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Debbie A Lawlor

Publications and source records attributed to Debbie A Lawlor.

105 records · Page 6Linked to original sources
PubMed2003

Smoking and ill health: does lay epidemiology explain the failure of smoking cessation programs among deprived populations?

The resistance of disadvantaged groups to anti-smoking advice is remarkable. In relation to the study of differing cultures, there is a long-standing academic tradition assuming that behavior that may otherwise be difficult to understand is indeed rational within particular cultural contexts. Persistent smoking among the most deprived members of society may represent a rational response to their life chances informed by a lay epidemiology. Health promotion initiatives designed to reduce smoking among members of these groups may continue to fail unless the general health and life chances of such individuals are first improved.

Attitude to Health↗
PubMed2003

Life course influences on insulin resistance: findings from the British Women's Heart and Health Study.

OBJECTIVE: To assess the independent associations of a broad range of early life risk factors and adult obesity with adult insulin resistance. RESEARCH DESIGN AND METHODS: This was a cross-sectional study of 1,394 women, aged 60-79 years, from 23 British towns. RESULTS: There was a strong (independent of confounding factors, other early life factors, and adult waist-to-hip ratio) inverse association between birth weight and insulin resistance in women in the highest third of BMI (>28.77 kg/m2): -0.12 (95% CI -0.19 to -0.04) log homeostasis model assessment (HOMA) score per 1 SD birth weight, but no association between birth weight and insulin resistance in women in the two lowest thirds of BMI (P for interaction = 0.04). Offspring birth weight, own leg length, and childhood manual social class did not interact with adult obesity and were all independently inversely associated with insulin resistance: -0.05 (-0.09 to -0.01) log HOMA score per 1 SD offspring birth weight, -0.09 (-0.12 to -0.06) log HOMA score per 1 SD leg length, and a -0.07 (-0.14 to 0.00) difference in log HOMA score between manual and nonmanual childhood social class. Childhood manual social class and shorter leg length were both independently associated with adverse lipid profiles. BMI and waist-to-hip ratio were independently positively associated with insulin resistance and with all other components of the insulin resistance syndrome. CONCLUSIONS: Insulin resistance is an important risk factor for type 2 diabetes and coronary heart disease. Our results suggest that genetic factors, intrauterine environment, early childhood, and adult environmental factors are all relevant in determining adult insulin resistance.

Aged↗
PubMed2003

The association of socio-economic position across the life course and age at menopause: the British Women's Heart and Health Study.

OBJECTIVE: To assess the association of indicators of adverse socio-economic position from across the life course with age at menopause. DESIGN: Cross sectional study as part of the British Women's Heart and Health Study. SETTING: 23 British towns. POPULATION: Three thousand and five hundred and thirteen women aged 60-79 years from a total cohort of 4286. Women who underwent a hysterectomy or oophorectomy prior to their 'natural' menopause or who were taking hormone replacement therapy around the perimenopausal period and for whom a biological age at menopause could not be calculated were excluded from this study. MAIN OUTCOME MEASURES: Age at menopause. RESULTS: Most of the 10 indicators of adverse socio-economic position from childhood through to adulthood were linearly associated with a younger age at menopause. In age adjusted analyses, women from manual social classes in childhood began their menopause on average 0.68 years (95% confidence interval [CI] 0.11, 1.3) earlier than those from non-manual social classes. Those who lived in a house as a child without a bathroom began their menopause 0.47 years (95% CI 0.12, 0.82) earlier than those with a bathroom. Those who shared a bedroom began 0.36 years (95% CI 0.03, 0.70) earlier than those who had their own bedroom and finally those who lived in a household with no access to a car as a child began their menopause 0.47 years (95% CI 0.02, 0.95) earlier than those with access to a car. Adult indicators of adverse socio-economic position were similarly associated with earlier age at menopause. Age at completing full time education was not substantively associated with age at menopause. The inverse associations between each of the indicators of both childhood and adult socio-economic position and age at menopause were not importantly affected by adjustment for other reproductive factors but they attenuated by between 6% and 21% with adjustment for adult smoking and body mass index. The inverse associations between each of the childhood indicators of socio-economic position only and age at menopause attenuated markedly (between 12% and 70%) with adjustment for adult leg length. There was a cumulative effect of disadvantage across the life course demonstrated by a strong linear trend between a composite score of the 10 socio-economic indicators and young age at menopause. The age at onset of menopause for women who had 9 or 10 adverse socio-economic indicators was on average 1.70 years (95% CI 0.36, 3.0) younger than that of women with none or only one indicator. CONCLUSIONS: Adverse socio-economic circumstances in childhood, as well as in adulthood, are associated with an earlier age at menopause. The association between childhood deprivation and early menopause may at least in part be mediated via exposures, such as childhood diet, which affect both linear growth and age at menopause.

Aged↗
PubMed2002

Is there a sex difference in the association between birth weight and systolic blood pressure in later life? Findings from a meta-regression analysis.

The aim of this study was to determine whether a sex difference exists in the association between birth weight and systolic blood pressure. A meta-analysis of all observational studies (n = 57) in which the study population contained both males and females and the association between birth weight and blood pressure was presented as a linear regression coefficient was undertaken. There were no differences in the pooled regression coefficients between males and females combining all studies; the regression of blood pressure on birth weight for males was -1.27 (95% confidence interval: -1.77, -0.77) mmHg/kg and for females was -1.24 (95% confidence interval: -1.90, -0.58) mmHg/kg. When studies in which blood pressure had been measured in childhood were considered separately from those in which it was measured in adulthood, there were no sex differences in either age group. The pooled regression coefficient tended to be weaker in studies reporting sex-specific results than in those reporting combined results. These findings suggest that reports of sex differences in the association between birth weight and blood pressure are chance findings.

Adult↗
PubMed2002

Secular trends in mortality by stroke subtype in the 20th century: a retrospective analysis.

BACKGROUND: Since both cerebral infarction and coronary heart disease are caused by atherosclerosis, they would be expected to have similar secular trends in mortality. Because differential diagnosis of stroke subtype on routine death certificates is inaccurate, we aimed to estimate secular trends in cerebral infarct and haemorrhage throughout the 20th century, for England and Wales, with data from autopsy studies. METHODS: We calculated the ratio of cerebral infarct to cerebral haemorrhage from all available sources of autopsy data from the 20th century. These data were used to estimate the ratio of cerebral infarct to haemorrhage for every year, and hence to estimate rates of cerebral infarct and cerebral haemorrhage from the total stroke mortality rate, obtained from the UK Office for National Statistics. FINDINGS: Data about stroke subtypes from autopsies were available from 1932 to 1999. The ratio of cerebral infarct to cerebral haemorrhage increased fourfold from 0.5 in the 1930s to 2.0 by the 1990s; most of the increase took place between the 1930s and the 1970s. Estimated secular trends suggested that there was a steady fall in mortality from cerebral haemorrhage throughout the 20th century, whereas mortality from cerebral infarct increased to a peak in the 1970s and then fell. Trends in estimated cerebral infarct mortality closely matched those for coronary heart disease mortality. INTERPRETATION: The closely related trends in cerebral infarct and coronary heart disease suggest common causes, but the very different trend in cerebral haemorrhage shows that its cause probably differs importantly from these conditions.

Adult↗
PubMed2002

Socioeconomic position in childhood and adulthood and insulin resistance: cross sectional survey using data from British women's heart and health study.

OBJECTIVE: To assess the associations between childhood and adulthood social class and insulin resistance. DESIGN: Cross sectional survey. SETTING: 23 towns across England, Scotland, and Wales. PARTICIPANTS: 4286 women aged 60-79 years. MAIN OUTCOME MEASURES: Insulin resistance and other cardiovascular disease risk factors. RESULTS: Belonging to manual social classes in childhood and in adulthood was independently associated with increased insulin resistance, dyslipidaemia, and general obesity. The association between childhood social class and insulin resistance was stronger than that for adult social class. The effect, on insulin resistance and other risk factors, of belonging to a manual social class at either stage in the life course was cumulative, with no evidence of an interaction between childhood and adult social class. Women who were in manual social classes in childhood remained at increased risk of insulin resistance, dyslipidaemia, and obesity--even if they moved into non-manual social classes in adulthood--compared with women who were in non-manual social classes at both stages. CONCLUSIONS: Adverse social circumstances in childhood, as well as adulthood, are strongly and independently associated with increased risk of insulin resistance and other metabolic risk factors.

Aged↗
PubMed2002

Birth weight of offspring and insulin resistance in late adulthood: cross sectional survey.

OBJECTIVE: To investigate the association between birth weight of offspring and mothers' insulin resistance in late adulthood. DESIGN: Cross sectional survey. SETTING: General practitioner's surgeries in 23 towns in Great Britain. PARTICIPANTS: 4286 women aged 60-79 years. MAIN OUTCOME MEASURES: Maternal insulin resistance. RESULTS: Birth weight of offspring was inversely related to maternal insulin resistance in late adulthood. For each 1 kg higher birth weight of offspring, women had a 15% reduction in the odds of being in the fourth with highest insulin resistance, compared to other fourths (odds ratio 0.85; 95% confidence interval 0.71 to 1.00). This increased to 27% (0.73; 0.60 to 0.90) after adjusting data for potential confounders. A U shaped relation between birth weight of offspring and diabetes in older age was found; women with the lightest and heaviest offspring had the highest prevalence of diabetes. CONCLUSIONS: Birth weight of offspring is inversely related to the mother's insulin resistance in late adulthood, despite the association of glucose intolerance during pregnancy with heavier offspring at birth. Common genetic factors contribute to the relation between birth weight and risk of cardiovascular disease and diabetes in adults.

Adult↗
PubMed2002

Lay perceptions of a 'natural' menopause. Cross sectional study of the British Women's Heart and Health Study.

Health practitioners and researchers define a natural menopause as one not due to a hysterectomy or oophorectomy. In a large cross sectional study of postmenopausal women, we found that the majority of women who report that their menopause was not natural gave a gynaecologic reason. However, 3% gave a major life event, such as divorce or bereavement. Age at menopause for women who had had a hysterectomy/oophorectomy was the same as that of women who reported that their periods has stopped because of a major life event-on average six years younger than that of women who described their menopause as natural. We suggest that women whose periods stop 'naturally' (from a medical perspective) but at a relatively young age perceive this as unnatural and search for an explanation for the early cessation of their menses.

Aged↗
PubMedDate not supplied

Asthma and internalizing behavior problems in adolescence: a longitudinal study.

OBJECTIVE: Clinical studies of asthmatic children have found an association between lung disease and internalizing behavior problems. The causal direction of this association is, however, unclear. This article examines the nature of the relationship between behavior and asthma problems in childhood and adolescence. METHODS: Data were analyzed on 5135 children from the Mater University Study of Pregnancy and its outcomes (MUSP), a large birth cohort of mothers and children started in Brisbane, Australia, in 1981. Lung disease was measured from maternal reports of asthma/bronchitis when the children were aged 5 and maternal reports of asthma symptoms when the children were aged 14. Symptoms of internalizing behaviors were obtained by maternal reports (Child Behavior Checklist) at 5 years and by maternal and children's reports at 14 years (Child Behavior Checklist and Youth Self Report). RESULTS: Although there was no association between prevalence of asthma and externalizing symptoms, asthma and internalizing symptoms were significantly associated in cross-sectional analyses at 5 and 14 years. In prospective analyses, after excluding children with asthma at 5 years, internalizing symptoms at age 5 were not associated with the development of asthma symptoms at age 14. After excluding children with internalizing symptoms at 5 years, those who had asthma at 5 years had greater odds of developing internalizing symptoms at age 14. CONCLUSION: Children who have asthma/bronchitis by the age of 5 are at greater risk of having internalizing behavior problems in adolescence.

Adolescent↗
PubMedDate not supplied

Socioeconomic position, cognitive function, and clustering of cardiovascular risk factors in adolescence: findings from the Mater University Study of Pregnancy and its outcomes.

OBJECTIVES: The objectives of this study were to examine the extent of clustering of smoking, high levels of television watching, overweight, and high blood pressure among adolescents and whether this clustering varies by socioeconomic position and cognitive function. METHODS: This study was a cross-sectional analysis of 3613 (1742 females) participants of an Australian birth cohort who were examined at age 14. RESULTS: Three hundred fifty-three (9.8%) of the participants had co-occurrence of three or four risk factors. Risk factors clustered in these adolescents with a greater number of participants than would be predicted by assumptions of independence having no risk factors and three or four risk factors. The extent of clustering tended to be greater in those from lower-income families and among those with lower cognitive function. The age-adjusted ratio of observed to expected co-occurrence of three or four risk factors was 2.70 (95% confidence interval [CI], 1.80-4.06) among those from low-income families and 1.70 (95% CI, 1.34-2.16) among those from more affluent families. The ratio among those with low Raven's scores (nonverbal reasoning) was 2.36 (95% CI, 1.69-3.30) and among those with higher scores was 1.51 (95% CI, 1.19-1.92); similar results for the WRAT 3 score (reading ability) were 2.69 (95% CI, 1.85-3.94) and 1.68 (95% CI, 1.34-2.11). Clustering did not differ by sex. CONCLUSION: Among adolescents, coronary heart disease risk factors cluster, and there is some evidence that this clustering is greater among those from families with low income and those who have lower cognitive function.

Adolescent↗