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Life-course and cohort trajectories of mental health in the UK, 1991–2008 – A multilevel age–period–cohort analysis

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  • Bell, Andrew

Abstract

There is ongoing debate regarding the shape of life-course trajectories in mental health. Many argue the relationship is U-shaped, with mental health declining with age to mid-life, then improving. However, I argue that these models are beset by the age–period–cohort (APC) identification problem, whereby age, cohort and year of measurement are exactly collinear and their effects cannot be meaningfully separated. This means an apparent life-course effect could be explained by cohorts. This paper critiques two sets of literature: the substantive literature regarding life-course trajectories in mental health, and the methodological literature that claims erroneously to have ‘solved’ the APC identification problem statistically (e.g. using Yang and Land's Hierarchical APC–HAPC-model). I then use a variant of the HAPC model, making strong but justified assumptions that allow the modelling of life-course trajectories in mental health (measured by the General Health Questionnaire) net of any cohort effects, using data from the British Household Panel Survey, 1991–2008. The model additionally employs a complex multilevel structure that allows the relative importance of spatial (households, local authority districts) and temporal (periods, cohorts) levels to be assessed. Mental health is found to increase throughout the life-course; this slows at mid-life before worsening again into old age, but there is no evidence of a U-shape – I argue that such findings result from confounding with cohort processes (whereby more recent cohorts have generally worse mental health). Other covariates were also evaluated; income, smoking, education, social class, urbanity, ethnicity, gender and marriage were all related to mental health, with the latter two in particular affecting life-course and cohort trajectories. The paper shows the importance of understanding APC in life-course research generally, and mental health research in particular.

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  • Bell, Andrew, 2014. "Life-course and cohort trajectories of mental health in the UK, 1991–2008 – A multilevel age–period–cohort analysis," Social Science & Medicine, Elsevier, vol. 120(C), pages 21-30.
    • Handle: RePEc:eee:socmed:v:120:y:2014:i:c:p:21-30
    DOI: 10.1016/j.socscimed.2014.09.008
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    2. Lucy Prior & Kelvyn Jones & David Manley, 2020. "Ageing and cohort trajectories in mental ill-health: An exploration using multilevel models," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-14, July.
    3. Mason, Joyce & Laporte, Audrey & McDonald, James Ted & Kurdyak, Paul & Fosse, Ethan & de Oliveira, Claire, 2024. "Assessing the “healthy immigrant effect” in mental health: Intra- and inter-cohort trends in mood and/or anxiety disorders," Social Science & Medicine, Elsevier, vol. 340(C).
    4. Edsel L. Beja, 2018. "The U-shaped relationship between happiness and age: evidence using world values survey data," Quality & Quantity: International Journal of Methodology, Springer, vol. 52(4), pages 1817-1829, July.
    5. Bell, Andrew & Evans, Clare & Holman, Daniel & Leckie, George, 2023. "Extending intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) for longitudinal data, with application to mental health trajectories in the UK," SocArXiv jq57s, Center for Open Science.
    6. Su, Yu-Sung & Lien, Donald & Yao, Yuling, 2022. "Economic growth and happiness in China: A Bayesian multilevel age-period-cohort analysis based on the CGSS data 2005–2015," International Review of Economics & Finance, Elsevier, vol. 77(C), pages 191-205.
    7. Jan C. van Ours, 2021. "What a drag it is getting old? Mental health and loneliness beyond age 50," Applied Economics, Taylor & Francis Journals, vol. 53(31), pages 3563-3576, July.
    8. Paccagnella, Omar & Pongiglione, Benedetta, 2022. "Depression deterioration of older adults during the first wave of the COVID-19 outbreak in Europe," Social Science & Medicine, Elsevier, vol. 299(C).
    9. Andrew Bell & Kelvyn Jones, 2018. "The hierarchical age–period–cohort model: Why does it find the results that it finds?," Quality & Quantity: International Journal of Methodology, Springer, vol. 52(2), pages 783-799, March.
    10. Bell, Andrew & Evans, Clare & Holman, Dan & Leckie, George, 2024. "Extending intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to study individual longitudinal trajectories, with application to mental health in the UK," Social Science & Medicine, Elsevier, vol. 351(C).
    11. Thomson, Rachel M. & Katikireddi, Srinivasa Vittal, 2018. "Mental health and the jilted generation: Using age-period-cohort analysis to assess differential trends in young people's mental health following the Great Recession and austerity in England," Social Science & Medicine, Elsevier, vol. 214(C), pages 133-143.
    12. van Ours, Jan C., 2020. "What a drag it is getting old? Mental health and loneliness beyond age 50," CEPR Discussion Papers 15438, C.E.P.R. Discussion Papers.
    13. Hugh-Jones, Sam & Wilding, Anna & Munford, Luke & Sutton, Matt, 2023. "Age-gender differences in the relationships between physical and mental health," Social Science & Medicine, Elsevier, vol. 339(C).

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