Hoang, Cung Truong

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2021 - 20222
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  • Publication
    Resilience, Accelerated Aging and Persistently Poor Health: Diverse Trajectories of Health among the Global Poor
    (2022-08-01) Kohler, Iliana V; Hoang, Cung Truong; Amin, Vikesh; Behrman, Jere R; Kohler, Hans-Peter
    Objectives: This study is among the first to document lifecourse trajectories of physical and mental health across adult and older ages (20-70 years) for a poor sub-Saharan African population having faced frequent and sustained adversities. Methods: The 2006-19 waves of the Malawi Longitudinal Study of Families and Health (MLSFH) were analyzed using group-based trajectory models (GBTM) to identify trajectories of heath (SF12 mental/physical health and BMI) across the lifecourse. Predictors of trajectory membership were estimated using fractional multinomial logits. Results: Analyses identified three distinct trajectories: (1) good initial mental/physical health that persisted throughout the lifecourse ("resilient aging"); (2) good initial mental and physical health that deteriorated with age ("accelerated aging"); or (3) poor initial mental and physical health with possibly further declines over the lifecourse ("aging with persistently poor health"). Predictors of trajectory group membership included gender, childhood poverty, and schooling. Discussion: Despite lifecourses being characterized by poverty and frequent adversities in this poor population, our analyses identified a sizable group (30%) of resilient individuals who experienced successful aging with good initial health that persisted across the lifecourse and into old age. Accelerated aging was the most common trajectory for SF12 physical and mental health in this poor population, while for BMI, persistently poor health was most common. Men were more likely to enjoy resilient aging than women in terms of physical/mental health, contrary to previous findings from high-income contexts. Other predictors of trajectory membership sometimes confirmed, and sometimes contradicted, hypotheses derived from high-income country studies.
  • Publication
    Heterogenous Trajectories in Physical, Mental and Cognitive Health among Older Americans: Roles of Genetics and Earlier SES
    (2021-09-12) Hoang, Cung Truong; Amin, Vikesh; Behrman, Jere R.; Kohler, Hans-Peter; Kohler, Iliana V.
    We investigate the roles of genetic predispositions, childhood SES and adult schooling attainment in shaping trajectories for three important components of the overall health and wellbeing of older adults -- BMI, depressive symptoms and cognition. We use the Health & Retirement Study (HRS) and group-based trajectory modelling (GBTM) to identify subgroups of people who share the same underlying trajectories over ages 50-94 years. After identifying common underlying trajectories, we use fractional multinomial logit models to estimate associations of (1) polygenic scores for BMI, depression, ever-smoked, education, cognition and subjective wellbeing, (2) childhood SES and (3) schooling attainment on the probabilities of trajectory group membership. While genetic predispositions do play a part in predicting trajectory group membership, our results highlight the long arm of socioeconomic factors. Schooling attainment is the most robust predictor—it predicts increased probabilities of belonging to trajectories with BMI in the normal rage, low depressive symptoms and high initial cognition. Childhood circumstances are manifested in trajectories to a lesser extent, with childhood SES only predicting the likelihood of being on the low depressive symptoms trajectory. We also find suggestive evidence that associations of schooling attainment on the probabilities of being on trajectories with BMI in the normal rage, low depressive symptoms and high initial cognition vary with genetic predispositions.