Family socioeconomic position and abnormal birth weight:evidence from a Chinese birth cohort

Background Birth weight is a strong determinant of infant short-and long-term health outcomes.Family socioeconomic position(SEP)is usually positively associated with birth weight.Whether this association extends to abnormal birth weight or there exists potential mediator is unclear.Methods We analyzed data from 14,984 mother-infant dyads from the Born in Guangzhou Cohort Study.We used multi-variable logistic regression to assess the associations of a composite family SEP score quartile with macrosomia and low birth weight(LBW),and examined the potential mediation effect of maternal pre-pregnancy body mass index(BMI)using causal mediation analysis.Results The prevalence of macrosomia and LBW was 2.62%(n=392)and 4.26%(n=638).Higher family SEP was associated with a higher risk of macrosomia(OR 1.30,95%CI 0.93-1.82;OR 1.53,95%CI 1.11-2.11;and OR 1.59,95%CI 1.15-2.20 for the 2nd,3rd,and 4th SEP quartile respectively)and a lower risk of LBW(OR 0.69,95%CI 0.55-0.86;OR 0.76,95%CI 0.61-0.94;and OR 0.61,95%CI 0.48-0.77 for the 2nd,3rd,and 4th SEP quartile respectively),compared to the 1st SEP quartile.We found that pre-pregnancy BMI did not mediate the associations of SEP with macrosomia and LBW.Conclusions Socioeconomic disparities in fetal macrosomia and LBW exist in Southern China.Whether the results can be applied to other populations should be further investigated.

Social Determinants of Change in Smoking Status over a 26-Year Follow up Period among Middle-Aged and Older Americans

Educational attainment and income are among major socioeconomic status (SES) indicators that are inversely associated with cigarette smoking. Marginalization-related Diminished Returns (MDRs), however, are weaker protective effects of SES indicators for racial and ethnic minority groups compared to non-Hispanic White people. The aim is to test whether racial and ethnic differences exist in the effects of educational attainment and income on cigarette smoking of middle-aged and older American adults. This is a 26-year longitudinal study using data from the Health and Retirement Study (HRS), a nationally representative study of middle-aged and older adults in the US. A total number of 11,316 middle-aged and older adults (age ≥ 50) were followed for up to 26 years. The independent variables were educational attainment and income. The dependent variables were always smoking and being quitters over the follow-up time. Age, gender, self-rated health, and chronic medical conditions were the covariates. Race/ethnicity was the moderator. Logistic regressions were used to analyze the data. Most participants were never smokers (n = 7950), followed by quitters (n = 1765), always smokers (n = 1272), and initiators (n = 329). Overall, high educational attainment (OR = 0.92, 95% CI = 0.90 - 0.95) and income (OR = 0.99, 95% CI = 0.99 - 0.99) reduced the odds of being always smoker. High educational attainment (OR = 1.05, 95% CI = 1.02 - 1.08) was associated with higher odds of being a quitter. Ethnicity, however, showed significant interactions with education on both outcomes suggesting that the effects of educational attainment on reducing the odds of always being a smoker (OR = 1.24, 95% CI = 1.14 - 1.35) and increasing the odds of quitting (OR = 0.84, 95% CI = 0.75 - 0.93) were smaller for Hispanics than non-Hispanics. In the United States, middle-aged and older Hispanic adults remain at high risk of smoking cigarettes despite high educational attainment. That is, high educational attainment may better help non-Hispanic than Hispanic middle-aged and older adults to avoid cigarette smoking. As a result, we may observe a more than expected burden of tobacco use in middle class Hispanic middle-aged and older adults. Policymakers should not reduce racial and ethnic tobacco inequalities to SES gap, as ethnic tobacco disparities may persist in high SES levels as well.

Diminished Health Returns of Own and Parental Education for Immigrants in the United States

Background:Educational attainment is a strong social determinant of health.Marginalization-related Diminished Returns(MDRs),however,refer to smaller health effects of socioeconomic status,particularly educational attainment for marginalized groups compared to mainstream populations.While multiple studies have documented MDRs of educational attainment for racial,ethnic,and sexual minorities,there are no previous studies on MDRs of education among immigrants.Aims:To understand if the MDRs phenomenon also applies to immigrants,we compared immigrant and non-immigrant American adults for the effects of their own and parental educational attainment on subjective health.Methods:This study used a cross-sectional design and borrowed data from the General Social Survey(1972-2018).GSS is a series of nationally representative surveys in the U.S.Our analytical sample included 38,399 adults who were either non-immigrants(n=34903;90.9%)or immigrants(n=3496;9.1%).The main independent variables were own and parental educational attainment measured as four-level categorical variables.The dependent variable(DV)was poor subjective health,measured using a single item.Age,sex,marital status,and year of the survey were the covariates.Immigration status was the moderator.Results:Overall,individuals with higher educational attainment of own and parents reported better subjective health.We,however,found significant interactions between immigration status and both own and parental educational attainment on subjective health,which was suggestive of weaker protective effects of own and parental educational attainment against poor subjective health in immigrants than non-immigrant individuals.Conclusions:In the United States,immigrant adults experience poor subjective health disproportionate to their own and their parents educational attainment.That means we may observe worse than expected health of immigrants across all educational levels and social classes.Public policies should go beyond equal access to education by empowering marginalized people to leverage their education and secure better outcomes.

Factors of heavy social media use among 13-year-old adolescents on weekdays and weekends

Background Few studies have investigated which factors were related to adolescents'social media use.This study aimed to evaluate which factors were associated with heavy social media use on weekdays and weekends among 13-year-old adolescents.Methods We analyzed data from 3727 children from the Generation R Study,a population-based cohort study in the Neth-erlands.Associations of demographic factors(child age,sex,ethnic background,and family situation),socioeconomic posi-tion(parental educational level,parental employment status,and net household income),screen-based behaviors(computer playing and TV viewing),and the home environment(communication,supervision,and restriction)with adolescents'heavy social media use(≥2 hours/day)were assessed separately on weekdays and weekends.Multivariate logistic regression analysis was applied.Results The prevalence of heavy social media use was 37.7%on a weekday and 59.6%on a weekend day.Being a girl,liv-ing in a one-parent family,and more time spent playing on the computer were associated with heavy social media use on weekdays and weekends(all P<0.05).Low socioeconomic position adolescents(low parental educational level and low household income)were more likely to show heavy social media use only on weekends(all P<0.05).Children whose social media use was restricted by parents on weekdays or children whose social media use was supervised by parents on weekends had lower odds of heavy social media use(all P<0.05).Conclusions Being a girl,living in a one-parent family,or having a longer computer playing time were associated with heavy social media use on weekdays and weekends.More studies are needed to understand the factors associated with heavy social media use and the impact of heavy social media use on child health.