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Lucy Prior

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An exploration using multilevel models

Journal article (2020) - Lucy Prior, Kelvyn Jones, David Manley
Analyses of health over time must consider the potential impacts of ageing as well as any effects relating to cohort differences. The British Household Panel Survey (BHPS) and Understanding Society longitudinal studies are employed to assess trends in mental ill-health over a 26-year period. This analysis uses cross-classified multilevel models in an exploratory, non-parametric approach to evaluate age and cohort effects net of each other. Mental ill-health evidences an initial worsening trend as people age which then reverses and exhibits improvement in late-middle-age, before declining again in the latter stages of life. There were less defined cohort trends. The modelling technique also reveals the relative importance of the temporal contexts in relation to inter- and intra-individual effects on mental ill-health, demonstrating that the ageing and cohort dimensions explain little variation compared to these more dominant within and between influences. Ultimately, we suggest that researchers would benefit from wider use of this exploratory modelling strategy when evaluating underlying health trends and more research is now needed to explore potential explanations of these baseline trajectories. ...

New ‘exposomic’ geographies of health and place

Journal article (2019) - Lucy Prior, David Manley, Clive E. Sabel
Investigating biologically plausible mechanisms for the embodiment of context is a key thoroughfare for progressing health geographies of place. Expanding knowledge of bio-processes such as epigenetics is providing a platform for appreciating the dynamic embedding of social relations in bodies over the lifecourse, and so to tracing the development of health inequalities. By providing a geographic lens on the biosocial, health geographers have key contributions to make regarding the theorisation of place. We put forward the exposome as a holistic framework in which to situate a biosocial health geography, placing ideas of dynamic exposure, plasticity and temporality as central. ...
Journal article (2018) - Lucy Prior, David Manley, Kelvyn Jones
Deprived neighbourhoods have long been associated with poorer health outcomes. However, many quantitative studies have not evidenced the mechanisms through which place ‘gets under the skin’ to influence health. The increasing prevalence of biosocial data provides new opportunities to explore these mechanisms and incorporate them into models of contextual effects. The stress pathway is a key biosocial mechanism; however, few studies have explicitly tested it in neighbourhood associations. This paper addresses this gap by investigating whether allostatic load, a biological response to chronic stress, mediates relationships of neighbourhood deprivation to physical and mental health. Data from UK Understanding Society is used to undertaken a multilevel mediation analysis. Allostatic load is found to mediate the association between neighbourhood deprivation and health, substantiating the biological mechanism of the stress pathway. More deprived areas are associated with higher allostatic load, and in turn worse allostatic load relates to poorer physical and mental health. Allostatic load is a stronger mediator of physical health than mental health, suggesting the stress pathway is more pertinent to explaining physical health gradients. Heterogeneity in the results between physical and mental health suggests more research is needed to disentangle the biosocial processes that could be important to health and place relationships. ...