Browsing by Subject "socioeconomic status"
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Item Disparities in Diffuse Cortical White Matter Integrity Between Socioeconomic Groups(Frontiers Media S.A., 2019-06-12) Shaked, Danielle; Leibel, Daniel K.; Katzel, Leslie I.; Davatzikos, Christos; Gullapalli, Rao P.; Seliger, Stephen L.; Erus, Guray; Evans, Michele K.; Zonderman, Alan B.; Waldstein, Shari R.There is a growing literature demonstrating a link between lower socioeconomic status (SES) and poorer neuroanatomical health, such as smaller total and regional gray and white matter volumes, as well as greater white matter lesion volumes. Little is known, however, about the relation between SES and white matter integrity. Here we examined the relation between SES and white matter integrity of the brain’s primary cortical regions, and evaluated potential moderating influences of age and self-identified race. Participants were 192 neurologically intact, community-dwelling African American and White adults (mean age = 52 years; 44% male, 60% White, low SES = 52%) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) SCAN study. Participants underwent 3.0-T cranial magnetic resonance imaging. Diffusion tensor imaging was used to estimate regional fractional anisotropy (FA) to quantify the brain’s white matter integrity and trace to capture diffusivity. Multiple regression analyses examined independent and interactive associations of SES, age, and race with FA of the frontal, temporal, parietal, and occipital lobes bilaterally. Sensitivity analyses assessed the influence of several biopsychosocial risk factors on these associations. Exploratory analyses examined these relations with trace and using additional SES indicators. Results indicated there were no significant interactions of SES, age, and race for any region. Individuals with low SES had lower FA in all regions, and higher trace in the right and left frontal, right and left temporal, and left occipital lobes. Findings remained largely unchanged after inclusion of sensitivity variables. Older age was associated with lower FA and greater trace for all regions, except for the right temporal lobe with FA. No main effects were found for race in FA, and Whites had higher trace values in the parietal lobes. Novel findings of this study indicate that relative to the high SES group, low SES was associated with poorer white matter integrity and greater diffusivity. These results may, in part, reflect exposures to various biopsychosocial risk factors experienced by those of lower SES across the lifespan, and may help explain the preponderance of cognitive and functional disparities between socioeconomic groups.Item Does the Supplemental Nutrition Assistance Program Affect Hospital Utilization Among Older Adults? The Case of Maryland(Mary Ann Liebert, Inc., 2018-04-01) Samuel, Laura J.; Szanton, Sarah L.; Cahill, Rachel; Wolff, Jennifer L.; Ong, Pinchuan; Zielinskie, Ginger; Betley, CharlesThis study sought to examine whether Supplemental Nutrition Assistance Program (SNAP) participation and benefit levels are associated with reduced subsequent hospital and emergency department utilization in low-income older adults. Study participants were 68,956 Maryland residents aged ≥65 years who were dually enrolled in Medicare and Medicaid (2009–2012). Annual inpatient hospital days and costs and emergency department visits were modeled as a function of either 1-year lagged SNAP participation or lagged SNAP benefit amounts, controlling for sociodemographic characteristics, autoregressive effects, year, health status, and Medicaid participation. SNAP participation (adjusted odds ratio [aOR] = 0.96, 95% confidence interval [CI]: 0.93, 0.99), and, among participants, each $10 increase in monthly benefits (aOR = 0.99, 95% CI: 0.99–0.99) are associated with a reduced likelihood of hospitalization, but not emergency department use. The authors estimate that enrolling the 47% of the 2012 population who were eligible nonparticipants in SNAP could have been associated with $19 million in hospital cost savings. Accounting for the strong effects of health care access, this study finds that SNAP is associated with reduced hospitalization in dually eligible older adults. Policies to increase SNAP participation and benefit amounts in eligible older adults may reduce hospitalizations and health care costs for older dual eligible adults living in the community.Item Does the thought of death accelerate a fast life history strategy?: Evaluating a mortality salience prime(2016) Frederick, Michael; Khan, Humama; Ancona, MatthewThe characteristics of the developmental environment can have long-term effects on an individual's metabolism, stress-sensitivity, hormone levels, and gene expression. Life history theory suggests these outcomes can be broadly viewed as individual strategies along a continuum from 'fast' to 'slow', with stressful environments predisposing individuals towards faster, more short-term oriented strategies. Griskevicius et al. (2011a) reported an interaction between childhood socioeconomic status and a mortality prime when measuring economic impulsivity using a delay-discounting task. Specifically, participants who grew up in wealthier homes responded to a mortality prime by becoming less impulsive, while those who grew up less wealthy reacted to the prime by becoming more impulsive. The current study sought to replicate and expand upon these findings using a sample of university undergraduates (66 females and 19 males). Participants were exposed to a mortality prime, an anxiety prime, or a neutral prime before completing a questionnaire that included questions about childhood socioeconomic status and a delay discounting survey. When the results of the delay discounting measure were analyzed, no significant interaction between childhood environment and priming condition was observed. Thus, we failed to replicate the findings of Griskevicius et al. (2011a). We suggest that the limited saliency of the mortality prime may account for this discrepancy, and note that the results of other priming studies have often been difficult to replicate. Limitations and future directions for priming studies and life history research are discussed.Item Education, lifelong learning and self-rated health in later life in the USA(SAGE journals, 2018-11-04) Yamashita, Takashi; Bardo, Anthony R.; Liu, Darren; Yoo, Ji WonObjective: This study examined the mediating effects of lifelong learning on the association between self-rated health and educational attainment among a nationally representative sample of US residents aged 50 years and older. Setting: Socioeconomic disparities in health are a major public health concern in economically developed nations where improving socioeconomic status (e.g. formal educational attainment) at the population level is challenging. In the light of population ageing, alternative approaches to improve health through malleable factors are urgently needed. Recent research suggests that participation in organised learning activities – lifelong learning – could attenuate the lack of formal educational attainment on health. Methods: Data come from the 2012 wave of the US Health and Retirement Study. Structural equation models with bootstrapping were used to estimate the mediation effect of lifelong learning activity in the relationship between self-rated health and formal educational attainment. Results: Approximately 3%–5% of the effect of formal education on self-rated health was mediated by lifelong learning activity. Findings from this study support the notion that ongoing participation in organised learning activities is beneficial for health in later life. Conclusion: Lifelong learning reflects a promising autonomous and sustainable strategy to improve health in later life. Future public health and education policy as well as education institutions should consider providing more learning opportunities for older populations.Item Interactive Relations of Racial Discrimination and Poverty Status and Sex with Blood Pressure among African Americans: HANDLS(2019-01-01) Darden, Taylor M.; Beatty Moody, Danielle L; Maton, Kenneth; Psychology; Human ServicesRacial discrimination has been linked to cardiovascular disease (CVD), but little is known about the pathways of this association due to limitations in previous literature. Specifically, more research is needed on the combined, interactive, and moderating influence of social statuses including socioeconomic status (SES) and sex on this association. The current study examined whether the association between racial discrimination and BP was moderated by poverty status and sex in African Americans. The sample (N=1,408) was drawn from the Healthy Aging in Neighborhoods of Diversity across the Life span (HANDLS) study (30-64 years; 43.8% male; 46% below the 125% poverty line). Multivariable and logistic regression analyses were used to examine interactive associations of racial discrimination, poverty status, and sex to resting blood pressure and hypertension status. The hypothesized interactions were not significant, and significant findings were found in the direction opposite of what was expected. The current study suggests that interactive relations of racial discrimination, poverty status, and sex are not consistently related to resting blood pressure and hypertension status in the present sample. This may be due to a true absence of association, or limitations related to the selected measures. Future research is suggested to account for these possibilities.Item Post-Secondary Enrollment Decisions of High School Students: The Effect of Socioeconomic Status(2021-05-01) Romberger, Madalyn; Shamshak, Gina; Shepard, Asha; Grossman, David; Center for People, Politics & Markets - Economics; Bachelor's DegreeDiscrepancies exist in the type of students who attend, and graduate from, post-secondary institutions. This study investigates the impact of socioeconomic status on students' enrollment decisions using the Education Longitudinal Study (ELS:2002). Using an ordinary least square (OLS) model specif cation, attendance is regressed against a combination of demographic and socioeconomic characteristics. The findings reveal that the statistical significance of the independent variables changes based on the inclusion of school income or parental income categories. Differences were observed among sex, race, standardized test scores, student work hours, and parental educational attainment variables.Item Sociodemographic disparities in corticolimbic structures(PLOS, 2019-05-09) Shaked, Danielle; Millman, Zachary B.; Beatty Moody, Danielle L.; Rosenberger, William F.; Shao, Hui; Katzel, Leslie I.; Davatzikos, Christos; Gullapalli, Rao P.; Seliger, Stephen L.; Erus, Guray; Evans, Michele K.; Zonderman, Alan B.; Waldstein, Shari R.This study sought to examine the interactive relations of socioeconomic status and race to corticolimbic regions that may play a key role in translating stress to the poor health outcomes overrepresented among those of lower socioeconomic status and African American race. Participants were 200 community-dwelling, self-identified African American and White adults from the Healthy Aging in Neighborhoods of Diversity across the Life Span SCAN study. Brain volumes were derived using T1-weighted MP-RAGE images. Socioeconomic status by race interactions were observed for right medial prefrontal cortex (B = .26, p = .014), left medial prefrontal cortex (B = .26, p = .017), left orbital prefrontal cortex (B = .22, p = .037), and left anterior cingulate cortex (B = .27, p = .018), wherein higher socioeconomic status Whites had greater volumes than all other groups. Additionally, higher versus lower socioeconomic status persons had greater right and left hippocampal (B = -.15, p = .030; B = -.19, p = .004, respectively) and amygdalar (B = -.17, p = .015; B = -.21; p = .002, respectively) volumes. Whites had greater right and left hippocampal (B = -.17, p = .012; B = -.20, p = .003, respectively), right orbital prefrontal cortex (B = -.34, p < 0.001), and right anterior cingulate cortex (B = -.18, p = 0.011) volumes than African Americans. Among many factors, the higher levels of lifetime chronic stress associated with lower socioeconomic status and African American race may adversely affect corticolimbic circuitry. These relations may help explain race- and socioeconomic status-related disparities in adverse health outcomesItem White Matter Tract Integrity as a Mediator of the Association Between Socioeconomic Status and Executive Function(2019-01-01) Shaked, Danielle; Waldstein, Shari R; Psychology; PsychologyLower socioeconomic status (SES) is related to poorer executive function, but the neural mechanisms of this association remain unclear. As optimal communication between brain regions is essential to our cognitive abilities, white matter integrity may be key to understanding cognitive disparities across socioeconomic groups. This study assessed the mediating role of white matter integrity on the relation between SES and executive function in adults. Participants were 201 African American and Whites from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) SCAN study. Participants underwent 3.0-T cranial magnetic resonance imaging and diffusion tensor imaging was used to estimate regional fractional anisotropy. Adjusting for age, mediation analyses examined if integrity of the anterior limb of the internal capsule, external capsule, superior longitudinal fasciculus, and cingulum independently mediated SES-executive function relations. Low SES was related to worse performance on all cognitive tests and poorer integrity of all white matter tracts. Lower Trails B performance was related to poorer integrity of the anterior limb of the internal capsule, external capsule, and superior longitudinal fasciculus, and lower Stroop performance was associated with poorer integrity of the anterior limb of the internal capsule and external capsule. The anterior limb of the internal capsule significantly mediated the SES-Trails B relation, and the external capsule significantly mediated the SES-Trails B and SES-Stroop relations. Exploratory analyses found that race rendered the external capsule mediations non-significant, and flipped models with race as the independent variable yielded similar results as the base models. Poorer integrity of the anterior limb of the internal capsule and external capsule may help explain SES disparities in executive function. Results related to the external capsule may be common across SES and race due to shared risk pathways pertaining to health disparities. Findings demonstrating cognitive and neuroanatomical disadvantage among low SES individuals highlight the need for promoting optimal brain health, in part via further elucidation of the biopsychosocial mediators of the SES-cognition association as to better target intervention and prevention efforts. Further research is therefore needed to elucidate the multilevel pathways that contribute to inequities in cognitive function among marginalized groups.