Background: Does the association between indebtedness and midlife health, that is, the debt gap in health, vary systematically by individuals' propensity for becoming indebted? To answer this question, we investigated potential heterogeneity in the debt-health association and tested competing hypotheses derived from cumulative inequality and relative deprivation. Methods: With data from the National Longitudinal Survey of Youth 1979 (NLSY79), we measured indebtedness as self-reported negative net worth. Midlife health was assessed using SF-12 mental and physical health scores at age 50. The analysis estimated Average Treatment Effects (ATEs) to test the overall association between debt and midlife health. We then applied matching-smoothing (MS) and stratification-multilevel (SM) estimators to assess heterogeneity in the debt gap in midlife health. Results: Indebtedness was associated with significantly poorer midlife mental and physical health. Both MS and SM estimators found evidence that the debt-health association varied systematically across the propensity for indebtedness, with the largest debt gap in health concentrated among those with the highest likelihood of experiencing indebtedness. Contribution: These findings provide empirical support for cumulative inequality theory, suggesting that the debt gap in midlife health widens significantly as chronic adversity increases. Findings highlight the importance of policies assisting financially vulnerable adults across the life course.
Background:Childhood residential mobility (RM) has been associated with adverse health and social outcomes. We examined differences in RM by family size and household composition in two diverse, disadvantaged UK populations. Methods:Using electronic health records (EHRs) and anonymised addresses, we examined if household characteristics are associated with RM in north-east London (NEL) and Wales. We conducted a longitudinal study of 240,509 (51.0 per cent male) and 398,959 (51.3 per cent male) children aged 0-13 years in NEL and Wales respectively on 1 January 2015, with complete follow-up until 31 December 2019. We defined RM as at least one change in address during follow-up. We estimated odds ratios (OR) and 95 per cent confidence intervals (CI) for RM by interactions between age group (0-4, 5-9, 10-13 years), number of children in household and household composition, adjusting for demographic, household and area-level characteristics. Results:Overall, 20.6 per cent and 32.1 per cent of children experienced RM. RM was highest in the youngest age group: NEL: 25.3 per cent, 18.7 per cent, 15.6 per cent; Wales: 40.1 per cent, 29.4 per cent, 23.6 per cent. RM was more likely among 10-13-year-olds living with a single adult than two working-age adults (NEL OR: 1.15; 95 per cent CI: 1.07,1.25; Wales: 1.82; 1.73,1.91). Children in households with four or more children were more likely to experience RM than those with no other child among 10-13-year-olds in NEL (1.31; 1.18,1.46) and 5-9-year-olds and 10-13-year-olds in Wales (1.21; 1.14,1.29 and 1.68; 1.56,1.82). Conclusion:RM is more common in early childhood and varies by household composition, region and age group. EHRs can be used to estimate RM using real-world data and have the potential to examine its impact on health and other outcomes.
The transition from socialism to a market economy in Central and Eastern Europe (CEE) brought significant societal and economic disruptions. While the shift restructured economies and integrated the region into the broader European market, it left a legacy of hardship that continues to shape individuals' lives. This study adopts a life-course perspective to examine how extended employment gaps, financial hardship and significant stress during the transition years (1987-93) have influenced work trajectories over a 31-year period in 11 CEE countries. Using retrospective data from the Survey of Health, Ageing and Retirement in Europe (N = 10,999), we apply sequence analysis and multinomial logistic regression to assess these associations. Among men, both an extended employment gap and financial hardship during the transition increased the risk of later unemployment, while significant stress increased the risk of health-related labour market withdrawal. Among women, fewer significant effects were observed, with the most notable being a heightened risk of unemployment following an extended employment gap. These findings offer new insights into the long-term consequences of the post-socialist transition and, more broadly, into how economic crises and social upheaval can shape working lives. This emphasizes the critical role of a life-course perspective in shaping policies that aim to mitigate long-term unemployment risks and ensure more equitable pathways to labour market exit.
Rising chronic health conditions in the US present a significant public health issue with implications that extend beyond individuals to their family members. We examined how the accumulation of mother's chronic health conditions (ranging from none to three or more) and the timing of first diagnosis were associated with early midlife children's depressive symptoms. We also examined variation across gender of early midlife children. Using data from Waves I, IV and V of Add Health and Waves I and II of the Add Health Parent Study (n=1,285), we found that 73 per cent of mothers reported at least one chronic health condition by their early 60s. We also found that early midlife children whose mothers had three or more chronic health conditions had significantly greater depressive symptoms, with stronger associations among daughters than sons. Early midlife children whose mothers were first diagnosed with a chronic health condition before their birth had significantly greater depressive symptoms compared to those whose mothers were first diagnosed when their children were ages 18-26. These findings highlight the importance of both mother's accumulation of chronic health conditions and timing of diagnosis for early midlife children's depressive symptoms.
Structural disparities between rural and urban labour markets delay labour market entry for rural youth and risk long-term scarring related to both labour market integration and earnings. Migration is often viewed as a strategy to avoid these disadvantages. Using a life course perspective, this study examines how mobility and labour market attachment co-evolve across two decades of adulthood. Based on Swedish register data for cohorts born between 1977 and 1982 (n = 42,913) and sequence analysis with fuzzy clustering, we identify four long-term trajectories: stayers with strong attachment; stayers with weak attachment; movers to metropolitan areas; and movers to other rural or small-city contexts. The results show that mobility and attachment develop jointly, with some individuals following stable paths from early adulthood while others experience prolonged instability or 'late leaving'. Gender and socio-economic background shape these patterns. Women more often pursue mobility-oriented trajectories, particularly towards metropolitan regions, whereas men are overrepresented among weakly attached stayers. These differences diminish among youth with highly educated parents. Place attachment effects are mixed; teenage parents are more likely to remain and achieve strong local attachment, while sibling migration has no long-term influence. Overall, the findings demonstrate that rural youths' labour market and mobility trajectories remain open to renegotiation well beyond early adulthood, shaped by gendered and familial resources.
