In a study published in the journal PNAS, a research team led by the University of Minnesota Medical School have shown that the socioeconomic status (SES) of cell donors affects the health outcomes of blood cancer patients who underwent haematopoietic cell transplantation (HCT).
The study examined the health outcomes of 2005 blood cancer patients treated with HCT in the United States. The research team found cancer patients who were transplanted with cells from donors of greatest socioeconomic disadvantage experienced a 9.7% reduction in overall survival and 6.6% increase in transplant-related mortality at three years compared to those transplanted from donors of high socioeconomic status – regardless of the cancer patient’s socioeconomic status.
“Our findings are quite remarkable. We have shown that social disadvantage penetrates so deeply that it is actually transplantable into a new host, and its effects persist over time,” said Lucie Turcotte, MD, MPH, MS, an associate professor at the University of Minnesota Medical School.
The results show the striking biological impact of social disadvantage and how it can alter health outcomes, specifically in the setting of cancer and hematopoietic cell transplantation.
The research team plans to conduct further research to investigate the underlying biological and physiologic drivers of these findings in order to develop interventions to mitigate the adverse health outcomes introduced by socioeconomic disadvantage.
“The importance of these findings reach far beyond cancer and bone marrow transplant care – they demonstrate the profound health effects of social inequality and highlight the critical need for public health interventions,” said Dr Turcotte.
The more gender equal a society is, the more similar men and women will be, adopting more similar interests, personality traits and behavioural patterns. Or so many people seem to believe.
Statements like this might sound like truisms, but science shows reality may be more complicated.
Several studies have found that some psychological sex differences, such as those in personality, are larger in more gender-equal countries. The same goes for countries that are more educated, prosperous and otherwise have better living conditions. This has become known as the gender-equality paradox.
Until recently, it was unclear how widespread this pattern might be. My team, which included research assistant Kare Hedebrant, tried to address that in a recently published study, where we investigated which psychological sex differences are associated with living conditions and, if so, how.
The study covered a range of themes, from personality and cognitive functions to sexting and circadian rhythm. Our study focused on mostly western countries but used some data from other countries such as India and Kenya.
We reviewed 54 articles that analyse the relationship between magnitudes of psychological sex differences and country-level indicators of living conditions. We also used data from 27 meta-analyses (reviews of previous research) of psychological sex differences and conducted new analyses to determine associations between sex differences and national economy, education, health, gender equality and more.
Sex differences
Each study used data from at least five countries, usually spanning several decades.
We grouped the many psychological dimensions covered by these studies into six categories: personal characteristics, cognition, interpersonal relations, emotion, academic preferences (such as a pull towards science, technology, engineering and maths) and morals and values.
Our findings paint a complex picture, showing that variation in psychological sex difference did not follow a uniform pattern. In countries with better living conditions, males and females are more alike in some regards and more different in others.
For example, differences in personality characteristics were frequently found to be larger in countries with better living conditions. This includes traits such as extroversion, agreeableness and altruism, which research seems to show are more strongly associated with women. The same was true for sex differences in some dimensions of emotion, specifically negative emotions in which females tend to score higher, such as shame.
There were also exceptions to the gender-equality paradox. Sex differences in sexual behaviour, like engaging in casual sex, were consistently found to be smaller in countries with better living conditions. This is probably because women in these countries, where there are more permissive norms, have better access to contraceptives.
A complicated phenomenon
For cognitive functions, sex differences were sometimes larger, sometimes smaller in countries with better living conditions. Interestingly, the sex differences were larger in cognitive domains where women have strengths.
For instance, episodic memory (memory for experienced events) and verbal ability, where females typically do better than males, saw larger sex differences as living conditions improved. Females got better at episodic memory when they had better living conditions. By contrast, sex differences in semantic memory (memory for facts) and mathematical ability, where males tend to do better, decreased when living conditions improved.
This suggests that, when it comes to cognitive abilities, females benefit more than males from improvements in living conditions. The performance gap increases in domains where females have an advantage and closes in domains where males are ahead.
Not all psychological sex differences were associated with living conditions in the same way. So, can we say that there is a gender-equality paradox? Yes, to some extent, since more sex differences grew, rather than decreased, in countries with better living conditions.
In most cases, however, psychological sex difference magnitudes were not significantly associated with living conditions. This suggests that, in general, psychological sex differences are not greatly affected by living conditions but seem instead quite stable. For instance, research often finds females get higher grades at school across different subjects. It’s also common for researcher to find males have greater interest in maths. But neither seems to be affected by living conditions.
Even in cases where the magnitude of sex differences did vary in relation to living conditions, the pattern of male and female advantages usually remained the same. So, for example, though the female advantage over males in episodic memory ability is greater in some countries than others, females outperform males in almost all countries.
In summary, we found little support for the idea that psychological sex differences will vanish as societies develop. Policymakers probably cannot rely on that if they hope to achieve equal distributions of men and women in different professions. Instead, it appears that the dominant feature of psychological sex differences is their robustness in the face of social change.
The “Thrive 5” are five conditions to ensure an infant in the first year of life has what they need for healthy development. Those conditions include environmental stimulation, nutrition, neighbourhood safety, positive caregiving and regular circadian rhythms and sleep. Simple, and yet, it has not yet been prioritised for many reasons including the fact that researchers had not provided empirical data to support making the Thrive 5 a public health priority.
Researchers at Washington University in St. Louis think it’s time to change that. In new research published in JAMA Pediatrics, Deanna Barch and Joan Luby make the case that “Thrive Factor” is a key element of healthy human brain, behavioural and cognitive development.
“When they have access to these basic supports, even in the face of adverse environments, it enhances their brain development, cognition (measures of IQ) and social-emotional development,” said Luby, MD, the university’s Samuel and Mae S. Ludwig Professor of Child Psychiatry at the School of Medicine.
There have been plenty of studies touting the benefits of individual thrive factors, such as encouraging breast-feeding to facilitate growth in general, but this new study looks at several key factors known to influence brain development and shows their relationship to outcomes at age 3.
“The novelty here is putting them all together and thinking of them as a constellation of things that are necessary and important for a child to be able to thrive,” said Barch, PhD, vice dean of research, a professor of psychological & brain sciences in Arts & Sciences and the Gregory B. Couch Professor of Psychiatry at the School of Medicine.
The study is part of a change in thinking in the child development field as scientists have learned that much of our health is not just genetically predetermined but is powerfully influenced by the psychosocial environment. The human brain is still undergoing rapid development at birth, and researchers are trying to understand the environmental factors that shape this development.
The study of 232 infants and their mothers looked at positive factors in the environment in the foetal period and first year of life that enhance brain development, minimise negative behaviours and increase cognitive outcomes. Participants were evaluated on social disadvantage indexes beginning in utero and early life T-Factor scores were also calculated. As infants approached age 3, they were re-evaluated for social, emotional and cognitive development along with using MRIs to scan brain structure.
The results were clear that T-Factor is powerful: Even infants coming from adverse conditions and under-resourced backgrounds can have healthy development if they get their Thrive 5.
The researchers note that policymakers and paediatric primary care providers should be informed about the importance of focusing on elements of the T-Factor and how they can lead to many downstream advantages for both the child and society.
It may seem obvious to anyone that a baby needs care, sleep, food, stimulation and safety but “nobody has particularly focused on or prioritised the importance of this during foetal development and in the first year of life to enhance critical developmental outcomes,” Luby said.
“The Thrive Factor provides a solid foundation for healthy development. It has been underappreciated in primary care just how malleable the brain is to experience,” Luby added.
Barch said the next step will be setting up interventions to test in randomised controlled trials. Another advantage to T-Factor is it is highly feasible to share and promote in broad populations.
Interventions would likely take the form of multiple Zoom sessions with parents to educate and coach them on how to best provide each thrive factor. But that would just be the start, since parents need resources to help them provide thrive factors.
Though T-Factor can help kids overcome adverse conditions, Barch emphasised the need for understanding just how tough those adverse conditions can be on a new parent.
“If you’ve never suffered from financial adversity, you don’t understand how hard that makes life,” she said.
Parents can struggle to provide conditions to thrive because they may have to support many people in their household, may not have adequate number of rooms to ensure easier child sleep training, must work multiple jobs and can’t get away to breast feed, and live in unsafe neighbourhoods that keep them in a constant state of vigilance.
Though education can help caregivers, it will take public policy interventions to ensure parents can access all the Thrive Factors, especially when it comes to access to safe housing and adequate income to support even these basic needs of developing infants.
“We need to make it so families can have the resources necessary to provide these core things to kids because it’s going to have such a big impact on kids’ development across the course of their lifespan,” she said.
People with low income or education levels may benefit from screening for alcohol-related conditions
Photo from Pixabay CC0
Men and women with lower income or education levels are more likely to develop medical conditions related to alcohol abuse compared to similar individuals with a higher socioeconomic status. Alexis Edwards of Virginia Commonwealth University, US, and colleagues report these findings in a new study published March 19th in the open access journal PLOS Medicine.
The World Health Organization estimates that harmful alcohol use accounts for 5.1% of the global burden of disease and injury worldwide, and results in three million deaths each year. Excessive alcohol consumption can also take an economic toll. Previous studies have identified links between a person’s socioeconomic status and alcohol use, but currently it is unclear how an individual’s social class impacts their future risk of acquiring alcohol-related medical conditions, like alcoholic liver disease.
In the new study, researchers used a model that follows people over time to estimate their risk of developing medical conditions from alcohol abuse using two indicators for socioeconomic status: income and education level. The researchers analysed data from more than 2.3 million individuals in a Swedish database to show that both men and women with a lower income or education level were more likely to develop these conditions. The associations held true, even when researchers controlled for other relevant factors, such as marital status, history of psychiatric illness and having a genetic predisposition to abuse alcohol.
The new findings are important for understanding which populations are most likely to suffer from medical conditions resulting from alcohol abuse, and contribute to a growing body of literature on health disparities that stem from socioeconomic factors. The researchers recommend that individuals with lower income or education levels might warrant additional screening by clinicians to evaluate their alcohol consumption and identify related conditions.
The authors add, “Among individuals with an alcohol use disorder, those with lower levels of education or lower incomes are at higher risk for developing an alcohol-related medical condition, such as cirrhosis or alcoholic cardiomyopathy. Additional screening and prevention efforts may be warranted to reduce health disparities.”
