Heterogeneous ozone effects on the DNA methylome of bronchial cells observed in a crossover study.

We used a randomized crossover experiment to estimate the effects of ozone (vs. clean air) exposure on genome-wide DNA methylation of target bronchial epithelial cells, using 17 volunteers, each randomly exposed on two separated occasions to clean air or 0.3-ppm ozone for two hours. Twenty-four hours after exposure, participants underwent bronchoscopy to collect epithelial cells whose DNA methylation was measured using the Illumina 450 K platform. We performed global and regional tests examining the ozone versus clean air effect on the DNA methylome and calculated Fisher-exact p-values for a series of univariate tests. We found little evidence of an overall effect of ozone on the DNA methylome but some suggestive changes in PLSCR1, HCAR1, and LINC00336 DNA methylation after ozone exposure relative to clean air. We observed some participant-to-participant heterogeneity in ozone responses.

Neighborhood disadvantage, disorder, and health.

We examine the question of whether living in a disadvantaged neighborhood damages health, over and above the impact of personal socioeconomic characteristics. We hypothesize that (1) health correlates negatively with neighborhood disadvantage adjusting for personal disadvantage, and that (2) neighborhood disorder mediates the association, (3) partly because disorder and the fear associated with it discourage walking and (4) partly because they directly impair health. Data are from the 1995 Community, Crime, and Health survey, a probability sample of 2,482 adults in Illinois, with linked information about the respondent's census tract. We find that residents of disadvantaged neighborhoods have worse health (worse self-reported health and physical functioning and more chronic conditions) than residents of more advantaged neighborhoods. The association is mediated entirely by perceived neighborhood disorder and the resulting fear. It is not mediated by limitation of outdoor physical activity. The daily stress associated with living in a neighborhood where danger, trouble, crime and incivility are common apparently damages health. We call for a bio-demography of stress that links chronic exposure to threatening conditions faced by disadvantaged individuals in disadvantaged neighborhoods with physiological responses that may impair health.

Age and the effect of economic hardship on depression.

The amount of depression associated with economic hardship among adults may depend on age. This study tests alternative hypotheses about the interaction. The first asserts that the amount of depression associated with economic hardship decreases with older age because of maturity and experience. The second, the opposite, asserts that the amount increases with older age because of increasingly limited future opportunities for recovery. The study analyzes data from 2,592 households in the 1995 and 1998 telephone survey of Aging, Status, and the Sense of Control (ASOC). Regression analyses find that the amount of depression associated with economic hardship decreases with older age, both cross-sectionally and over time. No model shows an increase with age in the depression associated with economic hardship. However, regressions do show that not having household wage income or having a disabling or life threatening chronic disease increases the depression associated with economic hardship. Those interactions somewhat suppress the moderating effect of older age on the association between economic hardship and depression.

Does medical insurance contribute to socioeconomic differentials in health?

Both access to insurance and health itself vary widely by socioeconomic status (SES). Are socioeconomic variations in health linked to insurance coverage or to factors that lie outside the medical care arena? Data from the Aging, Status, and the Sense of Control Survey were the basis of a representative U.S. national telephone survey conducted in 1995, and again in 1998. The results showed that persons with private insurance do not differ significantly from the uninsured in their self-reported health, physical functioning, or number of chronic conditions, whereas persons with public insurance report significantly worse health and more chronic conditions than the uninsured. These longitudinal results hold with adjustment for baseline health, SES, change in social status, and the hazard of attrition. Medical insurance does not mediate any associations between SES and health. Medical insurance of all kinds, however, does reduce difficulties in paying medical bills, and Medicaid is associated with more doctor visits and prescription drugs.

Refining the association between education and health: the effects of quantity, credential, and selectivity.

We refine the established association between education and health by distinguishing three aspects of a person's education (quantity, credential, and selectivity) and by examining the mechanisms through which they may correlate with health. Data are from the 1995 Aging, Status, and the Sense of Control Survey, a representative U.S. national telephone survey of 2,593 respondents aged 18 to 95, with an oversample of elderly. Results show that physical functioning and perceived health increase significantly with years of formal education and with college selectivity for those with a bachelor's or higher degree, adjusting for age, sex, race, marital status, and parental education. The credential of a college degree has no net association with physical functioning and perceived health beyond the amount attributable to the additional years of schooling. Of the three aspects of education, years of schooling has the largest effect. Most of that association appears attributable to its correlation with work and economic conditions, social psychological resources, and health lifestyle. A large portion of the net association of college selectivity with physical functioning and perceived health appears attributable to health lifestyle.

Subjective life expectancy in the US: correspondence to actuarial estimates by age, sex and race.

This study maps the relationship between subjective and actuarial life expectancy in a 1995 national sample of 2037 Americans of ages 18-95. Subjective estimates parallel age-specific actuarial ones based on current age-specific mortality rates. However males expect to live about 3 years longer than the actuarial estimate and blacks expect to live about 6 years longer. The apparent optimism remains after adjusting for socioeconomic status and the signs and symptoms of good health. Contrary to economists' rational-expectations hypothesis, young adults do not adjust their life expectancies upward to account for the favorable trends in mortality rates.

Age, subjective life expectancy, and the sense of control: the horizon hypothesis.

This article reports a test of the horizon hypothesis, which states that greater subjective life expectancy increases the sense of control over one's own life and in part accounts for the negative association between age and the sense of control. Results of a U.S. survey of 2,029 respondents aged 18 and older (934 aged 50 and older) support the hypothesis. Subjective life expectancy has a significant positive association with the sense of control that does not vanish with adjustment for race, sex, education, income, widowhood, inability to work because of a disability, physical impairment, and physical fitness. Adjustment for subjective life expectancy explains the part of the negative association between age and the sense of control that remains after adjustment for education and physical impairment. Adjusting the three factors together explains 93.1 percent of the total association between age and the sense of control, and renders the remaining association insignificant.

Age and the gender gap in depression.

Women average higher levels of depression than men. This paper tests the hypothesis that the gender gap in depression grows in adulthood as women and men enter and undergo their unequal adult statuses. The emerging gender stratification hypothesis has three parts: (1) The age increment hypothesis states that the difference in depression between women and men increases in successively older age groups at least until retirement age and perhaps throughout the lifetime; (2) The status mediation hypothesis states that rising sex differences in marital status, employment, house-work, child care, and economic strains account for much of the larger gender gap in depression among middle-aged adults than among young adults; (3) The differential change hypothesis states that women's depression drops more slowly than men's in early adulthood, so that the gender gap increases over time as implied by the concurrent differences among age groups. Analyses of three data sets (two from national U.S. samples) support the three component hypotheses.

Fundamental analysis in research on well-being: distress and the sense of control.

Fundamental analysis defines the basic terms of social and behavioral research. It usually follows the rule "one concept to a measure." However, some responses inherently reflect more than one underlying attribute, as when a test score reflects both knowledge of the subject and practice with taking tests. The standard methods of fundamental analysis break down in the presence of such cross-cutting factors. In this article, we discuss two instances of confusion and disagreement among social and behavioral scientists generated by the effects of cross-cutting factors on critical measures. In the first instance, a tendency to agree with the statements of others can make beliefs about personal control over events and outcomes seem unrelated to beliefs about control by chance, fate, or powerful others. The tendency to agree correlates positively with age. In the second instance, emotional expressiveness can make the frequency or intensity of sadness seem unrelated to the frequency or intensity of happiness. Women, who make up the large majority of older Americans, express themselves more freely than men. The apparent disjointedness of internal and external attributions of control, or of positive and negative emotions, results from methods assuming that the response to each question reflects one and only one underlying factor. Cross-cutting factor models eliminate the bias and confusion produced by response tendencies and help isolate and define the essential dimensions of response.

Does employment affect health?

Employment correlates positively with health, but is employment cause or consequence? The social causation hypothesis says that employment improves the health of men and women. The selection hypothesis says that healthy people get and keep jobs more than unhealthy people do. We test both hypotheses using longitudinal data from a national probability sample (N = 2,436 interviewed in both years). In the equations representing social causation, full-time employment predicts slower declines in perceived health and in physical functioning for both men and women. Full-time employment has the same effect for both sexes. Among women, it also has the same effect for White and non-White, and for married and nonmarried. In the equations representing social selection, physical functioning increases the odds of getting or keeping a full-time job for both sexes. Perceived health increases the odds for women but not for men. In regard to homemaking among women, homemaking predicts significantly greater declines in health, but health has no effect on the odds of becoming or staying a homemaker.

Age and depression.

In this study, the relationship between age and depression is analyzed, looking for effects of maturity, decline, life-cycle stage, survival, and historical trend. The data are from a 1990 sample of 2,031 U.S. adults and a 1985 sample of 809 Illinois adults. The results show that depression reaches its lowest level in the middle aged, at about age 45. The fall of depression in early adulthood and rise in late life mostly reflects life-cycle gains and losses in marriage, employment, and economic well-being. Depression reaches its highest level in adults 80 years old or older, because physical dysfunction and low personal control add to personal and status losses. Malaise from poor health does not create a spurious rise of measured depression in late adulthood. However, some of the differences among age groups in depression reflect higher education in younger generations, and some reflect different rates of survival across demographic groups that also vary in their levels of depression.

Control or defense? Depression and the sense of control over good and bad outcomes.

Defense theory holds that defensive illusions guard well-being. People supposedly are least depressed if they claim responsibility for good outcomes and deny responsibility for bad ones. Control theory states that active, effective problem solving builds well-being; thus a sense of personal control and responsibility for both success and failure is associated with low levels of depression. Which theory is right? Regression analyses of the self-reports of 809 randomly selected Illinois residents show that a sense of responsibility for both successes and failures (instrumentalism) is associated with low levels of depression. There is no measurable benefit from claiming responsibility for the good things while denying responsibility for the bad (self-defense). Depression is associated with not feeling in control of good outcomes, or of bad outcomes, or of both. The sense of control reflects the reality of social and economic status. It explains part of the relationship between status and depression. We infer that defensive illusions are no substitute for genuine control.

Explaining the social patterns of depression: control and problem solving--or support and talking?

Research on the social patterns of depression in the community finds consistently that high levels of education and income, being male, and being married are associated with lower levels of depression. We attempt to explain these patterns as the result of two essential social perceptions: the sense of controlling one's own life rather than being at the mercy of powerful others and outside forces, and the sense of having a supportive and understanding person to talk to in times of trouble. In theory, the sense of control reduces depression because it encourages active problem solving, and the sense of support reduces depression because it provides others to talk to. We find evidence for the first proposition: persons who feel in control of their lives are more likely to attempt to solve problems. Perceived control and problem solving decrease depression and largely explain the effects of income and education on depression. We find, however, that support has mixed effects. Support decreases depression, but talking to others when faced with a problem, which increases with the level of support, increases depression. Support explains a small part of the effect of marriage on depression. Control and support have an interactive effect on depression, suggesting that control and support can substitute for one another to decrease depression: a high level of one reduces the need for the other, and a low level of one is remedied by a high level of the other.

Psychiatric diagnosis as reified measurement.

Throughout the 1980s, psychiatry has promoted diagnosis--with its language of categories--as the preeminent measure of psychological problems. In clinical psychiatry, the decade opened with the publication of the Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III). In psychiatric epidemiology, the decade saw the development of the Diagnostic Interview Schedule (DIS) and its use in the large-scale Epidemiologic Catchment Area (ECA) surveys. Proponents of the diagnostic approach herald the DIS as a breakthrough. We argue, on the contrary, that diagnosis as a form of measurement hinders understanding. If the ECA studies provide new insight into the patterns and causes of psychological problems, they will do so despite the use of diagnostic measurement. We present here a critical analysis of the inherent weaknesses of diagnosis as a form of measurement, particularly as a means of representing psychological problems. First, we describe the weaknesses: diagnosis treats attributes as entities; it reduces the signal but not the noise; and it collapses the structural relationships. Second, we offer an interpretation of why psychiatry promotes a form of measurement poorly suited to its subject: the linguistic legacy of nineteenth-century biology and epidemiology; the social construction of the need for mental health services; and the enclosure of a scientific and professional domain. Third, we conclude that diagnostic measurement impedes understanding. We recommend eliminating diagnosis from research on the nature, causes, and consequences of mental, emotional, and behavioral problems.

Components of depressed mood in married men and women. The Center for Epidemiologic Studies' Depression Scale.

The Center for Epidemiologic Studies' Depression Scale (CES-D) was developed to measure depressive symptoms in community populations. To be useful for epidemiologic studies of depression, the scale should measure the same thing in various subgroups. This study examines the psychometric properties of the CES-D among men and women, including its factor structure, reliability, and characteristics of its subscales. A national sample of 1,360 married men and women, collected in 1978, was used. Factor analysis produced four major factors in the CES-D: depressed affect, enervation , lack of positive affect, and interpersonal problems. These factors are generalizable across men and women with two exceptions--crying spells, which are a good indicator of depressed mood for women, do not indicate depressed mood for men; and feeling one's life is a failure is associated with depressed affect for women and with a lack of positive affect for men. The two items in the interpersonal factor (feeling that people dislike you and that people are unfriendly ) do not show the expected pattern of association with gender, since men have significantly more interpersonal symptoms than women. Women have more symptoms of depressed affect, enervation , and lack of positive affect.