Socioeconomic differences in attitudes and beliefs about healthy lifestyles

Study objectives: The factors underlying socioeconomic status differences in smoking, leisure time physical activity, and dietary choice are poorly understood. This study investigated attitudes and beliefs that might underlie behavioural choices, including health locus of control, future salience, subjective life expectancy, and health consciousness, in a nationally representative sample.Design: Data were collected as part of the monthly Omnibus survey of the Office of National Statistics in Britain. Participants: A stratified, probability sample of 2728 households was selected by random sampling of addresses. One adult from each household was interviewed.Main results: Higher SES respondents were less likely to smoke and more likely to exercise and eat fruit and vegetables daily. Lower SES was associated with less health consciousness (thinking about things to do to keep healthy), stronger beliefs in the influence of chance on health, less thinking about the future, and lower life expectancies. These attitudinal factors were in turn associated with unhealthy behavioural choices, independently of age, sex, and self rated health.Conclusions: Socioeconomic differences in healthy lifestyles are associated with differences in attitudes to health that may themselves arise through variations in life opportunities and exposure to material hardship and ill health over the life course

The influence of low job control on ambulatory blood pressure and perceived stress over the working day in men and women from the Whitehall II cohort.

Objective: Work stress contributes to risk of coronary heart disease and hypertension. This study tested the influence of job control on ambulatory blood pressure, and ratings of perceived stress and happiness in men and women systematically sampled by socio-economic status from the Whitehall II epidemiological cohort. Participants: A total of 227 men and women aged 47-59 years sampled from higher, intermediate and lower employment grades. Outcome measures: Ambulatory blood pressure and ratings of stress, perceived control and happiness. Methods: Participants completed standard measures of job demands and job control, and undertook ambulatory monitoring with measures of blood pressure and subjective state every 20 min from early in the working day until going to bed. Results: Systolic and diastolic blood pressure were greater in participants reporting low rather than high job control (means 125.7/81.5 versus 122.4/78.6 mmHg, P < 0.05), independently of gender, employment grade, body mass index, age, smoking status, and physical activity. Differences persisted into the evening after work. Job demands and job strain (high demand/low control) were not associated with blood pressure. Participants reporting low job control experienced stress more frequently over the working day than did those with high job control. Higher socio-economic status participants and women were more stressed by low job control than were men and people of lower socio-economic status. Conclusions: Job control plays an important role in modulating cardiovascular and affective responses over the working day, and these responses may contribute to increased cardiovascular disease risk. © 2004 Lippincott Williams & Wilkins

Pathogen burden and cortisol profiles over the day

Hypothalamic-pituitary-adrenocortical (HPA) regulation in adults is influenced by early psychosocial adversity, but the role of infectious disease history is poorly understood. We studied the association between cumulative pathogen burden and cortisol profile over the day in a sample of 317 healthy men and women aged 51-72 years. Cumulative pathogen burden was defined as positive serostatus for Chlamydia pneumoniae, cytomegalovirus (CMV) and herpes simplex virus 1 (HSV-1). Salivary cortisol was sampled repeatedly over the day. The cortisol slope was defined as the decrease across the day and evening. Age, gender, grade of employment, body mass index, smoking status, self-rated health, cardiovascular medication, depressed mood and time of waking were included as covariates. The pathogen burden averaged 1.76 (S.D. = 0.92). The cortisol slope was inversely associated with pathogen burden after controlling for covariates. When individual pathogens were studied, only CMV was associated with flatter cortisol rhythms in isolation. We conclude that pathogen burden is independently associated with flatter cortisol slopes over the day, and may contribute to disturbed neuroendocrine regulation

Four-year stability of anthropometric and cardio-metabolic parameters in a prospective cohort of older adults

Aim: To examine the medium-term stability of anthropometric and cardio-metabolic parameters in the general population. Materials & methods: Participants were 5160 men and women from the English Longitudinal Study of Ageing (age ≥50 years) assessed in 2004 and 2008. Anthropometric data included height, weight, BMI and waist circumference. Cardio-metabolic parameters included blood pressure, serum lipids (total cholesterol, HDL, LDL, triglycerides), hemoglobin, fasting glucose, fibrinogen and C-reactive protein. Results: Stability of anthropometric variables was high (all intraclass correlations >0.92), although mean values changed slightly (-0.01 kg weight, +1.33 cm waist). Cardio-metabolic parameters showed more variation: correlations ranged from 0.43 (glucose) to 0.81 (HDL). The majority of participants (71–97%) remained in the same grouping relative to established clinical cut-offs. Conclusion: Over a 4-year period, anthropometric and cardio-metabolic parameters showed good stability. These findings suggest that when no means to obtain more recent data exist, a one-time sample will give a reasonable approximation to average levels over the medium-term, although reliability is reduced

Subjective Wellbeing, Health and Ageing

Life satisfaction dips around middle age and rises in older age in high-income, English-speaking countries, but that is not a universal pattern, according to a new report. In contrast, residents of other regions -- such as the former Soviet Union, Eastern Europe, Latin America and sub-Saharan Africa -- grow increasingly less satisfied as they age. The study -- conducted by researchers from Princeton University's Woodrow Wilson School of Public and International Affairs, Stony Brook University and University College London -- highlights how residents of different regions across the world experience varying life-satisfaction levels and emotions as they age

The protective scale of the Armidilo‐S:the importance of forensic and clinical outcomes

Background: The Armidilo has two scales—the risk scale and the protective scale. Research has been confined to the risk scale which appears to predict future incidents with medium to large effect sizes. There have been no publications on the use of the protective scale.Methods: The Armidilo was completed on four individuals with IDD who were either moving on from their placement or whose placement was in jeopardy because of new information or altered policies in the organization. The Armidilo was completed in the usual fashion.Results: Risk and protective results show that for each individual, recommendations could be made that ensured the best outcome. For two participants, restrictive placements were avoided because of the data on protective factors.Conclusions: The protective scale can be a powerful support for the clinician's case in offenders with IDD. The protective scale should be completed routinely for clinical evaluation

Behavioural counselling to increase consumption of fruit and vegetables in low income adults : randomised trial

Objective To measure the effect of brief behavioural counselling in general practice on patients’ consumption of fruit and vegetables in adults from a low income population. Design Parallel group randomised controlled trial. Setting Primary health centre in a deprived, ethnically mixed inner city area. Participants 271 patients aged 18-70 years without serious illness. Intervention Brief individual behavioural counselling based on the stage of change model; time matched nutrition education counselling. Main outcome measures Self reported number of portions of fruit and vegetables eaten per day, plasma β carotene, α tocopherol, and ascorbic acid concentrations, and 24 hour urinary potassium excretion. Assessment at baseline, eight weeks, and 12 months. Results Consumption of fruit and vegetables increased from baseline to 12 months by 1.5 and 0.9 portions per day in the behavioural and nutrition groups (mean difference 0.6 portions, 95% confidence interval 0.1 to 1.1). The proportion of participants eating five or more portions a day increased by 42% and 27% in the two groups (mean difference 15%, 3% to 28%). Plasma β carotene and α tocopherol concentrations increased in both groups, but the rise in β carotene was greater in the behavioural group (mean difference 0.16 μmol/l, 0.001 μmol/l to 1.34 μmol/l). There were no changes in plasma ascorbic acid concentrations or urinary potassium excretion. Differences were maintained when analysis was restricted to the 177 participants with incomes ≤ £400 (€596, $640) a week. Conclusions Brief individual counselling in primary care can elicit sustained increases in consumption of fruit and vegetables in low income adults in the general population

Life skills, wealth, health, and wellbeing in later life

Life skills such as persistence, conscientiousness, and control are important in early life. Our findings suggest that they are relevant in later life as well. Higher scores on five life skills (conscientiousness, emotional stability, determination, control, and optimism) were associated both cross-sectionally and longitudinally with economic success, social and subjective wellbeing, and better health in older adults. No single attribute was especially important; rather, effects depended on the accumulation of life skills. Our results suggest that fostering and maintaining these skills in adult life may be relevant to health and wellbeing at older ages

Psychosocial Factors in Diabetes and Cardiovascular Risk

Type 2 diabetes is a chronic disease that is increasing in prevalence globally. Cardiovascular disease is a major cause of mortality and morbidity in diabetes, and lifestyle and clinical risk factors do not fully account for the link between the conditions. This article provides an overview of the evidence concerning the role of psychosocial stress factors in diabetes risk, as well as in cardiovascular complications in people with existing diabetes. Several types of psychosocial factors are discussed including depression, other types of emotional distress, exposure to stressful conditions, and personality traits. The potential behavioral and biological pathways linking psychosocial factors to diabetes are presented and implications for patient care are highlighted