Life Course Patterns of Concurrent Trajectories of BMI and Affective Symptoms of Rural Mothers: Socioeconomic Antecedents and Disease Outcomes in Later Life

Abstract

Objectives The current study, using prospective data over 25 years (1991–2015), concurrently investigates patterns of body mass index (BMI) and affective symptom trajectories in middle-aged mothers and the socioeconomic antecedents and disease outcomes of these patterns. Method Growth mixture modeling was used to identify latent classes of conjoint health risk trajectories (BMI, depressive symptoms, and anxiety symptoms) from 1991 to 2001. For each latent class, we identified mean trajectories of each health risk. Then, analyses were conducted identifying how these conjoint health risk classes were associated with respondents’ socioeconomic background profiles in 1991 and subsequent chronic health problems in 2015. Results Socioeconomic background profiles were significantly associated with initially high-risk trajectories. There was a statistically significant association between membership in certain classes of conjoint trajectories and physical health outcomes in later years. Consistent patterns of association with changes in different health outcomes including onset of diseases were observed when classes of conjoint risk trajectories are examined. Discussion The identification of members of various conjoint risk trajectory groups provides a potentially useful prognostic tool for early preventive intervention efforts, treatment, and policy formation. Such interventions should promote and develop resiliency factors, thereby aiding in the redirection of middle-aged women’s adverse risk trajectories.

Aging Together in Enduring Couple Relationships: A Life Course Systems Perspective

“…Thus, bridging the life course and systems perspectives both hierarchically and longitudinally provides a synthesized life course systems perspective with enhanced explanatory power in relation to partners' aging process in the context of their enduring couple relationships. Figure provides a graphical representation of the associations highlighted for consideration within this integrated life course systems perspective, and key elements are described in the paragraphs that follow drawing from panel data available in the Later Adulthood Study (LAS) to inform examples of these elements (see Wickrama et al, for more on the study, including survey measures). (In the proposed framework and related discussion, heterosexual marriage is used as the template; thus, the terms husband and wife are employed.…”

“…It is also plausible for mutual influences between intraindividual development and social trajectories (S and H pathways) to produce self‐perpetuating life course processes (e.g., accelerating work and health stress). Similarly, the longitudinal comorbidity between two developmental or aging attributes (e.g., depression and loneliness; body mass index, or BMI, and depression) may be reflected by parallel intraindividual trajectories (multiple H pathways) when they demonstrate similar rates of change (i.e., longitudinal comorbidity), which has been shown to have a synergistic effect on disease outcomes (Ladwig, Marten‐Mittag, Löwel, Döring, & Wichmann, ; Wickrama et al, ).…”

“…Our purpose in this section is to provide examples of testable hypotheses and models that can be derived from this life course systems perspective with an emphasis on better understanding aging in the context of enduring relationships. Again drawing from the LAS panel data (see Wickrama et al, , for more on the study, including survey measures), we conceptualize a repeated measure of physical functioning (PF) as a valid indicator for aging, where PF can be captured from a physical impairment scale noting the range of impairment for vigorous and moderate activities (e.g., running and carrying groceries, respectively; RAND 36‐Item Health Survey 1.0; Hays, Sherbourne, & Mazel, ). We conceptualize a repeated measure of experiences of economic hardship (EH) as an example of a social experience influenced by social structure (stressful marital relations would be another example) with implications for partners in enduring couple relationships, where EH can be captured by summing yes responses to various items representing financial constraints and cutbacks (e.g., difficulty making ends meet, having a phone disconnected).…”

“…For partners in enduring couple relationships, longitudinal comorbidity or synchrony of health risks (e.g., trajectories of husbands' and wives' BMI) has been shown to amplify the health risk of both partners (Wickrama, Lee, & O'Neal, ). Furthermore, synchronized health risk trajectories may exist within individuals (e.g., individuals' trajectories of BMI and depressive symptoms), and there is evidence that these synergies explain more variation in health risks than examinations of individual risk trajectories (Wickrama et al, ). Thus, examining partners' health risk trajectories simultaneously within the life course systems perspective can shed light on the joint influences of partners' health risk trajectories on their health outcomes.…”

The influence of mastery on mother's health in middle years: Moderating role of stressful life context

“…The internal consistency for mothers was .56 in 1991 and was .71 in 2001. In previous applications, this measure has been shown to have good predictive validity (Wickrama, Hwa Kwag, Lorenz, Conger, & Surjadi, ; Wickrama, Kolpack, O'Neal, Beach, & Neppl, ).…”