C Mary Schooling
Biographic Data
| ID | 4720422 |
|---|---|
| NAME | C Mary Schooling |
| GIVEN NAMES | C Mary |
| FAMILY NAME | Schooling |
| SIGNATURE | SCHOOLING C M |
| AFFILIATIONS | University of Hong Kong |
| ORCID | 0000-0001-9933-5887 |
| VERIFIED | Yes |
| TOTAL WORKS | 75 |
| TOTAL CITATIONS | 67 |
| AUTHOR COUNT | 74 |
| EDITOR COUNT | 1 |
| FIRST PUBLICATION YEAR | 2007 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 6 |
Body mass index trajectories and all-cause mortality in older Chinese adults
BACKGROUND: Weight loss at older ages appears to be associated with higher mortality in Western and some East Asian countries, despite differences in the prevalence of obesity; whether it is relevant to China is unknown. We examined the association of body mass index (BMI) trajectories with all-cause mortality in older Chinese adults by sex and baseline age (65-69 years, 70+ years). METHODS: 54 160 participants aged 65 or above from Hong Kong's E…
Association of childhood food consumption and dietary pattern with cardiometabolic risk factors and metabolomics in late adolescence
BACKGROUND: Healthy diet might protect against cardiometabolic diseases, but uncertainty exists about its definition and role in adolescence. METHOD: In a subset of Hong Kong's 'Children of 1997' birth cohort (n=2844 out of 8327), we prospectively examined sex-specific associations of food consumption and dietary pattern, proxied by the Global Diet Quality Score (GDQS) at~12.0 years, with cardiometabolic risk factors and metabolomics at~17.6 year…
East Palestine, Ohio, Railroad Derailment—Lessons to Learn, Actions to Take
Relative Deprivation, Income Inequality, and Cardiovascular Health
The associations between absolute vs. relative income at the household or neighborhood level and cardiovascular disease (CVD) risk remain understudied in the Chinese context. Further, it is unclear whether stress biomarkers, such as cortisol, are on the pathway from income to CVD risk. We examined the associations of absolute and relative income with CVD risk observationally, as well as the mediating role of cortisol, and validated the role of co…
The impact of the minimum wage on suicide rates in Hong Kong
A life course approach to elucidate the role of adiposity in asthma risk
Background Adiposity is associated with asthma although studies do not usually explore the inter-related role of childhood and adult adiposity in asthma risk using a life course perspective. Methods We conducted a Mendelian randomisation (MR) study using genetic instruments for childhood body mass index (BMI) (n=47 541), childhood obesity (n=29 822) and adult BMI (n=681 725) applied to the UK Biobank (n=401 837), with validation in a genome-wide …
Reproduction and longevity
GnRH1 is a potential IHD genetic target. Apart from demonstrating a central tenet of evolutionary biology in humans, our study suggests that existing treatments and environmental factors targeting GnRH1, its drivers or consequences could be re-purposed to prevent and treat IHD. Given, the importance of reproduction to the human species, many such exposures likely exist
The relationship between greenspace and the mental wellbeing of adults
The association of air pollution with height
Objectives Within populations, height is positively associated with economic success and in economically developed populations inversely associated with health. Recent studies also suggest air pollution may result in higher bone turnover markers among children, which may affect growth. However, few studies have investigated the effect of air pollution on height or growth rate. We therefore assessed the associations of several air pollutants with …
Selection bias in population-representative studies? A commentary on Deaton and Cartwright
Let's Require the “T-Word”
A response is provided to an article in the issue by author Miguel A. Hernan on disease causation and causality, including in regard to the theory of causal mechanism. It compares the use of statistical methods and observational studies in conducting research on disease causation
Pubertal testis volume, age at pubertal onset, and adolescent blood pressure
OBJECTIVES: A warning from Health Canada suggests that testosterone increases blood pressure (BP). No evidence from large randomized controlled trials is available, and observational studies are confounded by ill-health lowering serum testosterone. To address the evidence gap, we assessed the association of pubertal testicular volume, as a reflection of testosterone production, with BP. METHODS: We examined whether testicular volume was associate…
Duration of puberty in preterm girls
OBJECTIVES: Preterm birth is associated with altered pubertal timing, but the effect on pubertal duration has rarely been assessed. Here, we tested the hypothesis that preterm birth is associated with shorter duration of puberty among girls in Hong Kong where preterm birth has little social patterning. METHODS: In the population-representative Chinese birth cohort "Children of 1997", we used multivariable linear regression to assess the associati…
The association of breastfeeding with insulin resistance at 17 years
Breastfeeding has many benefits for mother and infant. Whether breastfeeding also protects against type 2 diabetes is unclear. To clarify the role of breastfeeding in type 2 diabetes, we assessed the association of breastfeeding with insulin resistance in late adolescence in a birth cohort from a non-Western setting where breastfeeding was not associated with higher socio-economic position. We used multivariable linear regression, with multiple i…
Age–period–cohort analysis of trends in blood pressure and body mass index in children and adolescents in Hong Kong
BACKGROUND: The declining or fluctuating trend in blood pressure (BP) despite the rising trend in body mass index (BMI) during childhood and adolescence is unexplained. We decomposed trends in BP and BMI to identify the relevance of early-life and contemporaneous factors. METHODS: We assessed the relative contribution of age, period and cohort to secular trends in BP in children and adolescents (9-18 years) from 1999 to 2014 and BMI (6-18 years) …
Longitudinal Patterns and Predictors of Depression Trajectories Related to the 2014 Occupy Central/Umbrella Movement in Hong Kong
Objectives. To examine the longitudinal patterns and predictors of depression trajectories before, during, and after Hong Kong’s 2014 Occupy Central/Umbrella Movement. Methods. In a prospective study, between March 2009 and November 2015, we interviewed 1170 adults randomly sampled from the population-representative FAMILY Cohort. We used the Patient Health Questionnaire-9 to assess depressive symptoms and probable major depression. We investigat…
Could androgens be relevant to partly explain why men have lower life expectancy than women
Life expectancy is about 5 years shorter for men than for women.1 At any given age, men are more vulnerable than women to death from most major causes, including infections, cancer and cardiovascular disease.1 Lifestyle and stress undoubtedly play the same role in this disparity as in other health disparities, particularly given historically higher smoking rates for men than for women. Whether these factors provide a comprehensive explanation and…
Socioeconomic disparities in preterm birth and birth weight in a non-Western developed setting
BACKGROUND: Preterm birth (PTB), low birth weight and small-for-gestational age (SGA) are associated with lower socioeconomic position (SEP) in developed Western settings, but it is unclear if such disparities persist to the same extent elsewhere, and whether associations differ by measure of SEP used. Here, we assessed the association of SEP with PTB, birth weight and SGA in the recently developed non-Western setting of Hong Kong where few women…
Migrant status and child and adolescent psychological well-being
BACKGROUND: In Western settings, migration is associated with psychological well-being, but studies inevitably focus on culturally distinct ethnic minorities, making it difficult to distinguish migration from cultural assimilation. Many children in Hong Kong, a developed non-Western setting, have migrant parents with the same Chinese ethnicity. This study examined the association of migration with the child's psychological well-being in Hong Kong…
Smoking, sex, risk factors and abdominal aortic aneurysm
The microviscosity and fluidity of erythrocyte ghost membranes from lead workers and control subjects was measured by fluorescence polarisation using the fluorophore, 1,6-diphenyl-1,3,5-hexatriene (DPH). Increased lead was associated with a significant decrease in the average microviscosity of resealed and unsealed erythrocyte membranes. Since DPH fluorescence reflects the organisation of lipids in the central core of the membrane, two aspects of…
Liver enzymes and incident diabetes in China
BACKGROUND: Impaired liver function has been shown to be associated with incident diabetes. The independent role of the different liver enzymes, including γ-glutamyltransferase (GGT), alanine transaminase (ALT) and aspartate transaminase (AST), has not been addressed properly, taking into account their high collinearity. We used partial least squares (PLS) regression to identify the contribution of ALT, AST and GGT, which appears causally associa…
Life course epidemiology
Given the emphasis within the developmental origins of adult health and disease paradigm on the first 1000 days, Viner et al 1 are to be applauded for drawing attention to adolescence as a key developmental stage for brain development, psychosocial development, health behaviour, obesity and mental health, with ramifications throughout the life course. Viner et al 1 also highlight the importance of adolescence as a critical or sensitive period for…
Does falling testosterone with age among men underlie the increase in ischaemic heart disease
BACKGROUND: Observationally, testosterone falls with age among men and ischaemic heart disease (IHD) increases with age, so testosterone is commonly assumed to protect against IHD. Here we examined whether IHD mortality rates among men increased faster with age in the USA than China, where testosterone in men remains stable throughout adulthood, and also whether the increase with age in mortality rates for IHD is faster than for other causes of d…
Household income and adolescent blood pressure in a Chinese birth cohort
Estradiol concentrations in young healthy US versus Chinese men
OBJECTIVES: The role of estrogens among men has rarely been explicitly considered. We examined differences in total, free, and bioavailable estradiol (Bio E) between young men from the United States (US) and the most economically developed part of China, that is, Hong Kong (HK). METHODS: Cross-sectional analysis was conducted based on 365 young men from the Third National Health and Nutrition Examination Survey in the US and 299 young Chinese men…
A socio-biological explanation for social disparities in non-communicable chronic diseases
This study places social disparities in the major non-communicable chronic diseases within their global economic and historical contexts. Rapid economic transition outside the developed world provides a unique opportunity to re-examine the origins of, and biological mechanisms driving, social disparities. Gaps in prevailing theories focusing on material resources, civic infrastructure and social structure are identified. Using longstanding experi…
Are height and leg length universal markers of childhood conditions? The Guangzhou Biobank cohort study
OBJECTIVE: In developed western populations longer legs have been shown to be a marker of better early childhood conditions. In the first generations to experience the epidemiologic transition and associated economic development, epigenetic constraints on growth might preclude improved childhood conditions from increasing leg growth or height. DESIGN, SETTING AND PARTICIPANTS: Multivariable linear regression was used to assess the association of …
Inequality and inequity in access to health care and treatment for chronic conditions in China
Non-communicable diseases (NCDs) are a large and rapidly-growing problem in China and other middle-income countries. Clinical treatment of NCDs is long-term and expensive, so it may present particular problems for equality and horizontal equity (equal treatment for equal need) in access to health care, although little is known about this at present in low- and middle-income countries. To address this gap, and inform policy for a substantial propo…
Is leg length a biomarker of childhood conditions in older Chinese women? The Guangzhou Biobank Cohort Study
OBJECTIVE: In developed western populations longer legs have been shown to be a biomarker of better early childhood conditions. It was hypothesised that in transitioning populations better childhood conditions may bring forward puberty and thus decrease leg length, counteracting the overall positive effect of a favourable childhood environment on leg growth. DESIGN: Structural equation modelling was used to assess the interrelationship of age, ed…
Height, Its Components, and Cardiovascular Risk Among Older Chinese
Objectives. Better childhood conditions, inferred from height and specifically leg length, are usually protective against ischemic heart disease and its risk factors in Western countries. In other geoethnic populations, height is less clearly protective, casting doubt on there being a biological etiology. To clarify the role of childhood conditions, we examined the associations of height and its components with cardiovascular risk among older Chi…
Longitudinal Patterns and Predictors of Depression Trajectories Related to the 2014 Occupy Central/Umbrella Movement in Hong Kong
Objectives. To examine the longitudinal patterns and predictors of depression trajectories before, during, and after Hong Kong’s 2014 Occupy Central/Umbrella Movement. Methods. In a prospective study, between March 2009 and November 2015, we interviewed 1170 adults randomly sampled from the population-representative FAMILY Cohort. We used the Patient Health Questionnaire-9 to assess depressive symptoms and probable major depression. We investigat…
Socioeconomic influences at different life stages on health in Guangzhou, China
Understanding sociohistorical imprint on cancer risk by age–period–cohort decomposition in Hong Kong
BACKGROUND: Research on trends in cancer incidence has usually examined single sites in populations that long ago completed the economic transition. The trends in 11 cancers in three groups in the recently transitioned Hong Kong Chinese population were examined to delineate the effects of economic transition and provide generalised aetiological insights. METHODS: Sex-specific Poisson models were fitted to cancer incidence in Hong Kong (1974-2003)…
Intergenerational 'mismatch' and adiposity in a developing population
The impact of the minimum wage on suicide rates in Hong Kong
Household income and adolescent blood pressure in a Chinese birth cohort
Social disparities and cause-specific mortality during economic development
Let's Require the “T-Word”
A response is provided to an article in the issue by author Miguel A. Hernan on disease causation and causality, including in regard to the theory of causal mechanism. It compares the use of statistical methods and observational studies in conducting research on disease causation
Could androgens be relevant to partly explain why men have lower life expectancy than women
Life expectancy is about 5 years shorter for men than for women.1 At any given age, men are more vulnerable than women to death from most major causes, including infections, cancer and cardiovascular disease.1 Lifestyle and stress undoubtedly play the same role in this disparity as in other health disparities, particularly given historically higher smoking rates for men than for women. Whether these factors provide a comprehensive explanation and…
Liver enzymes and incident diabetes in China
BACKGROUND: Impaired liver function has been shown to be associated with incident diabetes. The independent role of the different liver enzymes, including γ-glutamyltransferase (GGT), alanine transaminase (ALT) and aspartate transaminase (AST), has not been addressed properly, taking into account their high collinearity. We used partial least squares (PLS) regression to identify the contribution of ALT, AST and GGT, which appears causally associa…
Life course epidemiology
Given the emphasis within the developmental origins of adult health and disease paradigm on the first 1000 days, Viner et al 1 are to be applauded for drawing attention to adolescence as a key developmental stage for brain development, psychosocial development, health behaviour, obesity and mental health, with ramifications throughout the life course. Viner et al 1 also highlight the importance of adolescence as a critical or sensitive period for…
Alcohol use and fasting glucose in a developing southern Chinese population
BACKGROUND: In observational studies, mainly from Western Caucasian populations, moderate alcohol use has been shown to be associated with a lower risk of diabetes. However, whether the protection is due to the attributes of alcohol or to those of moderate alcohol users is difficult to disentangle. A population with a different distribution of alcohol consumption and diabetes prevalence from Western populations was studied as a counterfactual com…
The relation of chronic cardiovascular diseases and diabetes mellitus to perceived health, and the moderating effects of sex and age
Smoking, quitting and mortality in an elderly cohort of 56 000 Hong Kong Chinese
In old age, smoking continues to be a major cause of death, and quitting is beneficial. Smoking cessation is urgently needed in rapidly ageing populations in the East
Height, Its Components, and Cardiovascular Risk Among Older Chinese
Objectives. Better childhood conditions, inferred from height and specifically leg length, are usually protective against ischemic heart disease and its risk factors in Western countries. In other geoethnic populations, height is less clearly protective, casting doubt on there being a biological etiology. To clarify the role of childhood conditions, we examined the associations of height and its components with cardiovascular risk among older Chi…
The relation of chronic cardiovascular diseases and diabetes mellitus to perceived health, and the moderating effects of sex and age
Are longer legs associated with enhanced fertility in Chinese women?☆
Does economic development contribute to sex differences in ischaemic heart disease mortality? Hong Kong as a natural experiment using a case-control study
Most of these people migrated as young adults; we speculate that environmentally mediated differences in pubertal maturation (when the male disadvantage in lipids and fat patterning emerges) may contribute to excess male premature IHD mortality in developed environments
Early life second-hand smoke exposure and serious infectious morbidity during the first 8 years
Household SHS exposure in early infancy increases severe infectious morbidity requiring hospital admission. Reducing SHS exposure in infants and particularly in more vulnerable infants will lower the bed-days burden due to infectious causes
Are height and leg length universal markers of childhood conditions? The Guangzhou Biobank cohort study
OBJECTIVE: In developed western populations longer legs have been shown to be a marker of better early childhood conditions. In the first generations to experience the epidemiologic transition and associated economic development, epigenetic constraints on growth might preclude improved childhood conditions from increasing leg growth or height. DESIGN, SETTING AND PARTICIPANTS: Multivariable linear regression was used to assess the association of …
Is leg length a biomarker of childhood conditions in older Chinese women? The Guangzhou Biobank Cohort Study
OBJECTIVE: In developed western populations longer legs have been shown to be a biomarker of better early childhood conditions. It was hypothesised that in transitioning populations better childhood conditions may bring forward puberty and thus decrease leg length, counteracting the overall positive effect of a favourable childhood environment on leg growth. DESIGN: Structural equation modelling was used to assess the interrelationship of age, ed…
Does Smoking Affect Hospital Use Before Death
BACKGROUND: Given the apparent greater use of health care services by smokers and predictions of higher costs for a never-smoking population, we aimed in this study to determine whether the acute hospital costs in the last years of life of never- and ever-smokers differed before death using a database of the decedents in 1 year in Hong Kong. OBJECTIVES: To compare the acute hospital use of ever- and never-smoker decedents. METHODS: The data on ca…
A socio‐historical hypothesis for the diabetes epidemic in Chinese—Preliminary observations from Hong Kong as a natural experiment
It has been hypothesized that the emerging epidemic of diabetes in economically transitioning or recently transitioned populations is due to mismatch between developmental and mature environments. We took advantage of migration within an ethnically homogenous population to investigate this hypothesis, and the potentially modifying role of postnatal growth conditions, proxied by greater height. We used multivariable logistic regression in a popula…
Alcohol and cardio-respiratory deaths in Chinese
High levels of alcohol use in an older Chinese population were associated with lower IHD mortality. Moderate alcohol use was less consistently protective against IHD mortality. Alcohol use was associated with lower COPD mortality particularly in men, either due to some yet to be clarified properties of alcohol or as the artefactual result of genetic selection into alcohol use in a Chinese population. Given the increasing use of alcohol in China w…
Alcohol use and fasting glucose in a developing southern Chinese population
BACKGROUND: In observational studies, mainly from Western Caucasian populations, moderate alcohol use has been shown to be associated with a lower risk of diabetes. However, whether the protection is due to the attributes of alcohol or to those of moderate alcohol users is difficult to disentangle. A population with a different distribution of alcohol consumption and diabetes prevalence from Western populations was studied as a counterfactual com…
Leg length and age of puberty among men and women from a developing population
OBJECTIVES: Leg length and relative leg length are considered to be reliable markers of prepubertal living conditions. Cessation of leg growth, driven by estrogen, occurs earlier in puberty in girls than boys. We hypothesized that leg length and relative leg length, as sitting height to leg ratio, might have sex-specific associations with age of puberty. METHODS: We used multivariable linear regression in 10,046 older (>or=50 years) Chinese from …
Estimated birth weight and adult cardiovascular risk factors in a developing southern Chinese population
Birth weight may impact blood pressure; however associations of birth weight with other cardiovascular risk factors may not be related to foetal exposures, but speculatively could be an historical co-incidence, with corresponding implications for prevention
Family structure, parent-child conversation time and substance use among Chinese adolescents
Non-intact families were associated with substance use among Hong Kong Chinese adolescents. The apparently stronger associations with substance use in paternal than maternal families were probably mediated by the poorer communication with the father
Understanding sociohistorical imprint on cancer risk by age–period–cohort decomposition in Hong Kong
BACKGROUND: Research on trends in cancer incidence has usually examined single sites in populations that long ago completed the economic transition. The trends in 11 cancers in three groups in the recently transitioned Hong Kong Chinese population were examined to delineate the effects of economic transition and provide generalised aetiological insights. METHODS: Sex-specific Poisson models were fitted to cancer incidence in Hong Kong (1974-2003)…
A socio-biological explanation for social disparities in non-communicable chronic diseases
This study places social disparities in the major non-communicable chronic diseases within their global economic and historical contexts. Rapid economic transition outside the developed world provides a unique opportunity to re-examine the origins of, and biological mechanisms driving, social disparities. Gaps in prevailing theories focusing on material resources, civic infrastructure and social structure are identified. Using longstanding experi…
Intergenerational 'mismatch' and adiposity in a developing population
Social disparities and cause-specific mortality during economic development
Intergenerational influences on diabetes in a developing population
OBJECTIVES: Intergenerational "mismatch" and/or growth conditions may be relevant to the epidemic of diabetes in developing populations. In a rapidly developing southern Chinese population, we tested whether maternal environment, proxied by maternal literacy, or family socio-economic position (SEP), proxied by paternal literacy, were associated with fasting glucose and diabetes. To assess if intergenerational mismatch contributed, we tested wheth…
Childhood meat eating and inflammatory markers
If confirmed, this hypothesis implies that economic development and the associated improvements in nutrition at puberty may be less beneficial among men than women; consistent with the widening sex differentials in life expectancy with economic development
Spatial proximity and childhood hospital admissions in a densely populated conurbation
SP2-5 Diabetes in Asia
Introduction With rapid economic development, diabetes is reaching epidemic proportions in Asia, even in relatively non-obese populations. Changing lifestyles, obesity and genetics undoubtedly play a key role, however it is increasingly recognised that causes of disease may extend over generations. Methods The developmental origins of health paradigm has focused on the health consequences of constrained pre-natal or infant growth. Here we conside…
SP1-34 Pubertal muscle mass and diabetes markers in Chinese adolescents
Introduction There is an emerging epidemic of diabetes in China despite a relatively non-obese population. Genetics and lifestyle undoubtedly play a key role. We hypothesise that environmentally driven muscle mass acquisition at puberty may also be relevant. To test this hypothesis we examined the association of sex-steroids with muscle mass and of muscle mass with fasting glucose and insulin in a sample of Chinese adolescents. Methods In 40 adol…
SP3-47 Spatial proximity and childhood hospital admissions in a densely populated conurbation
Introduction Physical distance is a barrier to hospital utilisation. In a very densely populated city in China, we examined whether use of public hospitals by children was associated with individual-level residential proximity, and whether these associations varied with type of admission. Methods The authors used multivariable negative binomial regression in a large, population-representative birth cohort to examine the adjusted associations of p…
Medicine (74 works) · Demography (55 works) · Internal Medicine (53 works) · Population (48 works) · Environmental health (41 works) · Cohort (39 works) · Cohort study (35 works) · Internal Medicine (28 works) · Birth, Development, and Health (26 works) · Gerontology (26 works)