class differences in health trajectories among employees have often omitted women and transitions to retirement. We examined social class trajectories in physical functioning among Finnish female employees from midlife to retirement age, and whether transitions to retirement modified these trajectories. Methods Data were derived from mail surveys at Phases 1–3 (2000–2012) among employees of the City of Helsinki, Finland, aged 40–60 at baseline (n = 8960, 80% women, response rates 69–83%). We included respondents to any of the Phases 1–3 aged 40–72 (n = 6976). We distinguished higher and lower social classes, and employment statuses, i.e. employed, mandatorily retired and disability-retired. Short Form 36 physical component summary was used to measure physical functioning. Mixed-effect growth curve models were used to assess the association of social class and employment status with functioning over age. Results For employed women, physical functioning deteriorated faster in the lower than in the higher class, with class trajectories widening in ages 40–65. After mandatory retirement, functioning deteriorated in both classes, whereas after disability retirement, functioning improved. Across employment statuses, functioning converged at older ages, and the disability-retired caught up with the better functioning of the employed and mandatorily retired. Employment status modified the trajectories, as among the continuously employed and mandatorily retired women functioning deteriorated, but among the disability-retired, trajectories improved and reached a similar level with employed and mandatorily retired women. Social class inequalities remained in all employment status groups. Conclusions Overall, our results suggest evidence for the cumulative disadvantage model, with accumulating work exposures among lower classes potentially contributing to their trajectories of ill health.

OBJECTIVES: Although adolescence is a sensitive developmental period in oral health, the social equalization hypothesis that suggests health inequalities attenuate in adolescence has not been examined. This study analyses whether the socioeconomic gap and ethnic disadvantage in oral health among children aged 5 reduces among adolescents aged 15.METHODS: Data from the cross-sectional Children's Dental Health Survey 2013 were analysed, comprising of 8541 children aged 5, 8, 12 and 15 attending schools in England, Wales and Northern Ireland. Oral health indicators included decayed and filled teeth, plaque, gingivitis and periodontal health. Ethnicity was measured using the 2011 UK census ethnic categories. Socioeconomic position was measured by family, school and residential deprivation. Negative binomial and probit regression models estimated the levels of oral health by ethnicity and socioeconomic position, adjusted for demographic and tooth characteristics.RESULTS: The predicted rate of decayed teeth for White British/Irish children aged 5 was 1.54 (95%CI 1.30-1.77). In contrast, the predicted rate for Indian and Pakistani children was about 2-2.5 times higher. At age 15, ethnic differences had reduced considerably. Family deprivation was associated with higher levels of tooth decay among younger children but not among adolescents aged 15. The influence of residential deprivation on the rate of tooth decay and filled teeth was similar among younger and older children. Moreover, inequalities in poor periodontal health by residential deprivation was significantly greater among 15-year-old children compared to younger children.CONCLUSIONS: This study found some evidence of smaller ethnic and family socioeconomic differences in oral health among British adolescents compared to younger children. However, substantial differences in oral health by residential deprivation remain among adolescents. Community levels of deprivation may be particularly important for the health of adolescents.

Background: Little is known about the role of sleep disturbance in relation to changes in depressive states. We used data obtained from the participants aged 65 and over in the English Longitudinal Study of Ageing (ELSA, waves 4 and 5, N=3108) and the Japan Gerontological Evaluation Study (JAGES, 2010 and 2013 sweeps, N=7527) to examine whether sleep disturbance is longitudinally associated with older adults’ patterns of depressive states. Methods: We created four patterns of depressive states (non-case, recovered, onset, repeatedly depressive) by combining responses to the measures (scoring four or more on seven items from the Center for Epidemiological Studies Depression Scale for the ELSA participants and scoring 5 or more for the Geriatric Depression Scale-15 for the JAGES participants) obtained at the baseline and follow-up. Sleep disturbance was assessed through responses to three questions on sleep problems. Age, sex, partnership status, household equivalised income, alcohol and cigarette use, and physical function were treated as confounders in this study. Additionally, information on sleep medication was available in JAGES and was included in the statistical models. Results: More ELSA participants were non-depressive cases and reported no sleep disturbances compared with the JAGES participants. Findings from multinomial logistic regression analysis showed that more sleep disturbance was associated with the onset group in ELSA (RRR=2.37, 95%CI=1.44-3.90) and JAGES (RRR=2.41, 95%CI=1.79-3.25) as well as the recovery (RRR=3.42, 95%CI=1.98-5.90, RRR=2.71, 95%CI=1.95-3.75) and repeatedly depressed group (RRR=7.24, 95%CI=3.91-13.40, RRR=5.16, 95%CI=3.82-6.98). Conclusions: Findings suggest that the association between sleep disturbance and depression in older adults is complex.Key words: Sleep; depressive states; cross-national comparisons; ELSA; JAGES

Background Although social inequalities in health are consistently observed across the lifecourse in different populations, there are methodological issues in describing whether these inequalities decrease in later life. The association between socioeconomic adversity and systemic inflammation is well documented in cross-sectional studies, however, the association between living in socioeconomic disadvantage and repeated systemic inflammation in older adults has not been examined in detail, particularly taking into account longitudinal patterns of missingness. Inference from longitudinal analyses of ageing populations is susceptible to biases arising from attrition and non-random dropout. The accumulation of drop-outs over several waves reduce the representativeness of the study population and certain subpopulations can be over or under-represented in the sample. Methods 4,574 men and women aged 52 years and older from the English Longitudinal Study of Ageing (ELSA) wave 2 onwards were analysed. ELSA is a prospective cohort study that is representative of the English population. C - reactive protein levels were measured in waves 2, 4, 6, and 8 (2004–2016). Latent growth curve models estimated the relationship between different measures of socioeconomic position (education, wealth, and social class) and C - reactive protein, compensating for missing data under different assumptions: complete case analysis, full information maximum likelihood, multiple imputation, Diggle-Kenward selection model, and pattern-mixture model. All models were adjusted for gender, age, ethnicity, and marital status. Results At baseline in wave 2, we found differences between the most and least affluent categories of socioeconomic position. Participants with foreign or no qualifications (0.16 log(mg/l), 95% CI 0.09–0.23), participants in the lowest wealth tertile (0.24 log(mg/l), 95% CI 0.16–0.32), and participants in manual occupations (0.13 log(mg/l), 95% CI 0.07–0.19) had increased levels of C-Reactive protein compared to the most advantaged categories of education, wealth, and social class. Although, C - reactive protein levels decreased in later waves, the differences between the most and least socioeconomic advantaged groups remained large. Furthermore, differences between the Diggle-Kenward and other methods for compensating for missing data suggest that the missing completely at random and missing at random analyses underestimated socioeconomic differences in C-Reactive protein. Conclusion This study demonstrates that living in socioeconomic disadvantage is associated with higher C - reactive protein levels over time and that the social discrepancies in health between the most and least affluent socioeconomic groups persist at older ages. It also highlights the importance of compensating for missingness in longitudinal studies with ageing participants who are susceptible to non-random drop out.

Background Retirement has been associated with improved mental health, but it is unclear how much this is due to the removal of work-related stressors. We examined rates of psychotropic medication use before and after the transition to disability retirement due to mental, musculoskeletal and other causes by pre-retirement levels of perceived work stress (effort-reward imbalance, ERI). Methods Register-based date and diagnosis of disability retirement of 2766 participants of the Finnish Public Sector study cohort were linked to survey data on ERI, social- and health-related covariates, and to national records on prescribed reimbursed psychotropic medication, measured as defined daily doses (DDDs). Follow-up for DDDs was 2–5 years before and after disability retirement. We assessed differences in the levels of DDDs before and after retirement among those with high vs. low level of pre-retirement ERI with repeated measures regression. Results Those with high (vs. low) levels of ERI used slightly more psychotropic medication before disability retirement due to mental disorders [rate ratio (RR) 1.14, 95% confidence intervals (CI) 0.94–1.37], but after retirement this difference attenuated (RR 0.94, 95% CI 0.80–1.10, P for interaction 0.02). Such a change was not observed for the other causes of disability retirement. Conclusions The level of psychotropic medication use over the transition to disability retirement due to mental, but not musculoskeletal or other, causes was modified by pre-retirement perceived work-related stress. This suggests that among people retiring due to mental disorders those who had stressful jobs benefit from retirement more than those with low levels of work-related stress.

Professor Michael Banton died in May 2018 aged 91. His long career involved a decade at the University of Edinburgh in the Department of Social Anthropology before spending the rest of his career at the University of Bristol. In Bristol he was Professor of Sociology (1965–1992) and subsequently Emeritus Professor, during which time he remained deeply engaged in scholarly research and publication (see Obituaries). It seems a fitting tribute, in the digital age, that electronic technologies provide a means to celebrate his having been the first editor of this journal, Sociology, between 1967 and 1969. In its series of e-Special Issues, Sociology collects together articles published in previous volumes of the journal. The eight e-Specials which have appeared so far have been thematically focused on the following topics: race and racism; trends and challenges in sociological research; Sociology in the 21st century; self-identity; gender; social class; families and relationships; and social movements. This e-Special is slightly different in that it commemorates the work of Michael Banton as scholar and journal editor. We have collected together the four scholarly articles which he contributed himself during his career. (In the early years, when copy for the journal was scarce, he also contributed commentaries and reviews.) The other material included consists of a selection of articles published during his editorship of Sociology. The articles chosen reflect the heterogeneity and diversity of the work emerging in the earliest years of the journal when there were few professional sociologists working in universities. In tone and content, we detect connections to contemporary activities and concerns, but there is much that feels unfamiliar about the editions of the 1960s.

Supplemental material, Supplementary_Tables_and_Figures for Are Flexible Work Arrangements Associated with Lower Levels of Chronic Stress-Related Biomarkers? A Study of 6025 Employees in the UK Household Longitudinal Study by Tarani Chandola, Cara L Booker, Meena Kumari and Michaela Benzeval in Sociology