Large numbers of foreign-born residents in the United States mean that many people receive at least part of their education abroad. Despite this fact, our understanding of nativity differences in the success of adults and their children is based on research that does not empirically consider variation in the benefits to schooling depending on where it is received. We use data from the Los Angeles Family and Neighborhood Survey (L.A. FANS) to examine: a) whether the socioeconomic and cognitive returns to education depend on whether it is received in the U.S. or abroad; and b) whether schooling location partially accounts for nativity differences in these returns. We find that the returns to schooling are generally largest for adults who receive at least some of their highest level of education in the U.S. The beneficial effects of U.S. schooling are more pronounced at higher levels of educational attainment. Schooling location accounts for a sizeable fraction of the lower socioeconomic and cognitive returns of the foreign-born, relative to natives; some meaningful differences remain, however. In addition, the higher cognitive skills of the children of foreign-born adults remain unexplained. Although we cannot distinguish among the possible pathways underlying these associations (e.g., school quality, transferability of credentials, the timing of immigration) our findings suggest the importance of considering factors related to schooling location as predictors of socioeconomic and cognitive success in the United States.
Two opposing hypotheses were proposed to explain the lifecourse pattern in the effect of education on mortality: “cumulative advantage,” where the education effect becomes stronger with age, and “age-as-leveler,” where the effect becomes weaker in old age. Most empirical studies bring evidence for the latter hypothesis but the observed convergence of mortality patterns could be an artifact of selective mortality due to unobserved heterogeneity. A simulation shows that unobserved heterogeneity can bias the estimated effect of education downward so that the cohort-average effect of education decreases in old age regardless of the shape of the underlying subject-specific trajectory.
education; mortality; heterogeneity; cumulative advantage; age-as-leveler; lifecourse
Short and long sleep duration and sleep quality are associated with health including all-cause mortality, cardiovascular disease, diabetes, and obesity. Inflammation may play a role in mediating these associations.
We examined associations between inflammation and self-reported sleep characteristics in 1020 respondents of the 2000 and 2006 Social Environment and Biomarkers of Aging Study (SEBAS), a nationally representative survey of Taiwanese adults ages 53 and over. Regression models were used to estimate cross-sectional relationships between inflammation (IL-6, CRP, fibrinogen, e-selectin, sICAM-1, albumin, and WBC) and a modified Pittsburgh Sleep Quality Index (PSQI), index subcomponents, and self-reported sleep duration. Change in inflammatory markers between 2000 and 2006 was also used to predict long or short sleep duration in 2006.
Inflammation was not related to the overall index of sleep quality. However, longer sleep (> 8 hours) was associated with higher levels of inflammation. These associations remained after adjustment for waist circumference, self-reported health decline, diabetes, arthritis/rheumatism, heart disease, and depressive symptoms. Increases in inflammation between 2000 and 2006 were associated with long but not short sleep duration in 2006 for several markers.
Long sleep duration may be a marker of underlying inflammatory illness in older populations. Future studies should explore whether inflammation explains observed relationships between long sleep and mortality.
sleep; inflammation; aging; Taiwan; CRP; IL-6
Polymorphisms of the apolipoprotein E gene (ApoE) have been associated with health and longevity. Numerous studies have linked ApoE to health outcomes including cardiovascular disease and mortality, but far fewer studies have examined the relationship of ApoE to other biological markers of health. This study investigates the relationship between ApoE and mortality, as well as ApoE and a set of biomarkers related to cardiovascular and immune function, in a population-based sample of Taiwanese adults ages 54+. ApoE ε2 carriers were less likely to have at-risk levels of high-density lipoprotein (HDL-C) and total cholesterol (total-C) than non-carriers (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.25-0.83 and OR 0.45, 95% CI 0.29-0.71, respectively). ApoE ε4 carriers were less likely to have elevated levels of C-reactive protein (CRP) than non-carriers (OR 0.62, 95% CI 0.39-0.96). ApoE genotype was not, however, associated with mortality after 8-years of follow-up. Our findings confirm the association between ApoE ε2 and cholesterol levels, suggesting a potential protective effect of ApoE ε2 on blood lipids. They also contribute to reports on the relationship between ApoE ε4 carrier status and lower CRP levels.
Apolipoprotein E; Cholesterol; C-reactive protein; Mortality
We investigate socioeconomic disparities in adolescent obesity in Mexico. Three questions are addressed. First, what is the social patterning of obesity among Mexican adolescents? Second, what are the separate and joint associations of maternal and paternal education with adolescent obesity net of household wealth? Third, are there differences in socioeconomic status (SES) gradients among Mexican boys and girls, rural residents and non-rural residents?
Using data from the Mexican National Health Survey 2000 we examined the slope and direction of the association between SES and adolescent obesity. We also estimated models for sub-populations to examine differences in the social gradients in obesity by sex and non-rural residence.
We find that household economic status (asset ownership and housing quality) is positively associated with adolescent obesity. High paternal education is related to lower obesity risk, whereas the association between maternal education and obesity is positive, but not always significant.
The household wealth components of SES appear to predispose Mexican adolescents to higher obesity risk. The effects of parental education are more complex. These findings have important policy implications in Mexico and the United States.
Obesity; socioeconomic status; Mexico; adolescents; parental education
Over the course of the 20th century, Mexico-U.S. migration has emerged as an important facet of both countries, with far reaching economic and social impacts. The health of Mexican immigrants in the U.S. has been well studied, but relatively less is known about the health of returned migrants to Mexico. The objectives of this paper are twofold. Relying on health data pertaining to two stages of the life course, early life health (pre-migration) and adult health (post-migration) from the Mexican Migration Project gathered between 2007 and 2009, we aim to assess disparities in adult health status between male returned migrants and male non-migrants in Mexico, accounting for their potentially different early life health profiles. While we find evidence that returned migrants had more favorable early life health, the results for adult health are more complex. Returned migrants have a higher prevalence of heart disease, emotional/psychiatric disorders, obesity, and smoking than non-migrants but no differences are found in self-rated health, diabetes, or hypertension.
Mexico; returned (or return) migrants; immigrants; migrant health selection; obesity; emotional/psychiatric disorders
Identifying how biological parameters change with age can provide insights into the physiological determinants of disease, and ultimately, death. Most prior studies of age-related change in biomarkers are based on cross-sectional data, small or selective samples, or a limited number of biomarkers. We use data from a nationally-representative longitudinal sample of 639 Taiwanese aged 54 and older in 2000 to assess changes over a six-year period in a wide range of biomarkers. Markers that increased most with age were glycoslyated hemoglobin, interleukin-6, and norepinephrine. Markers that decreased most with age were diastolic blood pressure and creatinine clearance. For example, glycoslyated hemoglobin increased by 8-13%, on average, over this six-year period. Several standard clinical risk factors exhibited little evidence of age-related change. Further research is needed to determine whether the observed variation between individuals in biomarker changes represents differences in underlying physiological function that are predictive of future health and survival.
This study assesses whether socioeconomic and demographic differences in reported mobility limitations are attributable to differential perceptions of mobility difficulty that result in the differential use of response categories.
Data come from the Social Environment and Biomarkers of Aging Study and its parent study, the Taiwan Longitudinal Study of Aging. Ordered probit models with person-specific cut-points are used to test whether, after controlling for underlying mobility using objective performance measures, cut-points for reporting mobility limitations vary across groups defined by demographic and socioeconomic characteristics.
Age is the only characteristic that is consistently associated with the location of the cut-points for reporting mobility difficulty: At the same level of underlying mobility difficulty, older adults are more likely than younger adults are to report difficulty with all tasks except short walks. Other variables showed differences but only for one specific activity, for example, urban residents are more likely to report difficulty running than are rural residents with the same underlying level of mobility function.
For most mobility activities, there are no systematic differences in the perception of difficulty by individual characteristics. Thus, for older Taiwanese adults, differences in mobility limitations associated with socioeconomic status are more likely to reflect underlying differences in function than differences in how these groups report the same capacity. The usual loss of mobility with age, however, reflects both a decrease in capacity and a lowering of the threshold for reporting difficulty.
Cut-point shifts; Mobility difficulty; Older adults; Taiwan
The purpose of this paper is twofold: 1) to assess the link between migrant networks and becoming overweight or obese and 2) to explore the pathways by which migrant networks may contribute to the increasing overweight and obese population of children in Mexico. Using two waves of the Mexican Family Life Survey (MxFLS), we find that children and adolescents (ages 3 to 15) living in households with migrant networks are at an increased risk of becoming overweight or obese over the period of observation, relative to their peers with no migrant networks. Sedentary behavior and household-level measures of economic wellbeing explain some of the association between networks and changes in weight status, but the role of extended networks remains significant. Community-level characteristics related to migration do not account for any of the observed relationship between household-level networks and becoming overweight or obese.
Mexico; Migration; Obesity; Networks; Obesity
Despite a myriad of studies examining the relationship between socioeconomic status and health outcomes, few have assessed the extent to which biological markers of chronic disease account for social disparities in health. Studies that have examined this issue have generally been based on surveys in wealthy countries that include a small set of clinical markers of cardiovascular disease. The availability of recent data from nationally representative surveys of older adults in Costa Rica and Taiwan that collected a rich set of biomarkers comparable to those in a recent US survey permits us to explore these associations across diverse populations. Similar regression models were estimated on three data sets – the Social Environment and Biomarkers of Aging Study in Taiwan, the Costa Rican Study on Longevity and Healthy Aging, and the Health and Retirement Study in the USA – in order to assess (1) the strength of the associations between educational attainment and a broad range of biomarkers; and (2) the extent to which these biomarkers account for the relationships between education and two measures of health status (self-rated health, functional limitations) in older populations. The estimates suggest non-systematic and weak associations between education and high risk biomarker values in Taiwan and Costa Rica, in contrast to generally negative and significant associations in the US, especially among women. The results also reveal negligible or modest contributions of the biomarkers to educational disparities in the health outcomes. The findings are generally consistent with previous research suggesting stronger associations between socioeconomic status and health in wealthy countries than in middle income countries and may reflect higher levels of social stratification in the US. With access to an increasing number of longitudinal biosocial surveys, researchers may be better able to distinguish true variations in the relationship between socioeconomic status and health across different settings from methodological differences.
Costa Rica; Taiwan; USA; biomarkers; biosocial survey; socioeconomic disparities; health outcomes; longitudinal
Greater educational attainment is consistently associated with lower mortality and better health, a pattern known as the social gradient. However, recent research suggests that Mexican-origin adults in the US have weak or flat gradients, in contrast to steep gradients for non-Hispanic whites. In this study we evaluate one hypothesis for this finding: Is the relative weakness of education gradients in health behaviors observed among Mexican-origin adults in the US due to weak gradients in the sending population? We test this “imported gradients” hypothesis with data from two nationally-representative datasets: the US National Health Interview Survey (NHIS) and the Mexican National Health Survey (ENSA 2000). We compare education gradients in smoking and obesity for recently-arrived Mexican immigrants in the US to the corresponding gradients in high-migration regions of Mexico. Results partially support the imported gradients hypothesis and have implications for health education and promotion programs targeted to immigrant populations to reduce racial and ethnic disparities in health in the US.
Mexico; Latino health; immigrant health; social disparities; migration; obesity; smoking; USA; education
We compare the genotype distribution for the serotonin transporter polymorphism (5-HTTLPR) in a sample of older Taiwanese adults with samples of various racial and ethnic groups collected in other studies. We also explore interactions among sex, stressors, and 5-HTTLPR genotype on depressive symptoms in our sample.
Using a nationally-representative sample of 984 Taiwanese aged 53 and older, we model depressive symptoms as a function of 5-HTTLPR genotype and two classes of stressors: lifetime trauma and recent major life events. We test two- and three-way interactions among stressors, 5 HTTLPR, and sex.
This sample exhibits higher frequency of S/S and lower frequency of L/L genotype than Western samples, but the distribution is comparable to those in East Asian populations. Nearly 9% carry an allele (XL) that has rarely been reported in the literature. Although the gene-environment (GxE) interaction with recent major life events is not significant, our results suggest that trauma has a worse effect on depressive symptoms for those with S/S or S/L genotype than for those who do not carry the S allele (p<0.05). We find no evidence that this GxE interaction varies by sex.
Previous studies of this GxE interaction have been inconclusive, perhaps because interactions between genotype and stressful events are more prominent under extreme stressors. Our findings underscore the need to move beyond a bi-allelic parameterization of the 5-HTTLPR polymorphism and raise questions about why East Asian populations exhibit low rates of depression despite a high frequency of the S allele.
SLC6A4 protein; depressive disorder; life change events; stressful events; Taiwan
Dehydroepiandrosterone (DHEA) and its sulfate form (DHEAS) have been the focus of considerable publicity because of their demonstrated associations with a broad range of health outcomes. Yet, knowledge about the effects of endogenous DHEA(S) on health in humans is limited and often inconclusive, largely because few of the studies have been based on prospective surveys of population-representative samples. This analysis uses a national longitudinal survey in Taiwan to investigate whether DHEAS is associated with subsequent changes (2000–2003) in functional limitations, cognitive impairment, depressive symptoms, and global self-rated health. Multivariate regression models based on this older Taiwanese sample show that among men, lower levels of DHEAS are related to declines in mobility and self-assessed health status and increases in depressive symptoms, while both low and very high levels of DHEAS are associated with poor cognitive function. There are no significant associations among women. These findings differ from those in a previous cross-sectional analysis based on the Taiwan study and underscore the importance of using prospective data to examine the effects of DHEAS on health. The evidence based on this and other longitudinal studies suggests that endogenous DHEAS is related to health outcomes for men, but not women, in both Western and non-Western populations.
Dehydroepiandrosterone; Dehydroepiandrosterone sulfate; Health; Mental Health; Longitudinal Survey; Aged; Taiwan
The objective of our study was to investigate whether life satisfaction and depressive symptoms are independent predictors of mortality in a non-Western sample of adults. The sample included 5,131 adults (aged 50 – 95 at baseline) in Taiwan who participated in the Survey of Health and Living Status of the Near Elderly and Elderly. There were 1,815 deaths recorded over a 10-year period. Higher life satisfaction significantly predicted lower risk of mortality after controlling for age, sex, education, marital status and health status. Depressive symptoms significantly predicted higher risk of mortality. A significant interaction with age revealed that the protective effect of life satisfaction weakened with age. The results suggest that life satisfaction and depressive symptoms independently predict mortality risk in adults.
life satisfaction; depressive symptoms; mortality; Taiwan
The authors used data from a nationally representative survey of 933 adults aged 54 years or older (mean age = 66.2 years; standard deviation, 8.0) in Taiwan to explore whether mortality prediction at older ages is improved by the use of 3 clusters of biomarkers: 1) standard cardiovascular and metabolic risk factors; 2) markers of disease progression; and 3) nonclinical (neuroendocrine and immune) markers. They also evaluated the extent to which these biomarkers account for the female advantage in survival. Estimates from logistic regression models of the probability of dying between 2000 and 2006 (162 deaths; mean length of follow-up = 5.8 years) showed that inclusion of each of the 3 sets of markers significantly (P = 0.024, P = 0.002, and P = 0.003, respectively) improved discriminatory power in comparison with a base model that adjusted for demographic characteristics, smoking, and baseline health status. The set of disease progression markers and the set of nonclinical markers each provided more discriminatory power than standard risk factors. Most of the excess male mortality resulted from the men being more likely than women to smoke, but each of 3 markers related to disease progression or inflammation (albumin, neutrophils, and interleukin-6) explained more than 10% of excess male mortality.
biological markers; mortality; risk factors; sex factors; Taiwan
To test the relation between socioeconomic status (SES) and biomarkers of chronic stress, including basal cortisol, and to test whether these biomarkers account for the relation between SES and health outcomes.
Cross sectional study using data from the 2000 social and environmental biomarkers of aging study (SEBAS).
Nationally representative sample of 972 men and women aged 54 and older.
Main outcome measures
Highest risk quartiles for 13 biomarkers representing functioning of the neuroendocrine system, immune/inflammatory systems, and the cardiovascular system: cortisol, adrenaline (epinephrine), noradrenaline (norepinephrine), serum dihydroepiandrosterone sulphate (DHEA‐S), insulin‐like growth factor 1 (IGF1), interleukin 6 (IL6), albumin, systolic blood pressure, diastolic blood pressure, waist‐hip ratio, total cholesterol‐HDL ratio, HDL cholesterol, and glycosylated haemoglobin; self reported health status (1–5) and self reported mobility difficulties (0–6).
Lower SES men have greater odds of falling into the highest risk quartile for only 2 of 13 biomarkers, and show a lower risk for 3 of the 13 biomarkers, with no association between SES and cortisol. Lower SES women have a higher risk for many of the cardiovascular risk factors, but a lower risk for increased basal readings of adrenaline, noradrenaline, and cortisol. Inclusion of all 13 biological markers does not explain the relation between SES and health outcomes in the sample.
These data do not support the hypothesis that chronic stress, via sustained activation of stress related autonomic and neuroendocrine responses, is an important mediator in the relation between SES and health outcomes. Most notably, lower SES is not associated with higher basal levels of cortisol in either men or women. These results place an increased burden of proof on researchers who assert that psychosocial stress is an important pathway linking SES and health.
socioeconomic status; stress; cortisol; inequalities in health; Taiwan
We examined whether perceived social position predicted mental and physical health outcomes (depressive symptoms, cognitive impairment, mobility restrictions, and self-assessed health) in a prospective study based on a nationally representative sample of older persons in Taiwan. Cross-sectional and longitudinal models were used to demonstrate the relationship between perceived social position and health, as reported by participants in the Social Environment and Biomarkers of Aging Study in Taiwan (SEBAS). Lower perceived social position predicted declining health beyond what was accounted for by objective indicators of socioeconomic position. As predicted, the effect was substantially reduced for all health outcomes in the presence of controls for baseline health. After including these controls, perceived social position was significantly related only to depressive symptoms. The findings suggest that the strength of the association between perceived social position and health may have been overstated in cross-sectional studies.
Taiwan; perceived social position; older adults; mental health; physical health