Inequalities in Disability-Free and Disabling Multimorbid Life Expectancy in Costa Rica, Mexico, and the United States.

OBJECTIVES: To better understand variations in multimorbidity severity over time, we estimate disability-free and disabling multimorbid life expectancy (MMLE), comparing Costa Rica, Mexico, and the United States (US). We also assess MMLE inequalities by sex and education. METHODS: Data come from the Costa Rican Study on Longevity and Healthy Aging (2005-2009), the Mexican Health and Aging Study (2012-2018), and the Health and Retirement Study (2004-2018). We apply an incidence-based multistate Markov approach to estimate disability-free and disabling MMLE and stratify models by sex and education to study within-country heterogeneity. Multimorbidity is defined as a count of 2 or more chronic diseases. Disability is defined using limitations in activities of daily living. RESULTS: Costa Ricans have the lowest MMLE, followed by Mexicans, then individuals from the US. Individuals from the US spend about twice as long with disability-free multimorbidity compared with individuals from Costa Rica or Mexico. Females generally have longer MMLE than males, with particularly stark differences in disabling MMLE. In the US, higher education was associated with longer disability-free MMLE and shorter disabling MMLE. We identified evidence for cumulative disadvantage in Mexico and the US, where sex differences in MMLE were larger among the lower educated. DISCUSSION: Substantial sex and educational inequalities in MMLE exist within and between these countries. Estimating disability-free and disabling MMLE reveals another layer of health inequality not captured when examining disability and multimorbidity separately. MMLE is a flexible population health measure that can be used to better understand the aging process across contexts.

The Effect of Financial Strain on the Health Outcomes of Older Mexican-Origin Adults: Findings From the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE).

Predictors of health across the life-course do not maintain the same significance in very late life and the role of financial strain in health outcomes of very old adults remain unclear. Data from adults aged 74 + in waves 5 and 7 of the Hispanic Established Population for the Epidemiological Study of the Elderly (n = 772) study was used to evaluate the role of financial strain on the health of older Mexican Americans who have the highest poverty rate of any racial or ethnic group in the United States. We evaluate the association between episodic (one wave) and persistent financial strain (two waves), with follow-up health outcomes (self-rated health, ADL (limitations in activities of daily living)/IADL (limitations in instrumental activities of daily living) disability, and depressive symptoms). Adults with persistent strain were twice as likely to experience depressive symptoms and three times more likely to experience IADL limitations than the unstrained. Our findings highlight the role of stress proliferation and allostatic load processes leading to deteriorated health over time.

Distinct domains of childhood disadvantage and cognitive performance among older Brazilians: Evidence from ELSI-Brazil.

Objective: To investigate the relationship between of distinct domains of childhood disadvantage and cognitive performance among older adults within the context of a middle-income country. Methods: This study used baseline data (2015/2016) from the Brazilian Longitudinal Study of Aging (ELSI), a nationally representative cohort of 9412 adults aged 50 and over. Nine childhood exposure variables were grouped into three domains (family SES, childhood health, and cultural capital), for which scores were created. Survey-weighted Ordinary Least Squares (OLS) regressions estimated the association childhood disadvantage with cognitive performance as measured by immediate memory, late memory and semantic verbal fluency. Mediation analysis assessed whether adulthood socioeconomic status (SES) mediated this relationship of interest. Results: Important disparities in cognitive performance were observed, particularly in terms of age, education, income, occupational status. Before controlling for adulthood SES in the multivariable analysis, all domains of childhood disadvantage were found to be associated with lower cognitive performance across all three measures. After inclusion of adulthood SES variables, the observed associations only remained for semantic verbal fluency. Formal mediation analysis indicated that adulthood SES mediates 47.9% (95% CI: 34.3%-78.6%) of the association between later-life verbal fluency and poor childhood health, and 49.9% (95% CI: 43.6%-57.8%) of the association between later-life verbal fluency and low childhood cultural capital. Conclusions: We found that childhood disadvantage is associated with low performance in memory tests and semantic verbal fluency tests among older Brazilians. Adulthood SES fully mediated the association between all domains of childhood disadvantage and memory performance and only partially mediated its association with verbal fluency. Our findings support policy efforts to enhance early childhood development and improve adulthood SES, and guide additional research to better the mechanisms driving these relationships.

Social communication therapy for children at risk for neurodevelopmental difficulties: Protocol for a clinical trial.

Exposure to adverse environments are risk factors for neurodevelopmental problems in childhood. Children exposed to such environments may benefit from interventions that target social communication abilities, since these are protective factors for healthy neurodevelopment. This randomized controlled trial will test the efficacy of Paediatric Autism Communication Therapy (PACT) in improving social communication development in young children at risk for neurodevelopmental difficulties living in poverty in Brazil. Participants will be 160 children aged 2-4 years with lower-than-average social communication abilities and their primary caregivers. Child-caregiver dyads will be recruited from public childhood education centers in impoverished urban regions of the city of São Paulo, Brazil. Lower-than-average social communication abilities will be defined by standard scores (≤84) on the socialization and/or communication domains of the Vineland Adaptive Behavior Scales. Child-caregiver dyads will be randomized to receive 12 sessions of the PACT intervention (n = 80) or 5 months of community support as usual plus psychoeducation (n = 80). The primary outcome (parent-child interaction) and secondary outcomes (parent-reported social communication abilities and neurophysiological activity during a live social interaction) will be measured pre- and postintervention. This study may lead to new interventions for vulnerable young children in Brazil and better understanding of the neural mechanisms of PACT.

Exploring the potential for a new measure of socioeconomic deprivation status to monitor health inequality.

BACKGROUND: Monitoring health inequalities is an important task for health research and policy, to uncover who is being left behind - and where - and to inform effective and equitable policies and programmes to tackle existing inequities. The choice of which measure to use to monitor and analyse health inequalities is thereby not trivial. This article explores a new measure of socioeconomic deprivation status (SDS) to monitor health inequalities. METHODS: The SDS measure was constructed using the Alkire-Foster method. It includes eight indicators across two equally weighted dimensions (education and living standards) and specifies a four-level gradient of socioeconomic deprivation at the household-level. We conducted four exercises to examine the value-added of the proposed SDS measure, using Demographic and Health Surveys data. First, we examined the discriminatory power of the new measure when applied to outcomes in four select reproductive, maternal, neonatal, and child health (RMNCH) indicators across six countries: skilled birth attendance, stunting, U5MR, and DTP3 immunisation. Then, we analysed the behaviour and association of the new SDS measure vis-à-vis the DHS Wealth Index, including chi-squared test and Pearson correlation coefficient. Third, we analysed the robustness of the SDS measure results to changes in its structure, using pairwise comparisons and Kendal Tau-b rank correlation. Finally, we illustrated some of the advantageous properties of the new measure, disaggregation and decomposition, on Haitian data. RESULTS: 1) Higher levels of socioeconomic deprivation are generally consistently associated with lower levels of achievements in the RMNCH indicators across countries. 2) 87% of all pairwise rank comparisons across a range of SDS measure structures were robust. 3) SDS and DHS Wealth Index are associated, but with considerable cross-country variation, highlighting their complementarity. 4) Haitian households in rural areas experienced, on average, more severe socioeconomic deprivation as well as lower levels of RMNCH achievement than urban households. CONCLUSIONS: The proposed SDS measure adds analytical possibilities to the health inequality monitoring literature, in line with ethically and conceptually well-founded notions of absolute, multidimensional disadvantage. In addition, it allows for breakdown by its dimensions and components, which may facilitate nuanced analyses of health inequality, its correlates, and determinants.

Income transfer programme for children and adolescents with disabilities in Brazil.

BACKGROUND: In Brazil, there are 55 million people living in extreme poverty. People with disabilities are doubly impacted by low income and the presence of the disability. The Continuous Cash Benefit Program (BPC) is an aid granted by the Brazilian federal government to people who attest to the condition of disability as an impediment to a life on an equal basis with other individuals. Requests to BPC are made to the national competence body that carries out an expert medical and social assessment, by means of an instrument that determines the degree of the disability. Our objective was to analyse the standard of BPC concessions for children and young people with disabilities and to identify the prevalence of major diseases in the concessions. METHODS: The exploratory, cross-sectional and retrospective research used primary data collected from 332 expert medical assessments of children under 16 years old. The standard and determinants of the concessions were established through Cluster Analysis by Ward's criterion and Euclidean distance, specifying the homogeneous groups of dysfunction classes. The prevalence of major diseases was performed by frequency analysis according to the International Classification of Diseases (ICD). The socioeconomic profile of BPC requirements and the main causes of BPC rejection were analysed through descriptive analysis. RESULTS: There was a predominance of male, preschoolers and illiterate individuals in the requirements and concessions. In the granting standard for impaired function class, problems related to congenital changes received benefits even in the absence of impairment, with childhood autism being the most prevalent diagnosis. CONCLUSIONS: The concessions seemed more dependent on the diagnosis itself and on the age of the beneficiaries than on the degree of dysfunction suffered, without exclusions, by the individuals.

Maternal care and child physical health: Impact of the exposure to adverse experiences during the first year of life of vulnerable children.

INTRODUCTION: Adverse childhood experiences (ACEs) can negatively affect children's current and future health. OBJECTIVES: This study aims to analyse the impact of ACE on the health of 12-month-old infants assessed by a Physical Health and Maternal Care Indicator (ISCM). METHODS: We conducted a retrospective cohort including 170 infants born in two public services for high-risk births in Brazil. ISCM gathers information that reflects maternal care and the child's health throughout the first year of life, such as vaccination, nutrition, growth, illnesses and accidents. The ACE impact on ISCM was analysed by multiple linear regression, and the d-Cohen test estimated its effect size. Spearman's correlation was used to analyse the cumulative ACE effect, measured by a score reflecting events such as family dysfunction, maternal mental health, poverty and exposure to violence. RESULTS: Most infants were born prematurely (71.7%), had low birthweight (64.7%) and were exposed to three ACEs on average. The ISCM was lower in children exposed to maternal depression (P < 0.001, d-Cohen = 0.08), substance abuse by family members (P = 0.02, d-Cohen = 0.6) and marital conflicts (P = 0.03, d-Cohen = 0.7). The Spearman's correlation showed that the greater the exposure to ACEs, the lower the ISCM (r = -0.40, P < 0.0001). CONCLUSION: Exposure to ACE, especially in the family environment, had negative effect on maternal care and child health. The impact could be detected in the first year of life and had cumulative effect. Our findings indicate the need for a broader approach to child health to minimize ACE's impacts.

Aging into disadvantage: Disability crossover among Mexican immigrants in America.

The "Hispanic paradox" refers to the accepted finding that Mexican immigrants have lower mortality compared to the US-born population, despite having lower levels of income, educational attainment, and health insurance coverage. However, Mexican immigrants' mortality advantage is not matched by lower disability rates, particularly later in the life course. Past studies have identified a crossover in disability rates for Mexican immigrants using age-specific disability rates but confound the effects of aging and duration of residence. By using the synthetic cohort method, I extend prior work on the disability crossover by tracing immigrant cohorts across the life course and disentangling newly arrived immigrants from those already established in the U.S. I use American Community Survey (ACS) 2015-2019 data to test whether the acculturation or cumulative disadvantage hypotheses account for the disability crossover. I find that, contrary to the expected finding of a socioeconomic health gradient in disability rates, Mexican immigrants' high disability rates converge regardless of education level or immigrant cohort. In addition, Mexican female immigrants are doubly disadvantaged, living in a protracted period of disability compared to males of the same education level. My findings support the negative health acculturation hypothesis as the dominant pathway for Mexican immigrants' later-life disability trajectories and consequently the explanation behind the disability crossover.

Gender differences in health in Havana versus in Mexico City and in the US Hispanic population.

Health progress in the 1960s and 1970s placed Cuba at the vanguard of longevity in Latin America and the Caribbean. This success has often been attributed to equity of access to the health care system and its cost-effectiveness in the country. Cuba also has a small gender gap in life expectancy. In this study, we examined how this pattern is reflected in the gender differences in health among the population aged 60+ in Havana. We compared gender differences in health in samples drawn from Havana, Mexico City, and the US Hispanic population: three geographic settings with very different political, health care, and social systems. The data come from the Survey on Health, Well-Being, and Aging in Latin America and the Caribbean and the 2000 Health and Retirement Study. Age-adjusted prevalence and logistic regressions were estimated for poor self-rated health, limitations on activities of daily living, depression, and mobility limitations. While an absolute female disadvantage in health was apparent in all three populations, the relative gender differences were inconsistent across all four health domains. Gender differences were most pronounced in Havana, even after adjusting for age, socio-economic status, family characteristics, and smoking behaviour. Despite having higher overall life expectancy and more equitable and universal access to primary care and preventive medicine, women in Havana appear to have a larger burden of ill health than women in less equitable societies. The study provides indirect evidence that Cuba faces challenges in combating the health threats posed by chronic diseases and other diseases and conditions common among the population aged 60+.

Intervención psicosocial, bienestar y capital social en comunidades con desventaja socioeconómica / Psychosocial intervention, welfare and social capital in communities with socio-economic disadvantage

Introducción: En Colombia se realizan programas de intervención psicosocial en comunidades con desventaja socioeconómica para mejorar su calidad de vida, sin embargo, no se realizan evaluaciones de impacto para medir su efectividad. Objetivo: Determinar la relación que existe entre el tiempo de exposición a procesos de intervención psicosocial en comunidades en desventaja socioeconómica, con su percepción de bienestar psicológico, bienestar social y capital social, en el área metropolitana de Barranquilla. Métodos: investigación fue de corte explicativo ex post facto, con una muestra de 135 personas mayores de 17 años. Se hizo un análisis de varianza para encontrar la dependencia entre los procesos de intervención y las variables dependientes. Resultados: Se encontró una relación de significancia entre el grupo etario de los participantes y algunas dimensiones del bienestar psicológico, del bienestar social y del capital social. No se encontraron relaciones significativas entre el tiempo de intervención y las variables dependientes mencionadas. Conclusiones: A pesar de la vulnerabilidad del entorno, las comunidades intervenidas participantes del estudio evidenciaron una percepción de bienestar psicológico y social y de valoración positiva de su capital social sin una relación significativa con el tiempo de exposición al trabajo comunitario. Los procesos de intervención psicosocial tienen el potencial suficiente para favorecer la mejora de las condiciones de las personas, grupos o comunidades, pero requieren de la implementación de procesos de evaluación que permitan hacer seguimiento a su impacto(AU)

Introduction: Colombia psychosocial intervention programs are carried out in communities with socioeconomic disadvantage to improve their quality of life; however, no impact's assessments are carried out to measure their effectiveness. Objective: Determine the relation between the time of exposure to psychosocial intervention's processes in communities at socioeconomic disadvantage, and their perception of psychological well-being, social welfare and social capital, in the metropolitan area of Barranquilla. Methods: The research was ex post facto explanatory one, with a sample of 135 people over the age of 17. A variance analysis was done to find the dependency between intervention processes and dependent variables. Results: A relationship of significance was found between the age group of the participants and some dimensions of psychological well-being, social welfare and social capital. No significant relationships were found between the intervention time and the dependent variables mentioned. Conclusions: Despite the vulnerability of the environment, the communities involved in the study demonstrated a perception of psychological and social well-being and positive assessment of their social capital without a significant relationship with the time of exposure to community work. Psychosocial intervention's processes have sufficient potential to promote the improvement of the conditions of individuals, groups or communities, but they require the implementation of assessment processes that allow to follow up on their impact(AU)

A mixed methods study examining neighborhood disadvantage and childhood behavior problems in Montevideo, Uruguay.

BACKGROUND: Neighborhood disadvantage (ND) is a risk factor for child behavior problems (CBPs), but is understudied outside the United States and Europe. Our mixed methods study aims to (1) create a culturally meaningful measure of ND, (2) test cross-sectional associations between ND and CBPs and (3) qualitatively explore life in the neighborhoods of families participating in the Salud Ambiental Montevideo (SAM) study. METHODS: The quantitative study (Study 1) comprised 272, ~7-year-old children with geolocation and complete data on twelve behavioral outcomes (Conner's Teachers Rating Scale - Revised Short Form: CTRS-R:S and Behavioral Rating Inventory of Executive Functioning: BRIEF). A ND factor was created at the census segment level (1,055 segments) with 19 potential indicators of ND downloaded from the Municipality of Montevideo Geographic Services. Children were assigned ND scores based on the location of their household within a census segment. Multilevel models tested associations between ND and all CBP scales, controlling for confounders at the individual level. The qualitative study (Study 2) comprised 10 SAM caregivers. Photovoice alongside semi-structured interviews in Spanish were used to foster conversations about neighborhood quality, activities, and raising children. Thematic analysis with inductive coding was used to summarize qualitative study findings. RESULTS: The ND factor consisted of 12 census-based indicators related to education, employment, ethnicity, housing quality, and age characteristics, but unrelated to home ownership and some ethnicity variables. In multivariable models, ND was associated with greater conduct problems (ß = 1.37, p < .05), poor shifting (ß = 1.56, p < .01) and emotional control problems (ß = 2.36, p < .001). Photovoice and semi-structured interviews yielded four themes: physical disorder, recreation, safety and crime, and community resources. Residents discussed improving waste management and transportation, updating playgrounds, and ensuring neighborhood safety. CONCLUSIONS: ND in Montevideo comprised a unique set of census indicators. ND was primarily related to behavioral regulation problems. Hypothesized pathways whereby ND affects CBPs are discussed.

Structural Disadvantage and Culture, Race, and Ethnicity in Early Psychosis Services: International Provider Survey.

OBJECTIVE: Little is known about provider perspectives on programmatic responses to structural disadvantage and cultural differences within early intervention in psychosis (EIP) services, programs, and models. The primary objective of this study was to investigate providers' perspectives on the impacts of disadvantage and minority race, ethnicity, and culture and to describe current practices and perceived gaps and concerns. METHODS: An online survey of specialized EIP providers was disseminated in the United Kingdom, United States, Canada, Australia, and Chile. A total of 164 providers, representing 110 unique sites, completed the survey. Closed-ended questions gathered demographic and program data, including information on formal assessment of trauma or adversity, integration of trauma-informed care, integration of formal cultural assessment tools, training focused on culture, programmatic changes to address culture-related issues, and consultation with cultural insiders. Open-ended questions addressed the demographic mix of the program's client population; the perceived role and influence of trauma, structural disadvantage, and cultural differences; and concerns and needs related to these topics. Frequencies were examined for closed-ended items; open-ended responses were systematically coded. RESULTS: Overall, survey findings suggested low levels of implementation of a variety of assessment and support practices related to cultural diversity in EIP programs. Coding of open-ended responses revealed numerous concerns regarding the impacts of disadvantage and cultural difference on clients and perceived gaps in policy and implementation. CONCLUSIONS: An expansion of research and service development aimed at better meeting the disadvantage- and culture-related needs of young people with early psychosis and their families should be a priority for the field.

Existe um efeito negativo duplo sobre os salários das mulheres migrantes nas regiões brasileiras? Uma abordagem não paramétrica / Is there a double negative effect on the wages of migrant women in Brazilian regions? A non-parametric approach / ¿Hay un doble efecto negativo en los salarios de las mujeres migrantes en las regiones brasileñas? Un enfoque no paramétrico

Este artigo busca verificar se existe um efeito negativo duplo sobre os salários das mulheres migrantes (não naturais e de retorno) nas regiões brasileiras. Para captar o diferencial salarial, empregou-se o método não paramétrico de Ñopo (2008) aplicado aos dados obtidos a partir da Pesquisa Nacional por Amostra de Domicílios (PNAD) de 2005 e 2015. Os resultados mostraram que apenas a mulher migrante não natural na região Sudeste sofre de dupla desvantagem no mercado de trabalho. A primeira desigualdade salarial refere-se à questão de gênero e ocorre também nas demais regiões brasileiras. A segunda diferença no salário deve-se à condição de migrante não natural da região Sudeste. Para as demais regiões, as mulheres migrantes (não naturais e de retorno) possuem uma vantagem salarial em relação às não migrantes.

This article seeks to verify the existence of a double negative effect on the wages of migrant women (non-natural and return) in Brazilian regions. To capture the wage differential, Ñopo's (2008) non-parametric method was applied to data obtained from the 2005 and 2015 PNADs. The results showed that only non-natural migrant women in the Southeast region suffer from double disadvantage in the employment market. The first wage inequality concerns gender issues and also occurs in other Brazilian regions. The second difference in salary is due to the condition of non-natural migrants from the Southeast region. For other regions, migrant women (non-natural and return) have a salary advantage over non-migrant women.

Este artículo busca verificar si existe un doble efecto negativo en los salarios de las mujeres migrantes (no naturales y de retorno) en las regiones brasileñas. Para capturar la brecha salarial, se utilizó el método no paramétrico Ñopo (2008) aplicado a los datos obtenidos de las encuestas nacionales por muestra de domicilios (PNAD) de 2005 y de 2015. Los resultados mostraron que solo las mujeres migrantes no naturales sufren doble desventaja en el mercado de trabajo en el sudeste. La primera desigualdad salarial se refiere al tema de género y también ocurre en otras regiones brasileñas. La segunda diferencia en el salario se debe a la condición de los migrantes no naturales de la región sudeste. Para otras regiones, las mujeres migrantes (no naturales y de retorno) tienen una ventaja salarial sobre las mujeres no migrantes.

'I never really left the university:' Continuity amongst male academics in the transition from work to retirement.

This study investigates the transition to retirement of male academics. It applies approaches drawn from Cumulative Advantage and Disadvantage (CAD) principles to expand Continuity theory by examining evidence for continuity and inequalities in the lifestyles of the respondents. Biographical-Narrative interviews with 20 retired academics in Brazil and the United Kingdom were conducted and analysed using Thematic Analysis. An exploration of the same occupational group in different cultural and social contexts was carried out to capture a diversity of CAD influences on retirement outcomes. The experience of continuity was individualised to each participant due to their unique combination of advantages, and their subjective interpretation of their experiences. Cumulative processes identified in this study related to (1) occupational roles played in their career; and (2) organisational level policies and practices for retirement. At the level of individual retired men, cultural and social context factors were not perceived as influential in the achievement of continuity in retirement. Continuity theory is still supported, but alone offers limited explanations of the diversity of experiences in the transition to retirement of male academics. A consideration of the role of cumulative processes and systemic dynamics, including how individuals respond to their experiences in retirement, shows how these different factors interact and affect retirement and ageing. Further studies should investigate the processes identified with other occupations, as well as women and minority groups.

Sociodemographic, sexual, and reproductive variables associated with pregnancy among adolescents from low socioeconomic background.

Adolescent pregnancy remains a public health concern in both developed and developing countries. Portugal and Brazil represent some of the best examples of this phenomenon. The present study aimed to identify sociodemographic, sexual, and reproductive health-related variables associated with adolescent pregnancy among students from low socioeconomic backgrounds in both countries. The sample included 984 female adolescents, among whom 215 became pregnant. Living with a partner and lack of information about sex and contraception from the family were the best explicative factors for pregnancy occurrence in both countries. Country-specific variables were also identified. Our results may contribute to developing global preventive interventions, addressing the school as an ideal setting for primary intervention and considering culture-specific characteristics of high-risk populations.

Geographic Variation in Sudden Unexpected Infant Death in the United States.

OBJECTIVES: To assess the geographic variation of sudden unexpected infant death (SUID) and test if variation in geographic factors, such as state, latitude, and longitude, play a role in SUID risk across the US. STUDY DESIGN: We analyzed the Centers for Disease Control and Prevention's Cohort Linked Birth/Infant Death dataset (2005-2010; 22 882 SUID cases, 25 305 837 live births, rate 0.90/1000). SUID was defined as infant deaths (ages 7-364 days) that included sudden infant death syndrome, ill-defined and unknown cause of mortality, and accidental suffocation and strangulation in bed. SUID geographic variation was analyzed using 2 statistical models, logistic regression and generalized additive model (GAM). RESULTS: Both models produced similar results. Without adjustment, there was marked geographic variation in SUID rates, but the variation decreased after adjusting for covariates including known risk factors for SUID. After adjustment, nine states demonstrated significantly higher or lower SUID mortality than the national average. Geographic contribution to SUID risk in terms of latitude and longitude were also attenuated after adjustment for covariates. CONCLUSION: Understanding why some states have lower SUID rates may enhance SUID prevention strategies.

Young Adolescents' Digital Technology Use, Perceived Impairments, and Well-Being in a Representative Sample.

OBJECTIVE: To examine the cross-sectional associations between young adolescents' access, use, and perceived impairments related to digital technologies and their academic, psychological, and physical well-being. STUDY DESIGN: There were 2104 adolescents (ages 10-15 years), representative of the North Carolina Public School population, who completed questionnaires in 2015. Administrative educational records were linked with parental consent. RESULTS: Nearly all young adolescents (95%) had Internet access, 67% owned a mobile phone, and 68% had a social media account. Mobile phone ownership was not associated with any indicators of well-being (math and reading test scores, school belonging, psychological distress, conduct problems, or physical health) after controlling for demographic factors. Having a social media account and frequency of social media use were only robustly associated with conduct problems (explaining ∼3% of the variation in conduct problems). Despite the lack of strong associations, 91% of adolescents reported at least 1 perceived technology-related impairment and 29% of adolescents reported online-to-offline spillover of negative experiences. Economically disadvantaged adolescents reported similar access, but greater online-to-offline spillover and stronger associations between social media account ownership and poor psychological well-being compared with their more affluent peers. CONCLUSIONS: At the population level, there was little evidence that digital technology access and use is negatively associated with young adolescents' well-being. Youth from economically disadvantaged families were equally likely to have access to digital technologies, but were more likely than their more affluent peers to report negative online experiences. Closing the digital divide requires prioritizing equity in experiences and opportunities, as well as in access.

Cumulative Dis/Advantage and Health Pattern in Late Life: A Comparison between Genders and Welfare State Regimes.

This study provides a cross-national perspective to apply Cumulative Dis/Advantage (CDA) in explaining health inequality between developing and developed countries in the context of Welfare State Theory. Cross-sectional data from the international Health Retirement Study (United States, China, Mexico, and England) in 2013-2014 were used (n = 97,978). Four health indicators were included: self-reported health, depressive symptoms, functional ability, and memory. Regression models were fitted to examine the moderation roles of country and gender. Results indicated older Chinese and Mexican had poorer health status than their British and American counterparts consistently except for Mexicans' memory. Cumulative health gaps between developing and developed countries existed only for functional ability. There is no evidence of a widening gap in health status between genders in late life. CDA explains the increasing gaps of functional ability across age groups between countries. General health and mental health, may however, depend more on individuals' intrinsic capacity and human agency.

Lifetime Socioeconomic Status and Late-life Health Trajectories: Longitudinal Results From the Mexican Health and Aging Study.

Objective: This article examines the association between childhood and adult socioeconomic status (SES) and late-life health trajectories for older adults in Mexico. Method: Data are from the Mexican Health and Aging Study, a panel survey that began with a nationally representative sample of Mexican adults 50 years and older at baseline (2001), with follow-up in 2003 and 2012. We use a hierarchical repeated measures model to estimate the relationship between SES and depressive symptoms, functional limitations, and self-rated health, respectively. We tested both discrete measures of SES in childhood and adulthood, as well as a combined indicator of lifetime SES. Results: Childhood SES was significantly associated with later-life health trajectories net of adulthood SES indicators. Adult SES was significantly associated with late-life health trajectories, with some differences by gender and outcome. There were significant SES disparities in health outcomes over the 11-year study period. However, there were no significant multiplicative interactions between SES and age, which would have indicated either diminishing or widening SES health disparities with age. Discussion: Socioeconomic disparities in health appear to persist into old age in the Mexican context. Efforts to reduce late-life health disparities in Mexico should target socioeconomic and material conditions across the life course.

Collective resistance despite complicity: High identifiers rise above the legitimization of disadvantage by the in-group.

How do individuals deal with group disadvantage when their fellow in-group members conceive it as legitimate? Integrating research on the normative conflict model (Packer, 2008, Pers. Soc. Psychol. Rev., 12, 50) and collective action, we expect high identifiers to reject the in-group norm of legitimacy that justifies the inequality, and to assert that the group is actually able and willing to contest the disadvantage by collective means. In Study 1 and Study 2, we tested this hypothesis in different intergroup contexts. The results confirmed our predictions and also showed one boundary condition for high identifiers, namely that the content of the social identity supports resistance. In Study 3, we found support for our hypothesis using artificial groups and manipulating identification experimentally. These results show that even when a disadvantaged group appears to accept its situation, high identified in-group members will still contest this and, moreover, expect other in-group members to support them in this endeavour.