The consequences of the COVID-19 pandemic are still working through health systems worldwide, and further reflections about the nature of health and disease, and about how to design and implement effective public health interventions are much needed. For numerous diseases and conditions, as well as for COVID-19, our knowledge base is rich. We know a lot about the biology of the disease, and we have plenty of statistics that relate health to socio-economic factors. In this paper, we argue that we need to add a third dimension to this knowledge base, namely a thorough description of the lifeworld of health and disease, in terms of the mixed biosocial mechanisms that operate in it. We present the concepts of lifeworld and of mixed mechanisms, and then illustrate how they can be operationalised and measured through mixed methodologies that combine qualitative and quantitative approaches. Finally, we explain the complementarity of our approach with the biological and statistical dimensions of health and disease for the design of public health interventions.
White blood cell (WBC) and mean platelet volume (MPV) counts are related to stroke events, but relationship between their combined indicator (WBC count-to-MPV count ratio (WMR)) and the risk of fatal stroke occurrence is unclear so far. In this retrospective analysis, we enrolled 27,163 participants aged 50 years or older without a stroke history in the Guangzhou Biobank Cohort Study. After a mean follow-up time of 15.0 (SD = 2.2) years with 389,242 person-years, 816 stroke (401 ischaemic, 259 haemorrhagic and 156 unclassified) deaths were recorded. Cox’s proportional hazards regression was used to estimate the hazard ratios (HRs) and the 95% confidence intervals (CIs). Compared with those in the lowest quartile, participants with the highest WMR had different risks for fatal all stroke and fatal ischaemic stroke, respectively, although an increased risk for fatal ischaemic stroke was observed among participants in the fourth WMR quartile and further hs-CRP adjustment; those in the WMR change with 10% increase had a 36% increased risk of fatal all stroke and a 79% increased risk of fatal haemorrhagic stroke, compared to those in a stable (the WMR change between −10% and 10%). Our findings suggest that higher WMR and its longitudinal change were associated with an increased risk of fatal stroke occurrence in middle-aged to older Chinese; it may be a potential indicator for the future fatal stroke occurrence in relatively healthy elderly populations.
Previous studies have shown that highly educated women are more likely to realise their fertility aspirations, or experience a faster progression to a higher order birth, compared to lower educated women. This is often explained by improved economic or social resources among the higher educated. However, it is unclear whether educational differences in health behaviours may also contribute to these differential fertility outcomes. In this study, we use data from Waves 1–7 of the UK Longitudinal Household Study, combined with data from the Nurse Health Assessment from Wave 2 to estimate couples’ likelihood of experiencing additional childbirth within six years. A discrete-time event history model is employed to analyse the transition to a higher order birth, while accounting for both partners’ level of education as well as smoking patterns and body mass index. We find that couples in which the female partner is highly educated are more likely to experience childbirth within six years compared to others. In addition, female smoking is negatively associated with the likelihood of childbirth, while no significant effect has been found for male health factors. Female health indicators explain some of the variation in fertility outcomes for women with lower secondary education compared to degree-educated women. However, education remains a significant predictor of the transition to higher order births, also after accounting for male and female health indicators. It is therefore important to consider both socio-economic and health factors in order to understand variations in fertility outcomes.
This study focuses on the constitution of financial reserves in Switzerland from a longitudinal perspective. Personal income after retirement derives from financial reserves whose constitution depends both on positional factors, such as sex and birth cohorts, and processual factors, such as occupational trajectories, in the institutional context of the Swiss pension system (structural factors). We hypothesise that some processual, positional and structural factors interact with each other to shape financial reserves available in old age. We assess this set of factors and their interactions using the occupational trajectory types stemming from optimal matching analysis (OMA) combined with the hierarchical clustering and regression tree methods. We used the retrospective biographic data SHARELIFE gathered during the third wave of the SHARE survey in 2009. The results show that occupational trajectories are influential factors accounting for much of the financial reserves available in later life. However, these processual factors interact with positional factors such as sex and birth cohort. The retirement schemes generalised in Switzerland during the period under consideration add up to the effect of positional factors on the constitution of financial reserves.
To review research developments on childhood adversity in the Christchurch Health and Development Study (CHDS) since 2001.
Narrative overview of the published work of the CHDS since 2001 in the context of research methods.
The CHDS research has continued to evolve as the cohort has aged. A clear focus has remained on the measurement of outcomes associated with psychosocial risk factors over the life course. This focus has allowed the CHDS to examine the linkages between exposure to adversity in childhood and later mental health, psychosocial and occupational outcomes across the life span to middle adulthood. The CHDS has many strengths, including prospective measurement of a broad and deep set of constructs, the use of multiple informants for data, and a range of statistical approaches suited to repeated measures longitudinal data. The CHDS has pioneered new approaches to the study of human development over the lifespan, which has been instrumental in investigating childhood adversity.
The CHDS continues to provide unique information from a population cohort that has been studied for more than four decades. Future research will include examination of factors that mitigate the effects of childhood adversity and enhance resilience.
Growing Up in Ireland (GUI) is the national longitudinal study of children and young people in the Republic of Ireland and has followed two cohorts for over ten years to date: Cohort ’98 who were recruited into the study at age nine years and Cohort ’08, recruited at age nine months. The study aims to describe the lives of Irish children and young people in terms of their development, with a view to positively affecting policies and services available for them. Traditionally, data collection involved in-home visits from an interviewer who conducted face-to-face interviews, recorded physical measurements of study participants and administered cognitive assessments. However, with the onset of the COVID-19 pandemic and the associated restrictions, significant adaptations were required to these methods to ensure data collection for the pilot and main fieldwork for Cohort ’08 at age 13 could continue to the expected timeline. Face-to-face interviews with participants were replaced with telephone and web-based modes, interviewer training was conducted online, online resources were made available for interviewers and participants and COVID-19 related items were added to questionnaires. In addition to the scheduled data collection, a special COVID-19 survey was also conducted on both GUI cohorts in December 2020 to explore the impact of the pandemic on participants’ lives. This paper outlines the adaptations made to traditional data collection methods in GUI, highlighting the challenges that were met, but also the benefits of some changes that may be worth incorporating into future waves of GUI.
As a major socio-historical event affecting different aspects of life, the COVID-19 pandemic presents a unique opportunity to study how different population groups adapt. We investigate the impact of this crisis on the evolution of perceived stress in the short and medium term in Switzerland, using data of the Swiss Household Panel from 2016 to early 2021, which include annual measures of perceived stress and a study between waves, conducted in May and June 2020 at the end of the first semi-lockdown. Using the longitudinal structure of the data with pre-crisis measurements, we estimate pooled OLS, fixed effects and first difference models, which include socio-demographic variables, life events, socio-economic status, work-related variables, stress-reducing resources and restrictions in place.
Results for the overall population show a continuous increase in stress levels between 2016 and 2019 and a stress reduction right after the first semi-lockdown followed by a return to pre-pandemic levels. Privileged groups with higher levels of stress before the pandemic were most likely to reduce perceived stress. Characteristics related to more favourable trajectories include stable or improved financial situations and high levels of education (short-term effects), and high-pressure jobs and working hours (short- and medium-term effects). Our analyses reveal the importance of resources, such as social relations and work–life balance, to individuals’ management of the effects of the pandemic.
Our results show that the effects of the pandemic on perceived stress are context-specific. They underline the importance of longitudinal analyses to understand the complexity of vulnerability and adaptation processes.
The COVID-19 pandemic has caused unexpected disruptions to Western countries which affected women more adversely than men. Previous studies suggest that gender differences are attributable to: women being over-represented in the most affected sectors of the economy, women’s labour market disadvantage as compared to their partners, and mothers taking a bigger share childcare responsibilities following school closures. Using the data from four British nationally representative cohort studies, we test these propositions. Our findings confirm that the adverse labour market effects were still experienced by women a year into the COVID-19 pandemic and that these effects were the most severe for women who lived with a partner and children, even if they worked in critical occupations. We show that adjusting for pre-pandemic job characteristics attenuates the gaps, suggesting that women were over-represented in jobs disproportionately affected by COVID-19 pandemic. However, the remaining gaps are not further attenuated by adjusting for the partner’s job and children characteristics, suggesting that the adversities experienced by women were not driven by their relative labour market position, as compared to their partners or childcare responsibilities. The residual gender differences observed in the rates of active, paid work and furlough for those who live with partner and children point to the importance of unobserved factors such as social norms, preferences, or discrimination. These effects may be long-lasting and jeopardise women’s longer-term position through the loss of experience, leading to reinforcement of gender inequalities or even reversal of the progress towards gender equality.
Working mothers face challenges in pursuing their career aspirations due to work–family conflict. The recent COVID-19 pandemic has posed added challenges for working mothers by increasing care demands while also causing numerous health, economic and social disruptions. In this paper, we examine the impact of COVID-19 on Korean working mothers’ career aspirations. We employ a longitudinal qualitative design by analysing 64 in-depth interviews with 32 mothers of young children in South Korea. By interviewing the same women before (2019) and during the COVID-19 pandemic (2020), we are able to document how working mothers’ career aspirations were impacted by COVID-19. Findings show that all working mothers in the sample experienced increased care demands due to COVID-19. However, the influence of COVID-19 on working mothers’ career aspirations hinged on gendered beliefs related to childcare responsibility. When working mothers believed or were subjected to beliefs that mothers should be the primary caregiver for children (gendered care belief), their career aspirations were tempered or relinquished. On the other hand, those who believed that mothers should not be held solely responsible for childcare (gender egalitarian care belief) continued to pursue their career aspirations or experienced career advancements during COVID-19. Findings suggest that beliefs related to care responsibilities play an important role in working mothers’ pursuit of their career aspirations, and potentially their future careers.
This paper presents the findings of longitudinal research conducted in Ethiopia exploring the effects of COVID-19 school closures on children’s holistic learning, including their socio-emotional and academic learning. It draws on data from over 2,000 pupils captured in 2019 and 2021 to compare primary school children’s dropout and learning before and after school closures. The study adapts self-reporting scales used in similar contexts to measure grade 4–6 pupils’ social skills and numeracy. Findings highlight the risk of widening inequality regarding educational access and outcomes, related to pupils’ gender, age, wealth and location. They also highlight a decline in social skills following school closures and identify a positive and significant relationship between pupils’ social skills and numeracy over time. In conclusion, we recommend a need for education systems to promote children’s holistic learning, which is even more vital in the aftermath of the pandemic.