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      Intragenerational social mobility and functional somatic symptoms in a northern Swedish context: analyses of diagonal reference models

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          Abstract

          Background

          Research indicate that social class mobility could be potentially important for health, but whether this is due to the movement itself or a result of people having been integrated in different class contexts is, to date, difficult to infer. In addition, although several theories suggest that transitions between classes in the social hierarchy can be stressful experiences, few studies have empirically examined whether such movements may have health effects, over and above the implications of “being” in these classes. In an attempt to investigate whether intragenerational social mobility is associated with functional somatic symptoms in mid-adulthood, the current study tests three partially contrasting theories.

          Method

          The dissociative theory suggests that mobility in general and upward mobility in particular may be linked to psychological distress, while the falling from grace theory indicates that downward mobility is especially stressful. In contrast, the acculturation theory holds that the health implications of social mobility is not due to the movement itself but attributed to the class contexts in which people find themselves. Diagonal Reference Models were used on a sample of 924 individuals who in 1981 graduated from 9 th grade in the municipality of Luleå, Sweden. Social mobility was operationalized as change in occupational class between age 30 and 42 (measured in 1995 and 2007). The health outcome was functional somatic symptoms at age 42, defined as a clustering self-reported physical symptoms, palpitation and sleeping difficulties during the last 12 months.

          Results

          Overall mobility was not associated with higher levels of functional somatic symptoms compared to being immobile ( p = 0.653). After controlling for prior and current class, sex, parental social position, general health, civil status, education and unemployment, the association between downward mobility was borderline significant ( p = 0.055) while upward mobility was associated with lower levels of functional somatic symptoms ( p = 0.03).

          Conclusion

          The current study did not find unanimous support for any of the theories. Nevertheless, it sheds light on the possibility that upward mobility may be beneficial to reduce stress-related health problems in mid-life over and above the exposure to prior and current class, while downward mobility can be of less importance for middle-age health complaints.

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          Most cited references50

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          Intergenerational Class Mobility in Three Western European Societies: England, France and Sweden

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            Association between health information, use of protective devices and occurrence of acute health problems in the Prestige oil spill clean-up in Asturias and Cantabria (Spain): a cross-sectional study

            Background This paper examines the association between use of protective devices, frequency of acute health problems and health-protection information received by participants engaged in the Prestige oil spill clean-up in Asturias and Cantabria, Spain. Methods We studied 133 seamen, 135 bird cleaners, 266 volunteers and 265 paid workers selected by random sampling, stratified by type of worker and number of working days. Information was collected by telephone interview conducted in June 2003. The association of interest was summarized, using odds ratios (OR) obtained from logistic regression. Results Health-protection briefing was associated with use of protective devices and clothing. Uninformed subjects registered a significant excess risk of itchy eyes (OR:2.89; 95%CI:1.21–6.90), nausea/vomiting/dizziness (OR:2.25; 95%CI:1.17–4.32) and throat and respiratory problems (OR:2.30; 95%CI:1.15–4.61). There was a noteworthy significant excess risk of headaches (OR:3.86: 95%CI:1.74–8.54) and respiratory problems (OR:2.43; 95%CI:1.02–5.79) among uninformed paid workers. Seamen, the group most exposed to the fuel-oil, were the worst informed and registered the highest frequency of toxicological problems. Conclusion Proper health-protection briefing was associated with greater use of protective devices and lower frequency of health problems. Among seamen, however, the results indicate poorer dissemination of information and the need of specific guidelines for removing fuel-oil at sea.
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              Midlife as a Pivotal Period in the Life Course: Balancing Growth and Decline at the Crossroads of Youth and Old Age.

              We provide evidence for multidirectionality, variability, and plasticity in the nature and direction of change in physical health, cognitive functioning, and well-being during the middle years of the life course. The picture of well-being in midlife based on longitudinal data from the Midlife in the United States (MIDUS) study is a more positive one than portrayed in previous cross-sectional studies. We present middle age as a pivotal period in the life course in terms of balancing growth and decline, linking earlier and later periods of life, and bridging younger and older generations. We highlight the role of protective factors and multisystem resilience in mitigating declines. Those in middle age play a central role in the lives of those who are younger and older at home, in the workplace, and in society at large. Thus, a focus on promoting health and well-being in middle age can have a far-reaching impact.
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                Author and article information

                Contributors
                +46 70 623 36 20 , frida.jonsson@umu.se
                miguel.san.sebastian@umu.se
                anne.hammarstrom@pubcare.uu.se
                per.e.gustafsson@umu.se
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                3 January 2017
                3 January 2017
                2017
                : 16
                : 1
                Affiliations
                [1 ]Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Umeå, SE-901 85 Sweden
                [2 ]Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
                Author information
                http://orcid.org/0000-0002-5902-3798
                Article
                499
                10.1186/s12939-016-0499-1
                5217297
                28057005
                900ea282-950b-4fcc-a2d9-009404cb71ca
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 27 September 2016
                : 13 December 2016
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001862, Svenska Forskningsrådet Formas;
                Award ID: 259-2012-37
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100002960, Västerbotten Läns Landsting;
                Award ID: 355661
                Award ID: 402131
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Health & Social care
                sweden,social mobility,intragenerational,social class,life course,diagonal reference model,self-reported symptoms

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