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Dong C, Chen H, Li Y, Sun Y, Pan Y, Xu Q, Sun H. Patterns of Health-Risk Behaviours and Their Associations With Anxiety and Depression Among Chinese Young Adults by Gender: A Latent Class Analysis. Psychol Rep 2024:332941241258922. [PMID: 38842056 DOI: 10.1177/00332941241258922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
This study investigated gender differences in health-risk behaviour patterns among young adults and assessed the associations of anxiety and depression with these patterns. A cross-sectional survey was conducted with 1740 young Chinese adults aged 18-24 years. Latent class analysis (LCA) and multinomial logistic regression were conducted to identify the clusters of health-risk behaviours and their associations with anxiety and depression. Three common patterns were found for both genders: physical inactivity, substance use, and insufficient fruit intake (5.7% for males [M] and 11.6% for females [F]); a sedentary lifestyle only (48.4% for M and 48.9% for F); and a sedentary lifestyle, substance use, and an unhealthy diet (7.6% for M and 20.0% for F). Additionally, two additional unique patterns were found: physical inactivity and unhealthy diet in males (38.3%) and physical inactivity and insufficient fruit intake in females (19.6%). Sociodemographic variables exert different effects on health-risk behaviour patterns as a function of gender. Lower anxiety levels (odds ratio [OR]: 0.892; 95% confidence interval [CI]: 0.823-0.966) and greater depression levels (OR: 1.074; 95% CI: 1.008-1.143) were associated with a sedentary lifestyle, substance use, and unhealthy diet class only in female young adults compared with a sedentary-only class. These findings underscore the need for the implementation of targeted interventions based on gender differences.
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Affiliation(s)
- Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Hua Chen
- School of Nursing, Peking University, Beijing, China
| | - Yi Li
- Medical Informatics Center, Institute of Advanced Clinical Medicine, Peking University, Beijing, China
| | - Yumei Sun
- School of Nursing, Peking University, Beijing, China
| | - Yinzhu Pan
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Qiongying Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Hongyu Sun
- School of Nursing, Peking University, Beijing, China
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Huang X, Guo X, Gao W, Xiong Y, Chen C, Zheng H, Pan Z, Wang L, Zheng S, Ke C, Stavrinou P, Hu W, Hong K, Zheng F. Causal association between years of schooling and the risk of traumatic brain injury: A two-sample mendelian randomization analysis. J Affect Disord 2024; 354:483-490. [PMID: 38484892 DOI: 10.1016/j.jad.2024.03.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/26/2024] [Accepted: 03/09/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE To investigate whether the number of years of schooling are causally associated traumatic brain injury (TBI). We aimed to investigate whether the number of years of schooling are causally associated TBI. METHODS We investigate the prospective causal effect of years of schooling on TBI using summary statistical data. The statistical dataset comprising years of schooling (n = 293,723) from genome-wide association studies (GWASs) deposited in the UK Biobank was used for exposure. We used the following GWAS available in the FinnGen dataset: individuals with TBI (total = 13,165; control = 136,576; number of single nucleotide polymorphisms [SNPs] = 16,380,088). RESULTS Seventy significant genome-wide SNPs from GWAS datasets with annotated years of schooling were selected as instrumental variables. The inverse variance weighted method results supported a causal relationship between years of schooling and TBI (odds ratio (OR), 0.78; 95 % confidence interval (CI), 0.62-0.98; P = 0.029). MR-Egger regression showed that polydirectionality was unlikely to bias the results (intercept = 0.007, SE = 0.01, P = 0.484) and demonstrated no causal relationship between years of schooling and TBI (OR, 0.52; 95%CI, 0.17-1.64; P = 0.270). The weighted median method revealed a causal relationship with TBI (OR, 0.73; 95%CI, 0.55-0.98; P = 0.047). A Cochran's Q test and funnel plot did not show heterogeneity nor asymmetry, indicating no directional pleiotropy. CONCLUSIONS The current investigation yields substantiation of a causal association between years of schooling and TBI development. More years of schooling may be causally associated with a reduced risk of TBI, which has implications for clinical and public health practices and policies.
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Affiliation(s)
- Xinyue Huang
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Xiumei Guo
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China; Department of Neurology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Wen Gao
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China; Department of Neurology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Yu Xiong
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Chunhui Chen
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Hanlin Zheng
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Zhigang Pan
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Lingxing Wang
- Department of Neurology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China.
| | - Shuni Zheng
- Division of Public Management, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Chuhan Ke
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Pantelis Stavrinou
- Department of Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany; Neurosurgery, Metropolitan Hospital, Athens, Greece.
| | - Weipeng Hu
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China.
| | - Kunda Hong
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
| | - Feng Zheng
- Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, Fujian Province, China.
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Liew TM, Ang LC. Examining the non-linear effects of education on Alzheimer's and non-Alzheimer's disease: Sex-stratified analysis of 17,671 older persons. Soc Sci Med 2024; 348:116845. [PMID: 38598986 PMCID: PMC11105760 DOI: 10.1016/j.socscimed.2024.116845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/08/2024] [Accepted: 03/27/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Higher educational attainment is strongly associated with a reduced risk of neurocognitive disorders (NCDs). However, the literature is not yet clear on (1) the minimum years of compulsory education that would sufficiently mitigate the risk of NCDs, and (2) whether educational attainment has differential effects across sexes. To bridge these gaps, this study sought to model potential non-linear relationship between years of education and NCD risk, across men and women. METHODS The study recruited 17,671 participants from Alzheimer's Disease Centres across United States, aged≥50 years and had normal cognition at baseline. Participants were followed up almost annually, and underwent standardized assessments to diagnose various aetiologies of NCDs. Cox proportional hazard regression was conducted to examine the relationship between years of education and NCD risk, stratified by sexes. Years of education were modelled using restricted cubic spline. RESULTS Lesser years of education were associated with higher NCD risk in both sexes (specifically, when <12 years of education; HR 1.80-3.48), yet with key differences across sexes. In women, a linear relationship was observed whereby increasing years of education reduced NCD risk correspondingly; but in men, the relationship was non-linear whereby adding years of education beyond 12 years did not reduce NCD risk further. Men of lower educational attainment were at risk of both Alzheimer's Disease (AD; HR up to 3.45) and non-AD (HR up to 2.57), while women of lower educational attainment were only at risk of AD (HR up to 2.11). CONCLUSIONS Educational attainment alters NCD risk differently across sexes, emphasizing the relevance of sex-specific research to better understand the moderating role of sex on NCD risk. The findings also highlight the need to reconsider public policies related to equitable access to education, as well as traditional assumptions on the minimum years of compulsory education.
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Affiliation(s)
- Tau Ming Liew
- Department of Psychiatry, Singapore General Hospital, Singapore, Singapore; SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore; Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Li Chang Ang
- Medicine Academic Clinical Programme, Singapore General Hospital, Singapore, Singapore
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Cai Q, Qian M, Chen M. Association between socioeconomic status and post-stroke depression in middle-aged and older adults: results from the China health and retirement longitudinal study. BMC Public Health 2024; 24:1007. [PMID: 38605383 PMCID: PMC11010318 DOI: 10.1186/s12889-024-18503-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION Post-stroke depression (PSD) is a common neuropsychiatric complication that affects approximately one-third of stroke patients. The treatment and prognosis of this disease are poor. Socioeconomic status (SES) is closely related to health outcomes; however, only a few previous studies have focused on the association between SES and PSD. Given the substantial population of stroke patients in China, it is crucial to examine the potential risk factors associated with PSD. Conducting studies on this population and investigating the influence of economic conditions can provide valuable guiding theoretical insights into PSD prevention and management. METHODS We used data from the 2018 China Health and Retirement Longitudinal Study and selected appropriate samples for analysis. Depression was estimated using the Center of Epidemiologic Studies Depression Scale-10, a validated tool for assessing depression in the general population. Multiple logistic regression analysis was employed to assess the association between SES and PSD and to evaluate any urban-rural differences. RESULTS Of the 749 respondents, 370 (49.4%) had depression. Stroke patients with a middle school education demonstrated a greater risk of developing depression than those with a primary school education or below after adjusting for all control variables (odds ratio (OR) = 1.60, 95% confidence interval (CI): 1.03-2.51, P = 0.036). However, stroke patients with a high school education or above had a lower risk of developing depression than those with a primary school education or below (OR = 0.50, 95% CI: 0.28-0.88, P = 0.016). In rural areas, stroke patients with a high school or above education level had lower rates of depression than those with a primary school education or below (OR = 0.44, 95% CI: 0.21-0.91, P = 0.027). This difference was not significant in urban areas. CONCLUSIONS SES significantly influences the occurrence of PSD, which is reflected by education attainment and annual household expenditures. Education attainment was an independent influence on PSD, with a more pronounced effect in rural versus urban areas. We hope to reduce the prevalence of PSD and enhance the comprehensive management of this disease by modifying the influencing factors. Sex, self-reported health status, activities of daily living, night-time sleep duration, and life satisfaction also influenced the occurrence of PSD.
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Affiliation(s)
- Qianru Cai
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Mengyi Qian
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Meiling Chen
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China.
- Institute of Zhejiang Chinese Medical Culture, Zhejiang Chinese Medical University, Hangzhou, China.
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Zanuzzi MG, Garzon ME, Cornavaca MT, Bernabeu F, Albertini RA, Ellena G, Romero CA. Social determinants of blood pressure control in a middle-income country in Latin America. J Biosoc Sci 2024; 56:50-62. [PMID: 36794341 DOI: 10.1017/s0021932023000044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Blood pressure (BP) control is a key intervention to decrease cardiovascular diseases (CVD), the main cause of death in low and middle-income countries (MIC). Scarce data on the determinants of BP control in Latin America are available. Our objective is to explore the role of gender, age, education, and income as social determinants of BP control in Argentina, a MIC with a universal health care system. We evaluated 1184 persons in two hospitals. Blood pressure was measured using automatic oscillometric devices. We selected those patients treated for hypertension. The average BP of less than 140/90 mmHg was considered a controlled BP. We found 638 hypertensive individuals, of whom 477 (75%) were receiving antihypertensive drugs, and of those, 248 (52%) had controlled BP. The prevalence of low education was more frequent in uncontrolled patients (25.3% vs. 16.1%; P < .01). We did not find association between household income, gender, and BP control. Older patients had less BP control (44% of those older than 75 years vs. 60.9% of those younger than 40; test for trend P < .05). Multivariate regression indicates low education (OR 1.71 95% CI [1.05, 2.79]; P = .03) and older age (OR 1.01; 95% IC [1.00, 1.03]) as independent predictors of the lack of BP control. We conclude that rates of BP control are low in Argentina. In a MIC with a universal health care system low education and old age but not household income are independent predictors of the lack of BP control.
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Affiliation(s)
- Matias G Zanuzzi
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Maria E Garzon
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Maria Teresita Cornavaca
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Francisco Bernabeu
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Ricardo A Albertini
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Gustavo Ellena
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Instituto Universitario de Ciencias Biomedicas de Córdoba (IUCBC), Argentina
| | - Cesar A Romero
- Servicio de Clinica Medica, Hospital Privado Universitario de Córdoba, Argentina
- Global Health Initiative, Henry Ford Hospital, Detroit, MI, USA
- Hypertension and Vascular Research Division, Internal Medicine Department, Henry Ford Hospital, Detroit, MI, USA
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Holttinen T, Lindberg N, Rissanen P, Kaltiala R. Educational attainment of adolescents treated in psychiatric inpatient care: a register study over 3 decades. Eur Child Adolesc Psychiatry 2023; 32:2163-2173. [PMID: 35932327 PMCID: PMC10576713 DOI: 10.1007/s00787-022-02052-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/16/2022] [Indexed: 11/03/2022]
Abstract
Mental disorders may for various reasons impair educational attainment, and with far-reaching consequences given the impact of education on subsequent employment, social life, life choices and even health and mortality. This register-based study addresses trends in educational attainment among Finnish adolescents aged 13-17 with mental disorders severe enough to necessitate inpatient treatment between 1980 and 2010. Our subjects (N = 14,435), followed up until the end of 2014, were at greater risk of discontinuing education beyond compulsory comprehensive school or of lower educational attainment than their age-peers in general population. Only 50.0% had completed any post-comprehensive education compared to 84.9% in same-aged general population. Those at highest risk were males and those with organic, intellectual disabilities and developmental, externalizing disorders or schizophrenia group diagnoses. Despite improvements in adolescent psychiatric care, school welfare services and pedagogical support, risks have remained high. Greater effort in psychiatric treatment, school welfare and pedagogy are needed to combat this severe inequality.
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Affiliation(s)
- Timo Holttinen
- Department of Adolescent Psychiatry, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Arvo Ylpön katu 34, 33014, Tampere, Finland.
| | - Nina Lindberg
- Helsinki University and Helsinki University Hospital, Forensic Psychiatry, Helsinki, Finland
| | - Pekka Rissanen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Riittakerttu Kaltiala
- Department of Adolescent Psychiatry, Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere University, Arvo Ylpön katu 34, 33014, Tampere, Finland
- Vanha Vaasa Hospital, Vaasa, Finland
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Chu LM, Rennie DC, Kirychuk S, Cockcroft D, Gordon JR, Pickett W, Dosman J, Lawson JA. Farm Exposures and Allergic Disease Among Children Living in a Rural Setting. J Agromedicine 2023; 28:676-688. [PMID: 37038656 DOI: 10.1080/1059924x.2023.2200427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVES The purpose of this study was to examine the association between farm exposures and asthma and allergic disease in children while also highlighting the experiences of non-farm rural children. METHODS This was a cross-sectional analysis of data collected from across the province of Saskatchewan, Canada in 2014. Surveys were completed by parents of 2275 rural dwelling children (farm and non-farm) aged 0 to 17 years within 46 rural schools. Questionnaires were distributed through schools for parents to complete. RESULTS Asthma prevalence was 7.6%, of which 29.5% of cases were allergic. After adjustment for potential confounders, home location (farm vs non-farm) and other farm exposures were not associated with asthma and asthma phenotypes. Those who completed farm safety education were more likely to have asthma (11.7% vs. 6.7%; p = .001) compared to children without asthma. In sub-analyses among 6-12-year-old children, boys were more likely to have asthma (non-allergic) and use short-acting beta-agonists compared to girls. Doing farm work in the summer was associated with an increased risk of asthma [adjusted OR (aOR) = 1.71 (1.02-2.88); p = .041]. Doing routine chores with large animals was associated with an increased risk of asthma [aOR = 1.83 (1.07-3.15); p = .027] and allergic asthma [aOR = 2.37 (95%CI = 1.04-5.40); p = .04]. CONCLUSION The present study showed that the prevalence of asthma and asthma phenotypes were similar between farm and non-farm rural children. There did not appear to be differential involvement in farming activities between those with and without asthma although those with asthma had more training suggesting possible attempts to mitigate harm from farm exposures.
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Affiliation(s)
- L M Chu
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - D C Rennie
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - S Kirychuk
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - D Cockcroft
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - J R Gordon
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - W Pickett
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - J Dosman
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - J A Lawson
- Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Department of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Schoen MS, Boland KM, Christ SE, Cui X, Ramakrishnan U, Ziegler TR, Alvarez JA, Singh RH. Total choline intake and working memory performance in adults with phenylketonuria. Orphanet J Rare Dis 2023; 18:222. [PMID: 37516884 PMCID: PMC10386684 DOI: 10.1186/s13023-023-02842-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/21/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Despite early diagnosis and compliance with phenylalanine (Phe)-restricted diets, many individuals with phenylketonuria (PKU) still exhibit neurological changes and experience deficits in working memory and other executive functions. Suboptimal choline intake may contribute to these impairments, but this relationship has not been previously investigated in PKU. The objective of this study was to determine if choline intake is correlated with working memory performance, and if this relationship is modified by diagnosis and metabolic control. METHODS This was a cross-sectional study that included 40 adults with PKU and 40 demographically matched healthy adults. Web-based neurocognitive tests were used to assess working memory performance and 3-day dietary records were collected to evaluate nutrient intake. Recent and historical blood Phe concentrations were collected as measures of metabolic control. RESULTS Working memory performance was 0.32 z-scores (95% CI 0.06, 0.58) lower, on average, in participants with PKU compared to participants without PKU, and this difference was not modified by total choline intake (F[1,75] = 0.85, p = 0.36). However, in a subgroup with complete historical blood Phe data, increased total choline intake was related to improved working memory outcomes among participants with well controlled PKU (Phe = 360 µmol/L) after adjusting for intellectual ability and mid-childhood Phe concentrations (average change in working memory per 100 mg change in choline = 0.11; 95% CI 0.02, 0.20; p = 0.02). There also was a trend, albeit nonsignificant (p = 0.10), for this association to be attenuated with increased Phe concentrations. CONCLUSIONS Clinical monitoring of choline intake is essential for all individuals with PKU but may have important implications for working memory functioning among patients with good metabolic control. Results from this study should be confirmed in a larger controlled trial in people living with PKU.
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Affiliation(s)
- Meriah S Schoen
- Department of Human Genetics, Emory University School of Medicine, 101 Woodruff Circle, Suite 7130, Atlanta, GA, 30322, USA.
| | - Kelly M Boland
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Shawn E Christ
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Xiangqin Cui
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Thomas R Ziegler
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jessica A Alvarez
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Rani H Singh
- Department of Human Genetics, Emory University School of Medicine, 101 Woodruff Circle, Suite 7130, Atlanta, GA, 30322, USA
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Skinner GCM, Farrington DP. Health of Convicted Persons in the Third Generation of the Longitudinal Cambridge Study in Delinquent Development. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023; 67:757-782. [PMID: 34963375 PMCID: PMC10126470 DOI: 10.1177/0306624x211066837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Research suggests that convicted persons are more likely than non-convicted persons to suffer poor health. However, few longitudinal studies have investigated associations between health and offending across generations. Using the Cambridge Study in Delinquent Development, this article prospectively investigates the relationship between health and offending across generations and between genders. At the average age of 25, third generation convicted males and females reported a higher incidence of serious drug use than non-convicted persons. Convicted males reported a higher incidence of mental illness and self-harm, whereas convicted females reported a lower incidence of physical illness, mental illness, self-harm and hospitalizations when compared to non-convicted females. Convicted males reported a higher incidence of industrial accidents, sports injuries and fight injuries, but a lower incidence of road accidents, whereas convicted females were more likely to report road accidents. Like their fathers, convicted males show worse health compared to non-convicted individuals.
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Salmela J, Lahti J, Kanerva N, Rahkonen O, Kouvonen A, Lallukka T. Latent classes of unhealthy behaviours and their associations with subsequent sickness absence: a prospective register-linkage study among Finnish young and early midlife employees. BMJ Open 2023; 13:e070883. [PMID: 37169500 DOI: 10.1136/bmjopen-2022-070883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVES Unhealthy behaviours are associated with increased sickness absence (SA), but few studies have considered person-oriented approach in these associations. Using latent class analysis, we examined clustering of unhealthy behaviours among Finnish municipal employees and their associations with subsequent SA. DESIGN A prospective register-linkage study. SETTING Unhealthy behaviours (low leisure-time physical activity, non-daily fruit and vegetable consumption, insufficient sleep, excessive alcohol use and tobacco use) were derived from the Helsinki Health Study questionnaire survey, collected in 2017 among 19- to 39-year-old employees of the City of Helsinki, Finland. PARTICIPANTS A total of 4002 employees (81% women) of the City of Helsinki, Finland. PRIMARY OUTCOME MEASURES The questionnaire data were prospectively linked to employer's SA register through March 2020. Associations between latent classes of unhealthy behaviours and subsequent SA (1-7 days/8+ days/all lengths) were examined using negative binomial regression. RESULTS Among women, a three-class latent class model was selected: (1) few unhealthy behaviours (84%), (2) excessive alcohol and tobacco use (12%) and (3) several unhealthy behaviours (5%). Women belonging to classes 2 and 3 had increased SA rates compared with those in class 1, regardless of the length of SA spells. Among men, a 2-latent class model was selected: (1) few unhealthy behaviours (53%) and (2) several unhealthy behaviours (47%). Men belonging to class 2 had increased rates of 1-7 days' SA compared with men in class 1. CONCLUSIONS This study suggests that preventive actions aiming to reduce employees' SA should consider simultaneously several unhealthy behaviours. Targeted interventions may benefit of identifying the clustering of these behaviours among occupational groups.
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Affiliation(s)
- Jatta Salmela
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jouni Lahti
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Noora Kanerva
- Department of Food and Nutrition, Faculty of Agriculture and Forestry, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Tea Lallukka
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Nelson MH. Explaining socioeconomic disparities in electoral participation: The role of health in the SES-voting relationship. Soc Sci Med 2023; 320:115718. [PMID: 36708609 DOI: 10.1016/j.socscimed.2023.115718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 01/13/2023] [Accepted: 01/20/2023] [Indexed: 01/25/2023]
Abstract
The substantial gap in electoral participation between upper and lower socioeconomic status (SES) groups has long been a vexing problem for modern democracies and one that demands explanation. Following separate bodies of scholarship that suggest (1) socioeconomic disadvantage diminishes health and (2) poor health demobilizes eligible voters, this paper proposes that health serves as a pathway through which social inequality manifests in disparities in electoral participation. This paper tests this hypothesis by analyzing U.S. presidential election data, in which structural equation modeling was used to decompose the association between SES and turnout, through health. Results show that health mediates approximately 20% of the relationship between SES and electoral participation. These findings imply a political explanation for the endurance of population health disparities; they may self-sustain by disproportionately limiting the political voice of the disadvantaged, for whom more egalitarian social and health policy would be most beneficial.
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Affiliation(s)
- Micah H Nelson
- Department of Sociology, University of North Carolina at Chapel Hill, 155 Pauli Murray Hall CB #3210, Chapel Hill, NC, 27599-3210, USA.
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Azil AA, Yusof ZYM, Marhazlinda J. Clustering of Health and Oral Health-Compromising Behaviours in Army Personnel in Central Peninsular Malaysia. Healthcare (Basel) 2023; 11:healthcare11050640. [PMID: 36900645 PMCID: PMC10000684 DOI: 10.3390/healthcare11050640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Health- and oral health-compromising behaviours (HOHCBs) impact the health readiness of military personnel, resulting in decreased fitness performance, thus affecting combat readiness. This study aimed to identify the clustering patterns and number of HOHCBs in army personnel in Central Peninsular Malaysia. Thus, a cross-sectional study using a multistage sampling technique and a validated 42-item online questionnaire was conducted to assess ten health (medical screening, physical activity, sedentary lifestyle, smoking status, alcohol consumption, substance abuse, aggressive behaviours, sleep, and road safety habits) and five oral health behaviour domains (tooth brushing, fluoridated toothpaste use, flossing, dental visits, and bruxism). Each HOHCB was dichotomised into healthy and health-compromising behaviour and analysed using hierarchical agglomerative cluster analysis (HACA). With the majority being males (92.5%), of other ranks (96.8%), and healthy (83.9%), 2435 army members of a mean age of 30.3 years (SD = 5.9) participated, with a response rate of 100%. HACA identified two clustering patterns: (i) 'high-risk behaviours' (30 HOHCBs) and (ii) 'most common risk behaviours' (12 HOHCBs) with a mean clustering number of 14.1 (SD = 4.1). In conclusion, army personnel in Central Peninsular Malaysia displayed 2 broad HOHCB clustering patterns, 'high-risk' and 'most common risk', with an average of 14 HOHCB clusters per person.
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Affiliation(s)
- Ahmad Asyraf Azil
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Dental Services Section, Health Services Division Malaysian Armed Forces, Kuala Lumpur 50634, Malaysia
| | - Zamros Yuzadi Mohd Yusof
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Jamaludin Marhazlinda
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Correspondence: ; Tel.: +60-3-79674866
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Guo J, Lin L, Aqeel MM, Gelfand SB, Eicher-Miller HA, Bhadra A, Hennessy E, Richards EA, Delp EJ. Joint Temporal Patterns By Integrating Diet and Physical Activity. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.23.23284780. [PMID: 36747820 PMCID: PMC9901045 DOI: 10.1101/2023.01.23.23284780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Both diet and physical activity are associated with obesity and chronic diseases such as diabetes and metabolic syndrome. Early efforts in connecting dietary and physical activity behaviors to generate patterns rarely considered the use of time. In this paper, we propose a distance-based cluster analysis approach to find joint temporal diet and physical activity patterns among U.S. adults ages 20-65. Dynamic Time Warping (DTW) generalized to multi-dimensions is combined with commonly used clustering methods to generate unbiased partitioning of the National Health and Nutrition Examination Survey 2003-2006 (NHANES) dataset. The clustering results are evaluated using visualization of the clusters, the Silhouette Index, and the associations between clusters and health status indicators based on multivariate regression models. Our experiments indicate that the integration of diet, physical activity, and time has the potential to discover joint temporal patterns with association to health.
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Affiliation(s)
- Jiaqi Guo
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | - Luotao Lin
- Department of Nutrition Science Purdue University, West Lafayette, IN, USA
| | - Marah M Aqeel
- Department of Nutrition Science Purdue University, West Lafayette, IN, USA
| | - Saul B Gelfand
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
| | | | - Anindya Bhadra
- Department of Statistics Purdue University, West Lafayette, IN, USA
| | - Erin Hennessy
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | | | - Edward J Delp
- School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, USA
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Disparities in fruit and vegetable intake at the intersection of gender and education in northern Sweden: a cross-sectional study. BMC Nutr 2022; 8:147. [PMID: 36510314 PMCID: PMC9743711 DOI: 10.1186/s40795-022-00641-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Even though the existence of inequalities in fruit and vegetable consumption has been well established, it is not clear how it is patterned across intersections of multiple social positions and identities. This study aims to investigate disparities in fruit and vegetable intake between groups at the intersection of education and gender in northern Sweden, and to estimate the discriminatory accuracy of the intersectional groups. METHODS Cross-sectional data from the 2018 Health on Equal Terms survey conducted in four regions in northern Sweden was used (N = 21,853). Four intersectional groups were created: high and low educated men, and high and low educated women. Prevalence differences corresponding to joint, referent, and excess intersectional inequalities, were estimated for three outcomes: inadequate fruit and vegetable intake combined, inadequate fruit intake, and inadequate vegetable intake. The discriminatory accuracy of the intersectional groups was estimated by the area under the receiver operating characteristic curve. RESULTS Low educated men had the highest prevalence of inadequate intake of fruits and vegetables combined (81.4%), fruits (83.4%), and vegetables (84.9%), while high educated women had the lowest (47.7, 60.2, and 51.8%, respectively). The joint disparities between high educated women and low educated men were both significant and substantial for all outcomes (34.6 percentage points (pp.), 25.2 pp., and 31.2 pp., adjusted), although differences in magnitude were noted between fruit and vegetable intake. The joint disparities were mostly explained by the two referent disparities for gender and education. The excess intersectional disparity - the part of the joint disparity not explained by either referent disparity - was negative for all three outcomes (-5.5 pp., - 4.2 pp., and - 4.6 pp. respectively, adjusted). The discriminatory accuracy of the intersectional groups was moderate (0.67, 0.65, and 0.68 respectively). CONCLUSIONS An intersectional approach can provide a more detailed view of inequalities in fruit and vegetable consumption between groups combining several social positions. The moderate discriminatory accuracy observed here suggests that interventions and policies aiming to reduce diet inequalities should not solely be targeted at certain groups, but also be universal.
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Zhou W, Lin H, Ren Y, Lin H, Liang Y, Chen Y, Zhang S. Mental health and self-management in glaucoma patients during the COVID-19 pandemic: a cross-sectional study in China. BMC Ophthalmol 2022; 22:474. [PMID: 36474185 PMCID: PMC9727872 DOI: 10.1186/s12886-022-02695-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To investigate mental health and self-management in glaucoma patients during the COVID-19 pandemic in China and to describe the correlation between anxiety, depression, glaucoma, and self-management. METHODS This cross-sectional study included glaucoma patients who enrolled in the case management platform and completed an online survey. The survey included the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Glaucoma Self-Management Questionnaire (GSMQ). RESULTS Among 109 glaucoma patients enrolled in this study, the proportions of patients suffering from depression and anxiety during the COVID-19 pandemic were 26.6% and 20.2%, respectively. A statistical association was found between depression and self-management behaviour in these glaucoma patients (r = -0.247, P = 0.010). The self-management scores in patients less than 35 years were lower than those in patients aged 35-60 years (P = 0.046). The scores of body function promotion in men were lower than those in women (P = 0.048). Patients with primary school education and below had lower scores in the medical management of disease than those with either middle school education (P = 0.032) or community college education or higher (P = 0.022). CONCLUSION A high proportion of anxiety and depression was found in glaucoma patients during the COVID-19 pandemic. Better self-management behaviour was associated with stronger mental health regulation. It is important to help glaucoma patients improve their self-management behaviours, especially for young men with low educational levels.
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Affiliation(s)
- Wenzhe Zhou
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Haishuang Lin
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China ,grid.268099.c0000 0001 0348 3990Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Yanhan Ren
- grid.168645.80000 0001 0742 0364University of Massachusetts Medical School, Worcester, USA
| | - Hao Lin
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Youping Liang
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Yanyan Chen
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Shaodan Zhang
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
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Canedo JR, Villalta-Gil V, Grijalva CG, Schlundt D, Jerome RN, Wilkins CH. How do Hispanics/Latinos Perceive and Value the Return of Research Results? HISPANIC HEALTH CARE INTERNATIONAL 2022; 20:238-247. [PMID: 35018873 PMCID: PMC9273811 DOI: 10.1177/15404153211070821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Interest in the return of research results has been increasing; however, little is known about how Hispanics/Latinos perceive and value receiving results. This study examined differences among Hispanics/Latinos by education and income in the experience and expectations about the return of research results, perceived value of specific types of information, and the least and most valuable specific information. Method: Retrospective observational design using a cross-sectional national survey sample of Hispanics/Latinos (n = 327). Results: Higher educational attainment was positively associated with the expectation to receive research results, likelihood to participate in research if given study findings, and likelihood to trust researchers if given results. Higher income was positively associated with the perceived value of getting results. Respondents with higher education specifically perceived greater value in information about how lifestyle and genetics affect their risk of disease, how genetics affect how they respond to medications, their ancestry, available clinical trials near them, and how to connect with other study participants. Respondents with higher income perceived greater value in information about how genetics affect their risk of disease and how they respond to medications. Conclusion: The findings offer important insights for planning research initiatives and for developing culturally targeted educational materials for Hispanics/Latinos.
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Affiliation(s)
- Juan R Canedo
- 12328Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - David Schlundt
- 12328Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Consuelo H Wilkins
- 12328Vanderbilt University Medical Center, Nashville, TN, USA
- 435391Meharry-Vanderbilt Alliance, Nashville, TN, USA
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Yan Z, Xiang N, Meng J, Liang H, Yue Z. Understanding the effect of retirement on health behaviors in China: Causality, heterogeneity and time-varying effect. Front Public Health 2022; 10:952072. [PMID: 36045724 PMCID: PMC9421064 DOI: 10.3389/fpubh.2022.952072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/26/2022] [Indexed: 01/24/2023] Open
Abstract
Retirement is an important turning point during the course of life, but few studies have examined the effects of retirement on a broad range of health behaviors in China. We use the longitudinal data of the China Health and Nutrition Survey (CHNS) from 2004 to 2015 to conduct empirical analysis. Fuzzy discontinuity regression was used to assess the association between retirement and health behaviors in the entire sample and subgroups based on gender and education. A time-varying effect model was used to measure the anticipatory effect, immediate effect and lag effect of retirement. We observed that the transition to retirement was associated with healthier lifestyle habits, such as reduced smoking and alcohol consumption and increased exercise motivation. However, the transition was associated with worse sedentary behavior. No significant statistical association was found between retirement and sleep duration. Men and those with higher education levels are more likely to experience the impact of retirement. The anticipatory effect suggests that as the statutory pension age is predictable, workers adjust their behaviors 4 and 5 years before retirement. The lagged effect indicates that it takes time to develop new habits; thus, retirees change their behaviors 2-3 years after retirement. The paper discusses possible reasons for our findings and proposes several policy implications from the perspectives of the government and society to facilitate the realization of healthy aging.
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Browne FA, Peasant Bonner C, Kline TL, Cox EN, Gichane MW, Wechsberg WM. Alcohol, drug use, and sexual risk among young African American women in North Carolina: Is educational attainment protective? VULNERABLE CHILDREN AND YOUTH STUDIES 2022; 18:149-155. [PMID: 38076331 PMCID: PMC10704931 DOI: 10.1080/17450128.2022.2089794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 06/09/2022] [Indexed: 01/03/2024]
Abstract
Previous research shows that educational attainment is a protective factor for substance use and sexual risk among adolescents and young adults. Evidence also shows that this relationship may differ by race/ethnicity and gender. This study aimed to elucidate the relationship between educational attainment, substance use and sexual risk among African American women in emerging adulthood. This study uses cross-sectional data from 646 African American women (aged 18 to 25) enrolled in a randomized trial of a behavioral HIV risk-reduction intervention. At enrollment, participants completed a risk behavior assessment via audio-computer assisted self-interview and provided a urine sample for drug screening. Bivariate logistic regression analyses were conducted to examine substance use and sexual risk factors associated with educational attainment: completing some college or more vs. completing high school or less). Participants who completed some college or more (52%) were more likely to report heavy alcohol use (four or more drinks in one day) in the past 30 days (OR=1.48; p=0.014) and more likely to report alcohol or other drug use just before or during last sex (OR=1.43; p=0.026) compared with participants who completed high school or less. Completing some college or more was protective for having a positive urine screen for cocaine (OR=0.43; p=0.018) and reporting condomless sex at last sex (OR=0.71; p=0.041). Differences in positive marijuana screens, reporting a previous STI, or reporting their partner used alcohol or other drugs at last sex were not statistically significant. The findings reveal notable differences in the magnitude and direction of associations between educational attainment and substance use and sexual risk. Although educational attainment is subject to change because of the frequent pursuit of education during emerging adulthood, the findings may have important implications for tailoring HIV risk-reduction interventions to key populations, such as African American women.
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Affiliation(s)
- Felicia A. Browne
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
- Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Courtney Peasant Bonner
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Tracy L. Kline
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Erin N. Cox
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Margaret W. Gichane
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Wendee M. Wechsberg
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
- Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- Psychology, North Carolina State University, Raleigh, NC, USA
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Zhang Y, Zhang N, Xu C. Implicit theories of body weight and engagement in healthy lifestyles among young adults: The mediating effect of self-control. J Health Psychol 2021; 27:2797-2805. [PMID: 34964398 DOI: 10.1177/13591053211065102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Engaging in a healthy lifestyle could be helpful to decrease lifestyle-related health risks and bring long-term health benefits. This research investigated how implicit theories of body weight influence people's engagement in healthy lifestyle among young adults in China. The results suggested that implicit theories of body weight significantly influence people's engagement in heathy eating behaviors and physical activity. Self-control mediated the effect of implicit (incremental) theories of body weight on people's engagement in healthy eating. Implications of the current research for understanding how to promote engagement in healthy lifestyle and directions for future research are discussed.
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Affiliation(s)
- Ying Zhang
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, China
| | - Ning Zhang
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, China
| | - Chenyang Xu
- School of Public Health and the Second Affiliated Hospital of Zhejiang University School of Medicine, China
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20
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Muñoz IG, Santos-Lozada AR. Educational Attainment and Psychological Distress Among Working-Age Adults in the United States. SSM - MENTAL HEALTH 2021; 1:100003. [PMID: 38571576 PMCID: PMC10989279 DOI: 10.1016/j.ssmmh.2021.100003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
This study builds on a growing body of literature analyzing the education-health gradient across detailed educational categories, which documents that US working-age adults who attended college but did not earn a bachelor's degree report equal or worse health than adults with a high school diploma. This is known as the "anomaly" in the education-health gradient. The purpose of this study is to test whether this pattern extends to measures of serious psychological distress (SPD) and individual symptoms by using data from the National Health Interview Survey (NHIS, 1997-2018) and a series of logistic regression models. We find that the anomaly in the education-health gradient is present for a summary measure of SPD as well as for five of the six symptoms that make up this measure. The exception was reporting feeling sad most or all the time during the last month, where adults with "some college" were found to have lower odds than those with a high school diploma. Further stratified analysis by sex revealed that this result for feeling sad was driven by women. In terms of associate degrees, our models show that adults with a vocational/technical associate degree have statically similar odds of SPD and reporting four out of six symptoms (exceptions were feeling hopeless and sadness), while those with an academic associate degree have significantly lower odds in all outcomes. The robustness of the models used is supported by an extensive sensitivity analysis. Overall, we find evidence of the anomaly in the education-health gradient in SPD and individual symptoms of psychological distress at the sub-baccalaureate level, adding to previous studies that document the anomaly in markers of physiological dysregulation, health conditions, vision problems, functional limitations, and pain.
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Affiliation(s)
- Ismael G. Muñoz
- Department of Education Policy Studies, Pennsylvania State University
- Population Research Institute, Pennsylvania State University
| | - Alexis R. Santos-Lozada
- Population Research Institute, Pennsylvania State University
- Department of Human Development and Family Studies, Pennsylvania State University
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21
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Wang C, Sun Y, Jiang D, Wang C, Liu S. Risk-Attributable Burden of Ischemic Heart Disease in 137 Low- and Middle-Income Countries From 2000 to 2019. J Am Heart Assoc 2021; 10:e021024. [PMID: 34585592 PMCID: PMC8649139 DOI: 10.1161/jaha.121.021024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background Ischemic heart disease (IHD) imposes the greatest disease burden globally, especially in low‐ and middle‐income countries (LMICs). We aim to examine the population‐attributable fraction and risk‐attributable death and disability‐adjusted life years (DALYs) for IHD in 137 low‐ and middle‐income countries. Methods and Results Using comparative risk assessment framework from the 2019 Global Burden of Disease study, the population‐attributable fraction and IHD burden (death and DALYs) attributable to risk factors in low‐income countries, lower‐middle‐income countries (LMCs), and upper‐middle‐income countries were assessed from 2000 to 2019. In 2019, the population‐attributable fraction (%) of IHD deaths in relation to all modifiable risk factors combined was highest in lower‐middle‐income countries (94.2; 95% uncertainty interval, 91.9–96.2), followed by upper‐middle‐income countries (93.5; 90.4–95.8) and low‐income countries (92.5; 90.0–94.7). There was a >13‐fold difference between Peru and Uzbekistan in age‐standardized rates (per 100 000) of attributable death (44.3 versus 660.4) and DALYs (786.7 versus 10506.1). Dietary risks accounted for the largest proportion of IHD’s behavioral burden in low‐ and middle‐income countries, primarily attributable to diets low in whole grains. High systolic blood pressure and high low‐density lipoprotein cholesterol remained the 2 leading causes of DALYs, with the former topping the list in 116 countries, while the latter led in 21 of the 137 countries. Compared with 2000 to 2010, the increases in risk‐attributable deaths and DALYs among upper‐middle income countries were slower from 2010 to 2019, while the trends in low‐income countries and lower‐middle income countries were opposite. Conclusions IHD’s attributable burden remains high in low‐ and middle‐income countries. Considerable heterogeneity was observed among different income‐classified regions and countries.
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Affiliation(s)
- Chenran Wang
- Weifang Medical University Weifang China.,National Center for Women and Children's HealthChinese Center for Disease Control and Prevention Beijing China
| | | | | | | | - Shiwei Liu
- Tobacco Control officeChinese Center for Disease Control and Prevention Beijing China
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22
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Cantu PA, Sheehan CM, Sasson I, Hayward MD. Increasing Education-Based Disparities in Healthy Life Expectancy Among U.S. Non-Hispanic Whites, 2000-2010. J Gerontol B Psychol Sci Soc Sci 2021; 76:319-329. [PMID: 31711225 DOI: 10.1093/geronb/gbz145] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less-educated white Americans during the first decade of the twenty-first century. METHODS This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (i) change in age-specific mortality rates; and (ii) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). RESULTS Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. In contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less-educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages. DISCUSSION Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less-educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.
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Affiliation(s)
- Phillip A Cantu
- Department of Sociology and Population Research Center, University of Texas at Austin.,Preventative Medicine and Population Health, University of Texas Medical Branch, Galveston
| | - Connor M Sheehan
- School of Social and Family Dynamics, Arizona State University, Tempe
| | - Isaac Sasson
- Department of Sociology and Anthropology and the Herczeg Institute on Aging, Tel Aviv University, Israel
| | - Mark D Hayward
- Department of Sociology and Population Research Center, University of Texas at Austin
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Andersson MA, Maralani V, Wilkinson R. Origins and Destinations, but How Much and When? Educational Disparities in Smoking and Drinking Across Adolescence and Young Adulthood. POPULATION RESEARCH AND POLICY REVIEW 2021. [DOI: 10.1007/s11113-021-09659-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
It is well established that adverse childhood experiences (ACEs) are linked to health and emotional outcomes. However, less is known about the relationship between ACEs and educational attainment—a potentially important feature of educational stratification in America. Using the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative study following 7–12th grade students in the 1994–95 school year, I investigate the link between ACEs and these students’ timely post-secondary attainment. I also explore the role of health and socio-emotional factors as mediators. Results confirm that there is a graded relationship between ACEs and timely bachelor’s degree attainment—an additional ACE decreases the odds of timely bachelor’s degree attainment by about 17%, even after accounting for other related factors. In addition, the findings suggest that general health partially mediates this link.
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25
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Ramo DE, Thrul J, Vogel EA, Delucchi K, Prochaska JJ. Multiple Health Risk Behaviors in Young Adult Smokers: Stages of Change and Stability over Time. Ann Behav Med 2021; 54:75-86. [PMID: 31157881 DOI: 10.1093/abm/kaz025] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Health risk behaviors (HRBs) are common, yet not well understood in young adult smokers. PURPOSE We examined HRB profiles over 12 months in young adult smokers participating in a Facebook smoking cessation intervention clinical trial. METHODS Participants (N = 500; age M = 20.9 years; 54.6% women) were recruited online and randomized to receive either a 3-month Facebook smoking cessation intervention or referral to Smokefree.gov (control). A Health Risk Assessment determined risk for 10 behaviors at baseline and 3, 6, and 12 months. Latent class analysis (LCA) and latent transition analysis (LTA) were used to identify patterns of HRBs and changes over time. RESULTS At baseline, participants reported an average of 5.4 (standard deviation [SD] = 1.7) risk behaviors, including smoking (100%), high-fat diet (84.8%), poor sleep hygiene (71.6%), and low fruit and vegetable intake (69.4%). A 3-class model fit the data best at baseline and all follow-up time points: low risk (28.8% at baseline) with low likelihood of risk on all behaviors except smoking, substance use risk (14.0% at baseline) characterized by heavy episodic drinking, cannabis use, and other illicit drug use, and metabolic risk (57.2% at baseline), with a high percentage of members at risk for a low fruit and vegetable intake, high-fat diet, inactivity, stress, and poor sleep hygiene. Classes were very stable at 3, 6, and 12 months, with few participants transitioning between classes. CONCLUSIONS Most young adult smokers engaged in multiple risk behaviors, with meaningful clustering of behaviors, and demonstrated stability over a year's time. In addition to smoking, targets for intervention are co-occurring substance use and metabolic risk behaviors. CLINICAL TRIALS REGISTRATION NCT02207036.
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Affiliation(s)
- Danielle E Ramo
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, Suite, San Francisco, CA, USA.,Hopelab, San Francisco, CA, USA
| | - Johannes Thrul
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Erin A Vogel
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, Suite, San Francisco, CA, USA
| | - Kevin Delucchi
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, Suite, San Francisco, CA, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
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Xiao Y, Bian Y, Zhang L. Mental Health of Chinese Online Networkers under COVID-19: A Sociological Analysis of Survey Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238843. [PMID: 33260696 PMCID: PMC7730967 DOI: 10.3390/ijerph17238843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/14/2020] [Accepted: 11/24/2020] [Indexed: 01/10/2023]
Abstract
This paper reports the results of a recent survey of Chinese WeChat networkers (n = 2015, August 2020) about China’s mental health conditions under COVID-19. The purpose of the survey was to measure symptoms of depression, anxiety, and somatization by using a standard 18-item battery and assess how the results were related to an individual’s socioeconomic status, lifestyle, and social capital under an ongoing pandemic. The survey reveals that the pandemic has had a significant impact, as the respondents had more serious mental symptoms when their residential communities exhibited a greater exposure to the spread of the virus. The socioeconomic status of the respondents was negatively associated with the mental symptoms. It modified the impact of COVID-19, and its effect was substantially mediated by measures of lifestyle and social capital.
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Affiliation(s)
- Yang Xiao
- School of Philosophy and Government, Shaanxi Normal University, Xi’an 710119, China;
| | - Yanjie Bian
- Institute for Empirical Social Science Research, Xi’an Jiaotong University, Xi’an 710049, China
- Department of Sociology, University of Minnesota, Minneapolis, MN 55455, USA
- Correspondence:
| | - Lei Zhang
- Department of Sociology, University of Colorado Colorado Springs, Colorado Springs, CO 80918, USA;
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Dartanto T, Pramono W, Lumbanraja AU, Siregar CH, Bintara H, Sholihah NK, Usman. Enrolment of informal sector workers in the National Health Insurance System in Indonesia: A qualitative study. Heliyon 2020; 6:e05316. [PMID: 33163673 PMCID: PMC7609471 DOI: 10.1016/j.heliyon.2020.e05316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/10/2020] [Accepted: 10/16/2020] [Indexed: 11/16/2022] Open
Abstract
One of the main challenges facing the expansion of universal health coverage (UHC) in developing countries like Indonesia is the high prevalence of those working in the informal sector who must voluntarily register in the National Health Insurance System (NHIS). This condition hinders some from being covered by the NHIS. Following Bourdieu's concepts of field, capital and habitus, this research aims to analyse some aspects that influence the decision of informal sector workers to join the NHIS in Indonesia. We conducted qualitative methods, including in-depth interviews of 29 informants and Focus Group Discussion (FGD) in the three selected regions of Deli Serdang (North Sumatera), Pandeglang (Banten) and Kupang (East Nusa Tenggara). Using thematic content analysis and several triangulation processes, this study found that three main factors influence the decisions of those working in the informal sector to join the NHIS: health conditions, family and peers, and existing knowledge and experience. The stories provided by the informants regarding their decision-making processes in joining NHIS also reveal the necessary and sufficient conditions that enable informal sector workers to join the NHIS, which are individual-specific and which may differ between people, depending on individual characteristics, regional socioeconomic and demographic characteristics and belief systems. These three factors are all necessary conditions to support the joining of informal sector workers into the NHIS. This study suggests that one possible route for expanding the UHC coverage of informal sector workers is through maximising the word-of-mouth effect by engaging local or influential leaders.
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Affiliation(s)
- Teguh Dartanto
- Research Cluster on Poverty, Social Protection and Development Economics, Department of Economics, Faculty of Economics and Business, Universitas Indonesia, Campus UI Depok, Depok, 16424, Indonesia
- Institute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, Indonesia
| | - Wahyu Pramono
- Institute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, Indonesia
| | - Alvin Ulido Lumbanraja
- Institute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, Indonesia
| | - Chairina Hanum Siregar
- Institute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, Indonesia
| | - Hamdan Bintara
- Institute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, Indonesia
| | - Nia Kurnia Sholihah
- Institute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, Indonesia
| | - Usman
- PT Sarana Multi Infrastruktur (Persero), Sahid Sudirman Center 47-48 floor, Jakarta, 10220, Indonesia
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Campbell R, Wright C, Hickman M, Kipping RR, Smith M, Pouliou T, Heron J. Multiple risk behaviour in adolescence is associated with substantial adverse health and social outcomes in early adulthood: Findings from a prospective birth cohort study. Prev Med 2020; 138:106157. [PMID: 32473267 PMCID: PMC7378566 DOI: 10.1016/j.ypmed.2020.106157] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/31/2020] [Accepted: 05/24/2020] [Indexed: 01/20/2023]
Abstract
Adolescents' engage in new behaviours such as substance use and change others, such as reducing physical activity. Risks to health from these tend to be considered separately. We examined the association between multiple risk behaviours at age 16 years and outcomes in early adulthood. 5591 young people enrolled in the Avon Longitudinal Study of Parents and Children provided data on at least one of seven adverse outcomes at age ~18 years. We used logistic regression to examine associations between total number of risk behaviours and rates of depression, anxiety, problem gambling, getting into trouble with the police, harmful drinking, obesity and not in education, employment or training (NEET) at age 18 years. We found strong associations between multiple risk behaviours and all seven adverse outcomes. For each additional risk behaviour engaged in the odds of harmful drinking increased by OR = 1.58[95%CI:1.48,1.69], getting into trouble with the police OR = 1.49[95%CI:1.42,1.57], having depression OR = 1.24[95%CI:1.17,1.31], problem gambling OR = 1.20[95%CI:1.13,1.27], NEET OR = 1.19[95%CI:1.11,1.29], anxiety OR = 1.18[95%CI:1.12,1.24] and obesity OR = 1.09[95%CI:1.03,1.15]. Neither adjustment for sex, parental socio-economic position and maternal risk behaviours, nor confining analyses to adolescents with no previous presentation of these adverse outcomes, resulted in any notable reductions in the odds ratios. Investment in interventions and environments that effectively prevent multiple risk behaviour is likely to improve a range of health outcomes in young adults.
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Affiliation(s)
- Rona Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
| | - Caroline Wright
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
| | - Ruth R Kipping
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
| | - Michèle Smith
- School of Clinical Sciences, University of Bristol, Bristol BS8 2BN, UK
| | | | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
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Holahan CJ, Holahan CK, Lim S, Powers DA. Living with a Smoker and Multiple Health-Risk Behaviors. Ann Behav Med 2020; 55:287-297. [PMID: 32814951 DOI: 10.1093/abm/kaaa059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Behavioral medicine is showing growing theoretical and applied interest in multiple health-risk behaviors. Compared to engaging in a single health-risk behavior, multiple health-risk behaviors are linked to increased morbidity and mortality. A contextual determinant of multiple risk behaviors may be living with a smoker. PURPOSE This study investigated the role of living with a smoker in predicting multiple health-risk behaviors compared to a single health-risk behavior, as well as whether these multiple risk behaviors occur across both physical activity and dietary domains. Moreover, the study tested these effects across 3 years in longitudinal and prospective (controlling for health-risk behaviors at baseline) analyses. METHODS Participants were 82,644 women (age M = 63.5, standard deviation = 7.36, age range = 49-81) from the Women's Health Initiative Observational Study. Analyses used multinomial and binary logistic regression. RESULTS Living with a smoker was more strongly associated with multiple health-risk behaviors than with a single health-risk behavior. These multiple risk behaviors occurred across both physical activity and dietary domains. The effects persisted across 3 years in longitudinal and prospective analyses. Living with a smoker, compared to not living with a smoker, increased the odds of multiple health-risk behaviors 82% cross-sectionally and, across 3 years, 94% longitudinally and 57% prospectively. CONCLUSIONS These findings integrate research on multiple health-risk behaviors and on living with a smoker and underscore an unrecognized public health risk of tobacco smoking. These results are relevant to household-level interventions integrating smoking-prevention and obesity-prevention efforts.
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Affiliation(s)
- Charles J Holahan
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Carole K Holahan
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - Sangdon Lim
- Department of Educational Psychology, University of Texas at Austin, Austin, TX, USA
| | - Daniel A Powers
- Department of Sociology, University of Texas at Austin, Austin, TX, USA
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30
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Allman-Farinelli M, Nour M. Exploring the role of social support and social media for lifestyle interventions to prevent weight gain with young adults: Focus group findings. J Hum Nutr Diet 2020; 34:178-187. [PMID: 32519384 DOI: 10.1111/jhn.12774] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Young adults gain more weight annually than other adults and may be destined for future obesity. Effective interventions are needed, and social support may be a key element for success. The present study explores how best to leverage social media to support young adults with their health goals in a healthy lifestyle programme. METHOD Young adults aged 18-25 years were recruited from the community to a series of four focus groups led by an experienced facilitator who used a discussion guide developed a priori. The discussion explored their opinions regarding which social media platforms were appropriate for providing social support, the types of support that were relevant (family and friends versus strangers) and factors that would encourage peer-to-peer communication in a healthy lifestyle intervention. Sessions were audio-taped, transcribed and analysed using the qualitative software, nvivo, version 11 (QSR International Pty Ltd., Melbourne, VIC, Australia). Themes were generated using an inductive approach informed by the Theory of Social Identity and Social Influence Model of Consumer Participation. RESULTS Thirty-three people (12 male) participated. Facebook was the most popular platform for facilitating social support as a result of its private group capabilities and already being embedded into their daily routines. The preference was to be grouped with strangers who shared similar goals in smaller groups of participants. The discussions highlighted the integral role of a credible and relatable health coach to serve as a mentor, mediator and role model. CONCLUSIONS The learnings from this research will be applied to optimise engagement within social media support groups in lifestyle interventions.
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Affiliation(s)
- M Allman-Farinelli
- School of Life and Environmental Sciences, The University of Sydney, Discipline of Nutrition and Dietetics, The University of Sydney, Sydney, NSW, Australia
| | - M Nour
- School of Life and Environmental Sciences, The University of Sydney, Discipline of Nutrition and Dietetics, The University of Sydney, Sydney, NSW, Australia
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Dobewall H, Koivusilta L, Karvonen S, Lindfors P, Kinnunen JM, Vainikainen MP, Rimpelä A. Late start of upper secondary education and health-compromising behaviours among Finnish adolescents-a follow-up study. Eur J Public Health 2020; 30:438-443. [PMID: 31598643 PMCID: PMC7292345 DOI: 10.1093/eurpub/ckz178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background The Finnish government has emphasized the need to expedite educational transitions. We study if a late start of upper secondary education is related to health-related selection, namely health-compromising behaviours in adolescence. Methods A large cohort of adolescents from the seventh (12–13 years) and ninth (15–16 years) grades answered online classroom surveys (total n = 10 873). They were followed to the start of upper secondary education, obtained from the Joint Application Registry. We compared those who continued studies directly from the ninth grade with later starters. We measured late bedtime, breakfast not every school day, tooth brushing less than twice-a-day, monthly alcohol consumption, weekly smoking, daily energy drinks, physical activity <6 days/week and excessive screen time. Multilevel logistic regressions and latent class analyses were conducted. Results In gender and school adjusted models in the seventh grade, all behaviours except physical activity predicted the late start. The strongest predictor was smoking, OR = 2.96 (CI = 2.25–3.89). In the ninth grade, smoking, breakfast, tooth brushing and energy drinks, OR = 1.80, (CI = 1.36–2.39, strongest), were predictive. After controlling for sociodemographic background and academic achievement, associations for alcohol and screen time became non-significant in the seventh grade. In the ninth grade, only screen time remained significant, OR = 1.33 (CI = 1.04–1.71). Health-compromising behaviours formed clusters. Belonging to the unhealthy cluster predicted the late start in both grades, in adjusted models only in the seventh grade. Conclusions Students with health-compromising behaviours are less likely to start upper secondary education directly after the compulsory education. This may increase the risk for fragmentary educational trajectories and work careers.
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Affiliation(s)
- Henrik Dobewall
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,PERLA-Tampere Centre for Childhood, Youth and Family Research, Tampere University, Tampere, Finland
| | - Leena Koivusilta
- Department of Social Research, Faculty of Social Sciences, Turku, Finland
| | - Sakari Karvonen
- Social Policy Research Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Pirjo Lindfors
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,PERLA-Tampere Centre for Childhood, Youth and Family Research, Tampere University, Tampere, Finland
| | - Jaana M Kinnunen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,PERLA-Tampere Centre for Childhood, Youth and Family Research, Tampere University, Tampere, Finland
| | - Mari-Pauliina Vainikainen
- Centre for Educational Assessment, University of Helsinki, Helsinki, Finland.,Faculty of Education and Culture, Tampere University, Tampere, Finland
| | - Arja Rimpelä
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.,PERLA-Tampere Centre for Childhood, Youth and Family Research, Tampere University, Tampere, Finland.,Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
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32
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Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P, Brauer M, Kutty VR, Gupta R, Wielgosz A, AlHabib KF, Dans A, Lopez-Jaramillo P, Avezum A, Lanas F, Oguz A, Kruger IM, Diaz R, Yusoff K, Mony P, Chifamba J, Yeates K, Kelishadi R, Yusufali A, Khatib R, Rahman O, Zatonska K, Iqbal R, Wei L, Bo H, Rosengren A, Kaur M, Mohan V, Lear SA, Teo KK, Leong D, O'Donnell M, McKee M, Dagenais G. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet 2020; 395:795-808. [PMID: 31492503 PMCID: PMC8006904 DOI: 10.1016/s0140-6736(19)32008-2] [Citation(s) in RCA: 830] [Impact Index Per Article: 207.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/12/2019] [Accepted: 08/14/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Global estimates of the effect of common modifiable risk factors on cardiovascular disease and mortality are largely based on data from separate studies, using different methodologies. The Prospective Urban Rural Epidemiology (PURE) study overcomes these limitations by using similar methods to prospectively measure the effect of modifiable risk factors on cardiovascular disease and mortality across 21 countries (spanning five continents) grouped by different economic levels. METHODS In this multinational, prospective cohort study, we examined associations for 14 potentially modifiable risk factors with mortality and cardiovascular disease in 155 722 participants without a prior history of cardiovascular disease from 21 high-income, middle-income, or low-income countries (HICs, MICs, or LICs). The primary outcomes for this paper were composites of cardiovascular disease events (defined as cardiovascular death, myocardial infarction, stroke, and heart failure) and mortality. We describe the prevalence, hazard ratios (HRs), and population-attributable fractions (PAFs) for cardiovascular disease and mortality associated with a cluster of behavioural factors (ie, tobacco use, alcohol, diet, physical activity, and sodium intake), metabolic factors (ie, lipids, blood pressure, diabetes, obesity), socioeconomic and psychosocial factors (ie, education, symptoms of depression), grip strength, and household and ambient pollution. Associations between risk factors and the outcomes were established using multivariable Cox frailty models and using PAFs for the entire cohort, and also by countries grouped by income level. Associations are presented as HRs and PAFs with 95% CIs. FINDINGS Between Jan 6, 2005, and Dec 4, 2016, 155 722 participants were enrolled and followed up for measurement of risk factors. 17 249 (11·1%) participants were from HICs, 102 680 (65·9%) were from MICs, and 35 793 (23·0%) from LICs. Approximately 70% of cardiovascular disease cases and deaths in the overall study population were attributed to modifiable risk factors. Metabolic factors were the predominant risk factors for cardiovascular disease (41·2% of the PAF), with hypertension being the largest (22·3% of the PAF). As a cluster, behavioural risk factors contributed most to deaths (26·3% of the PAF), although the single largest risk factor was a low education level (12·5% of the PAF). Ambient air pollution was associated with 13·9% of the PAF for cardiovascular disease, although different statistical methods were used for this analysis. In MICs and LICs, household air pollution, poor diet, low education, and low grip strength had stronger effects on cardiovascular disease or mortality than in HICs. INTERPRETATION Most cardiovascular disease cases and deaths can be attributed to a small number of common, modifiable risk factors. While some factors have extensive global effects (eg, hypertension and education), others (eg, household air pollution and poor diet) vary by a country's economic level. Health policies should focus on risk factors that have the greatest effects on averting cardiovascular disease and death globally, with additional emphasis on risk factors of greatest importance in specific groups of countries. FUNDING Full funding sources are listed at the end of the paper (see Acknowledgments).
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Affiliation(s)
- Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
| | - Philip Joseph
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Shofiqul Islam
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Andrew Mente
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | - Rajeev Gupta
- Eternal Heart Care Centre & Research Institute, Jaipur, India
| | - Andreas Wielgosz
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Antonio Dans
- Department of Cardiac Sciences, University of Philippines, Manila, Philippines
| | - Patricio Lopez-Jaramillo
- Fundación Oftalmológica de Santander Clínica Carlos Ardila Lulle (FOSCAL), Bucaramanga, Colombia; Escuela de Medicina, Universidad de Santander, Bucaramanga, Colombia
| | - Alvaro Avezum
- Department of Medicine, Universidade de Santo Amaro, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Fernando Lanas
- Department of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Aytekin Oguz
- Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Iolanthe M Kruger
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa
| | - Rafael Diaz
- Estudios Clínicos Latinoamérica (ECLA), Rosario, Santa Fe, Argentina
| | - Khalid Yusoff
- Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia; UCSI University, Cheras, Kuala Lumpur, Malaysia
| | - Prem Mony
- St John's Research Institute, St John's Medical College, Bangalore, India
| | - Jephat Chifamba
- Physiology Department, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Karen Yeates
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Roya Kelishadi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Afzalhussein Yusufali
- Department of Medicine, Dubai Medical University, Hatta Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Rasha Khatib
- Institute for Community and Public Health, Birzeit University, Birzeit, Palestine; Advocate Health Care, Chicago, IL, USA
| | | | - Katarzyna Zatonska
- Department of Social Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Romaina Iqbal
- Department of Community Health Sciences and Medicine, Aga Khan University, Karachi, Pakistan
| | - Li Wei
- National Centre for Cardiovascular Diseases, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hu Bo
- National Centre for Cardiovascular Diseases, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Manmeet Kaur
- School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation, Chennai, India; Dr Mohan's Diabetes Specialities Centre, Chennai, India
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Koon K Teo
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Darryl Leong
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Martin O'Donnell
- Department of Medicine, National University of Ireland Galway, London, UK
| | - Martin McKee
- Department of Public Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Gilles Dagenais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, QC, Canada
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Burgard SA, Lin KYP, Segal BD, Elliott MR, Seelye S. Stability and Change in Health Behavior Profiles of U.S. Adults. J Gerontol B Psychol Sci Soc Sci 2020; 75:674-683. [PMID: 32059056 DOI: 10.1093/geronb/gby088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES While understanding of complex within-person clustering of health behaviors into meaningful profiles of risk is growing, we still know little about whether and how U.S. adults transition from one profile to another as they age. This study assesses patterns of stability and change in profiles of tobacco and alcohol use and body mass index (BMI). METHOD A nationally representative cohort of U.S. adults 25 years and older was interviewed up to 5 times between 1986 and 2011. Latent transition analysis (LTA) models characterized the most common profiles, patterning of transitions across profiles over follow-up, and assessed whether some were associated with higher mortality risk. RESULTS We identified 5 profiles: "health promoting" with normal BMI and moderate alcohol consumption; "overweight"; "current smokers"; "obese"; and "nondrinkers". Profile membership was largely stable, with the most common transitions to death or weight gain. "Obese" was the most stable profile, while "smokers" were most likely to transition to another profile. Mortality was most frequent in the "obese" and "nondrinker" profiles. DISCUSSION Stability was more common than transition, suggesting that adults sort into health behavior profiles relatively early. Women and men were differently distributed across profiles at baseline, but showed broad similarity in transitions.
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Affiliation(s)
| | | | - Brian D Segal
- Department of Biostatistics, University of Michigan, Ann Arbor
| | | | - Sarah Seelye
- Population Studies Center, University of Michigan, Ann Arbor
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Burrus BB, Krieger K, Rutledge R, Rabre A, Axelson S, Miller A, White L, Jackson C. Building Bridges to a Brighter Tomorrow: A Systematic Evidence Review of Interventions That Prepare Adolescents for Adulthood. Am J Public Health 2019; 108:S25-S31. [PMID: 29443561 DOI: 10.2105/ajph.2017.304175] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Data suggest that adverse social determinants during adolescence can set in motion a lifetime of poor social and health outcomes. Vulnerable youths are at particularly high risk in this regard. OBJECTIVES To identify and assess the current evidence base for adolescent-focused interventions designed to influence adulthood preparation that could affect longer-term social determinants. SEARCH METHODS Using a systematic review methodology, we conducted an initial assessment of intervention evaluations targeting 6 adulthood preparation subject (APS) areas to assess the quality and character of the evidence base. The review is specific to evaluated interventions that address at least 1 of the 6 APS areas: healthy relationships, adolescent development, financial literacy, parent-child communication, educational and career success, and healthy life skills. SELECTION CRITERIA The inclusion criteria were as follows: (1) published in English in an independent, peer-reviewed journal; (2) conducted in developed, English-speaking countries; (3) implemented an intervention that addressed at least 1 of the 6 APS areas, delivered in an in-person setting; (4) included youths at the 5th- through 12th-grade levels or aged 10 to 18 years at some point during intervention implementation; (5) included an evaluation component with a comparison group and baseline and follow-up measures; (6) included behavioral measures as outcomes; and (7) reported statistical significance levels for the behavioral outcome measures. DATA COLLECTION AND ANALYSIS We developed an abstraction form to capture details from each article, including key details of the intervention, such as services, implementer characteristics, and timing; adulthood preparation foci; evaluation design, methods, and key behavioral measures; and results, including key statistically significant results for behavior-based outcome measures. We assessed study quality by using several key factors, including randomization, baseline equivalence of treatment and control groups, attrition, and confounding factors. We characterized the quality of evidence as high, moderate, or low on the basis of the described design and execution of the research. Our assessment included only information stated explicitly in the manuscript. MAIN RESULTS A total of 36 independent intervention evaluations met the criteria for inclusion. Of these, 27 (75%) included significant findings for behavioral outcomes related to adulthood preparation. Quality was mixed across studies. Of the 36 studies reviewed, 27 used a randomized controlled design (15 group randomization, 12 individual randomization), whereas the others used observational pre-post designs. Ten studies used mixed-methods approaches. Most (n = 32) studies used self-report questionnaires at baseline with a follow-up questionnaire, and 14 studies included multiple follow-up points. Of the studies reviewed, 7 studies received a high-quality rating, indicating no significant issues identified within our quality criteria. We rated 23 studies as moderate quality, indicating methodological challenges within 1 of the quality criteria categories. The most common reasons studies were down-rated were poor baseline equivalency across treatment groups (or no discussion of baseline equivalency) and high levels of attrition. Finally, 6 studies received a low-quality rating because of methodological challenges across multiple quality domains. The studies broadly represented the APS areas. We identified no systematic differences in study quality across the APS areas. AUTHOR'S CONCLUSIONS Although some of the intervention results indicate behavioral changes that may be linked to adulthood preparation skills, many of the extant findings are derived from moderate- or poor-quality studies. Additional work is needed to build the evidence base by using methodologically rigorous implementation and evaluation designs and execution. Public Health Implications. Interventions designed to help adolescents better prepare for adulthood may have the potential to affect their longer-term social determinants of health and well-being. More theory-driven approaches and rigorously evaluated interventions could strengthen the evidence base and improve the effectiveness of these adulthood preparation interventions.
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Affiliation(s)
- Barri B Burrus
- Barri B. Burrus, Christine Jackson, Audra Miller, Alexander Rabre, and Regina Rutledge are with the Center for the Health of At-Risk Populations, RTI International, Research Triangle Park, NC. Kathleen Krieger is with Behavioral Health and Criminal Justice Division, RTI International. Sarah Axelson and LeBretia White are with the Adolescent Pregnancy Prevention Program, Family and Youth Services Bureau, Administration for Children and Families, Department of Health and Human Services, Washington, DC. Barri B. Burrus is also a Guest Editor for this supplement issue
| | - Kathleen Krieger
- Barri B. Burrus, Christine Jackson, Audra Miller, Alexander Rabre, and Regina Rutledge are with the Center for the Health of At-Risk Populations, RTI International, Research Triangle Park, NC. Kathleen Krieger is with Behavioral Health and Criminal Justice Division, RTI International. Sarah Axelson and LeBretia White are with the Adolescent Pregnancy Prevention Program, Family and Youth Services Bureau, Administration for Children and Families, Department of Health and Human Services, Washington, DC. Barri B. Burrus is also a Guest Editor for this supplement issue
| | - Regina Rutledge
- Barri B. Burrus, Christine Jackson, Audra Miller, Alexander Rabre, and Regina Rutledge are with the Center for the Health of At-Risk Populations, RTI International, Research Triangle Park, NC. Kathleen Krieger is with Behavioral Health and Criminal Justice Division, RTI International. Sarah Axelson and LeBretia White are with the Adolescent Pregnancy Prevention Program, Family and Youth Services Bureau, Administration for Children and Families, Department of Health and Human Services, Washington, DC. Barri B. Burrus is also a Guest Editor for this supplement issue
| | - Alexander Rabre
- Barri B. Burrus, Christine Jackson, Audra Miller, Alexander Rabre, and Regina Rutledge are with the Center for the Health of At-Risk Populations, RTI International, Research Triangle Park, NC. Kathleen Krieger is with Behavioral Health and Criminal Justice Division, RTI International. Sarah Axelson and LeBretia White are with the Adolescent Pregnancy Prevention Program, Family and Youth Services Bureau, Administration for Children and Families, Department of Health and Human Services, Washington, DC. Barri B. Burrus is also a Guest Editor for this supplement issue
| | - Sarah Axelson
- Barri B. Burrus, Christine Jackson, Audra Miller, Alexander Rabre, and Regina Rutledge are with the Center for the Health of At-Risk Populations, RTI International, Research Triangle Park, NC. Kathleen Krieger is with Behavioral Health and Criminal Justice Division, RTI International. Sarah Axelson and LeBretia White are with the Adolescent Pregnancy Prevention Program, Family and Youth Services Bureau, Administration for Children and Families, Department of Health and Human Services, Washington, DC. Barri B. Burrus is also a Guest Editor for this supplement issue
| | - Audra Miller
- Barri B. Burrus, Christine Jackson, Audra Miller, Alexander Rabre, and Regina Rutledge are with the Center for the Health of At-Risk Populations, RTI International, Research Triangle Park, NC. Kathleen Krieger is with Behavioral Health and Criminal Justice Division, RTI International. Sarah Axelson and LeBretia White are with the Adolescent Pregnancy Prevention Program, Family and Youth Services Bureau, Administration for Children and Families, Department of Health and Human Services, Washington, DC. Barri B. Burrus is also a Guest Editor for this supplement issue
| | - LeBretia White
- Barri B. Burrus, Christine Jackson, Audra Miller, Alexander Rabre, and Regina Rutledge are with the Center for the Health of At-Risk Populations, RTI International, Research Triangle Park, NC. Kathleen Krieger is with Behavioral Health and Criminal Justice Division, RTI International. Sarah Axelson and LeBretia White are with the Adolescent Pregnancy Prevention Program, Family and Youth Services Bureau, Administration for Children and Families, Department of Health and Human Services, Washington, DC. Barri B. Burrus is also a Guest Editor for this supplement issue
| | - Christine Jackson
- Barri B. Burrus, Christine Jackson, Audra Miller, Alexander Rabre, and Regina Rutledge are with the Center for the Health of At-Risk Populations, RTI International, Research Triangle Park, NC. Kathleen Krieger is with Behavioral Health and Criminal Justice Division, RTI International. Sarah Axelson and LeBretia White are with the Adolescent Pregnancy Prevention Program, Family and Youth Services Bureau, Administration for Children and Families, Department of Health and Human Services, Washington, DC. Barri B. Burrus is also a Guest Editor for this supplement issue
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Leppert B, Havdahl A, Riglin L, Jones HJ, Zheng J, Davey Smith G, Tilling K, Thapar A, Reichborn-Kjennerud T, Stergiakouli E. Association of Maternal Neurodevelopmental Risk Alleles With Early-Life Exposures. JAMA Psychiatry 2019; 76:834-842. [PMID: 31042271 PMCID: PMC6495368 DOI: 10.1001/jamapsychiatry.2019.0774] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/14/2019] [Indexed: 12/27/2022]
Abstract
Importance Early-life exposures, such as prenatal maternal lifestyle, illnesses, nutritional deficiencies, toxin levels, and adverse birth events, have long been considered potential risk factors for neurodevelopmental disorders in offspring. However, maternal genetic factors could be confounding the association between early-life exposures and neurodevelopmental outcomes in offspring, which makes inferring a causal relationship problematic. Objective To test whether maternal polygenic risk scores (PRSs) for neurodevelopmental disorders were associated with early-life exposures previously linked to the disorders. Design, Setting, and Participants In this UK population-based cohort study, 7921 mothers with genotype data from the Avon Longitudinal Study of Parents and Children (ALSPAC) underwent testing for association of maternal PRS for attention-deficit/hyperactivity disorder (ADHD PRS), autism spectrum disorder (ASD PRS), and schizophrenia (SCZ PRS) with 32 early-life exposures. ALSPAC data collection began September 6, 1990, and is ongoing. Data were analyzed for the current study from April 1 to September 1, 2018. Exposures Maternal ADHD PRS, ASD PRS, and SCZ PRS were calculated using discovery effect size estimates from the largest available genome-wide association study and a significance threshold of P < .05. Main Outcomes and Measures Outcomes measured included questionnaire data on maternal lifestyle and behavior (eg, smoking, alcohol consumption, body mass index, and maternal age), maternal use of nutritional supplements and medications in pregnancy (eg, acetaminophen, iron, zinc, folic acid, and vitamins), maternal illnesses (eg, diabetes, hypertension, rheumatism, psoriasis, and depression), and perinatal factors (eg, birth weight, preterm birth, and cesarean delivery). Results Maternal PRSs were available from 7921 mothers (mean [SD] age, 28.5 [4.8] years). The ADHD PRS was associated with multiple prenatal factors, including infections (odds ratio [OR], 1.11; 95% CI, 1.04-1.18), use of acetaminophen during late pregnancy (OR, 1.11; 95% CI, 1.04-1.18), lower blood levels of mercury (β coefficient, -0.06; 95% CI, -0.11 to -0.02), and higher blood levels of cadmium (β coefficient, 0.07; 95% CI, 0.05-0.09). Little evidence of associations between ASD PRS or SCZ PRS and prenatal factors or of association between any of the PRSs and adverse birth events was found. Sensitivity analyses revealed consistent results. Conclusions and Relevance These findings suggest that maternal risk alleles for neurodevelopmental disorders, primarily ADHD, are associated with some pregnancy-related exposures. These findings highlight the need to carefully account for potential genetic confounding and triangulate evidence from different approaches when assessing the effects of prenatal exposures on neurodevelopmental disorders in offspring.
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Affiliation(s)
- Beate Leppert
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alexandra Havdahl
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Lucy Riglin
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Hannah J. Jones
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute for Health Research Biomedical Research Centre, University Hospitals Bristol NHS (National Health Service) Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - Jie Zheng
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Kate Tilling
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Anita Thapar
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Evie Stergiakouli
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Oral and Dental Sciences, University of Bristol, Bristol, United Kingdom
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Omodior O, Ramos WD. Social Determinants of Health-Related Quality of Life: A Recreation Setting Analysis. Health Promot Pract 2019; 21:952-961. [PMID: 30786790 DOI: 10.1177/1524839919827572] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective. To determine if significant differences between park users and non-park users are associated with scores on a composite health-related quality of life (HRQoL) index. Methods. Data for this study were collected based on random intercept of a cross section of eligible Monroe County, Indiana, residents at four selected public recreational parks, as well as nonpark locations from July to December 2017. Based on data collected using validated survey items, we created a composite HRQoL index. Statistical analysis included independent-samples t test, chi-square cross-tabulation, bivariate regression, and multivariate regression. Results. Frequent park users were significantly different from nonfrequent park users in various respects. The most leisure-time physical activity (LTPA) experiences of frequent park users occurred at a park location. Body mass index and park-based LTPA were significantly positively associated with HRQoL scores in a linear regression model. Conclusion. Frequent park use was shown to be positively associated with increased park-based LTPA and HRQoL. It is therefore possible that increasing park visitation will result in more members of a community who report experiencing their LTPA at a park location. Study outcomes lend support to the validity of a composite HRQoL index for population health assessments.
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Havigerová JM, Dosedlová J, Burešová I. One health behavior or many health-related behaviors? Psychol Res Behav Manag 2018; 12:23-30. [PMID: 30643472 PMCID: PMC6311327 DOI: 10.2147/prbm.s173692] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective Of the many existing health models, models of health behavior are considered optimal for research and application as they focus on concrete forms of behavior that support, maintain, or undermine one’s health, and they accentuate the individual as the initiator of this behavior. Research in this area follows a broad range of concrete partial manifestations of health behavior. Is it necessary to differentiate between various types of health behavior or could these partial manifestations be combined under one common scale? Methods Data acquisition tool: Health-Related Behavior Scale (HRBS, 42 items). Data processing methods: principal component analysis (the internal structure of HRBS), confirmatory factor analysis (the latent factor structure of four tested models). Sample: N=1,664 adult respondents. Results The HRBS described ten areas of health-related behavior (ten extracted factors). All tested models of latent structure showed almost identical mathematical and statistical values of the model. Conclusion Health-related behavior includes a set of partial behaviors (behavior related to nutrition, addictive substances, movement, and physical exercises). An unambiguous latent factor structure has not been revealed. An open question remains whether there is one latent factor behind all health-related behaviors or whether there are multiple latent factors. The use of one or the other model should be deduced from the underlying theory and research objectives. To find a reliable model of health behavior, it is necessary to include moderators and mediators such as personality, attitude, or economic status.
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Affiliation(s)
- Jana Marie Havigerová
- Institute of Psychology, Faculty of Arts, Masaryk Univeristy, 603 00 Brno, Czech Republic,
| | - Jaroslava Dosedlová
- Institute of Psychology, Faculty of Arts, Masaryk Univeristy, 603 00 Brno, Czech Republic,
| | - Iva Burešová
- Institute of Psychology, Faculty of Arts, Masaryk Univeristy, 603 00 Brno, Czech Republic,
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Analysis of healthcare service utilization after transport-related injuries by a mixture of hidden Markov models. PLoS One 2018; 13:e0206274. [PMID: 30408046 PMCID: PMC6224052 DOI: 10.1371/journal.pone.0206274] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/10/2018] [Indexed: 12/15/2022] Open
Abstract
Background Transport injuries commonly result in significant disease burden, leading to physical disability, mental health deterioration and reduced quality of life. Analyzing the patterns of healthcare service utilization after transport injuries can provide an insight into the health of the affected parties, allow improved health system resource planning, and provide a baseline against which any future system-level interventions can be evaluated. Therefore, this research aims to use time series of service utilization provided by a compensation agency to identify groups of claimants with similar utilization patterns, describe such patterns, and characterize the groups in terms of demographic, accident type and injury type. Methods To achieve this aim, we have proposed an analytical framework that utilizes latent variables to describe the utilization patterns over time and group the claimants into clusters based on their service utilization time series. To perform the clustering without dismissing the temporal dimension of the time series, we have used a well-established statistical approach known as the mixture of hidden Markov models (MHMM). Ensuing the clustering, we have applied multinomial logistic regression to provide a description of the clusters against demographic, injury and accident covariates. Results We have tested our model with data on psychology service utilization from one of the main compensation agencies for transport accidents in Australia, and found that three clear clusters of service utilization can be evinced from the data. These three clusters correspond to claimants who have tended to use the services 1) only briefly after the accident; 2) for an intermediate period of time and in moderate amounts; and 3) for a sustained period of time, and intensely. The size of these clusters is approximately 67%, 27% and 6% of the number of claimants, respectively. The multinomial logistic regression analysis has showed that claimants who were 30 to 60-year-old at the time of accident, were witnesses, and who suffered a soft tissue injury were more likely to be part of the intermediate cluster than the majority cluster. Conversely, claimants who suffered more severe injuries such as a brain head injury or anon-limb fracture injury and who started their service utilization later were more likely to be part of the sustained cluster. Conclusion This research has showed that clustering of service utilization time series is an effective approach for identifying the main user groups and utilization patterns of a healthcare service. In addition, using logistic regression to describe the clusters in terms of demographic, injury and accident covariates has helped identify the salient attributes of the claimants in each cluster. This finding is very important for the compensation agency and potentially other authorities as it provides a baseline to improve need understanding, resource planning and service provision.
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Zhang W, Meng H, Yang S, Luo H, Liu D. Changes in Hypertension-Related Knowledge and Behavior and Their Associations with Socioeconomic Status among Recently Urbanized Residents in China: 2013⁻2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081701. [PMID: 30096907 PMCID: PMC6121690 DOI: 10.3390/ijerph15081701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/04/2018] [Accepted: 08/07/2018] [Indexed: 12/13/2022]
Abstract
The rapid urbanization in China has brought with it some health benefits, but it also brought about a negative influence on the lifestyle of residents. We conducted this study to assess the change in hypertension-related knowledge and behavior from 2013 to 2016 among recently urbanized residents and determine their association with socioeconomic status (SES). This research used data from two cross-sectional studies conducted in Hezuo community in Chengdu, Sichuan province of China. A total of 2268 and 2601 individuals, respectively, participated and completed standard questionnaires. According to the results, the median (IQR) scores of health knowledge was 1 (0,3) and 3 (1,5), respectively, (p < 0.001) and the median (IQR) scores of health behavior was 6 (5,6) and 5 (5,6), respectively, (p < 0.001) in 2013 and 2016. The rate of sufficient knowledge increased from 8.8% to 18.1% (p < 0.001), while the rate of correct behavior decreased from 54.5% to 45.5% (p < 0.001) in three years. Logistic regression analysis showed that higher education was associated with sufficient hypertension-related knowledge (p < 0.05), and those with higher education, unemployment, and retirement were more likely to have sufficient behavior (p < 0.05). The impact of SES on knowledge was stable between 2013 and 2016. The behavior difference between the middle school educated and the illiterate increased from 2013 to 2016 (p < 0.05), and the behavior difference between the unemployed and manual workers decreased from 2013 to 2016 (p < 0.05). Our results revealed that hypertension-related knowledge improved with no corresponding improvement in self-reported behavior among recently urbanized residents from 2013 to 2016. Organizational strategy should be implemented to improve health education on knowledge, and what is more, translate knowledge into behavior. All these measures should be given more attention to the lower educated and manual workers among recently urbanized residents to eliminate the SES disparity.
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Affiliation(s)
- Wenjie Zhang
- Department of Health and Social Behavior, School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Hongdao Meng
- School of Aging Studies, College of Behavioral &Community Sciences, University of South Florida, Tampa, FL 33620, USA.
| | - Shujuan Yang
- Department of Health and Social Behavior, School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Honglin Luo
- He Zuo Community Health Service Center in Chengdu Hi-Techzone, Chengdu 610041, China.
| | - Danping Liu
- Department of Health and Social Behavior, School of Public Health, Sichuan University, Chengdu 610041, China.
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Lawrence EM, Hummer RA, Domingue BW, Harris KM. Wide educational disparities in young adult cardiovascular health. SSM Popul Health 2018; 5:249-256. [PMID: 30094320 PMCID: PMC6072902 DOI: 10.1016/j.ssmph.2018.07.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/19/2018] [Accepted: 07/19/2018] [Indexed: 01/09/2023] Open
Abstract
Widening educational differences in overall health and recent stagnation in cardiovascular disease mortality rates highlight the critical need to describe and understand educational disparities in cardiovascular health (CVH) among U.S. young adults. We use two data sets representative of the U.S. population to examine educational disparities in CVH among young adults (24-34) coming of age in the 21st century: the National Health and Nutrition Examination Survey (2005-2010; N= 689) and the National Longitudinal Study of Adolescent to Adult Health (2007-2008; N=11,200). We employ descriptive statistics and regression analysis. The results show that fewer than one in four young adults had good CVH (at least 5 out of 7 ideal cardiovascular indicators). Young adults who had not attained a college degree demonstrate particularly disadvantaged CVH compared with their college-educated peers. Such educational disparities persist after accounting for a range of confounders, including individuals' genetic propensity to develop coronary artery disease. The results indicate that the CVH of today's young adults is troubling and especially compromised for individuals with lower levels of educational attainment. These results generate substantial concern about the future CVH of the US population, particularly for young adults with a low level of education.
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Affiliation(s)
- Elizabeth M. Lawrence
- Department of Sociology, University of Nevada, Las Vegas, 4505 S. Maryland Pkwy., Las Vegas, NV, USA
| | - Robert A. Hummer
- Carolina Population Center, University of North Carolina – Chapel Hill, USA
- Department of Sociology, University of North Carolina – Chapel Hill, USA
| | | | - Kathleen Mullan Harris
- Carolina Population Center, University of North Carolina – Chapel Hill, USA
- Department of Sociology, University of North Carolina – Chapel Hill, USA
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Wright C, Kipping R, Hickman M, Campbell R, Heron J. Effect of multiple risk behaviours in adolescence on educational attainment at age 16 years: a UK birth cohort study. BMJ Open 2018; 8:e020182. [PMID: 30061432 PMCID: PMC6067358 DOI: 10.1136/bmjopen-2017-020182] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 05/18/2018] [Accepted: 06/11/2018] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To explore the association between adolescent multiple risk behaviours (MRBs) and educational attainment. DESIGN Prospective population-based UK birth cohort study. SETTING Avon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of children born in 1991-1992. PARTICIPANTS Data on some or all MRB measures were available for 5401 ALSPAC participants who attended a clinic at age 15 years and/or completed a detailed questionnaire at age 16 years. Multiple imputation was used to account for missing data. PRIMARY OUTCOME MEASURES Capped General Certificate of Secondary Education (GCSE) score and odds of attaining five or more GCSE examinations at grades A*-C. Both outcome measures come from the National Pupil Database and were linked to the ALSPAC data. RESULTS Engagement in MRB was strongly associated with poorer educational attainment. Each additional risk equated to -6.31 (95% CI -7.03 to -5.58, p<0.001) in capped GCSE score, equivalent to a one grade reduction or reduced odds of attaining five or more A*-C grades of 23% (OR 0.77, 95% CI 0.74 to 0.81, p<0.001). The average cohort member engaged in 3.24 MRB and therefore have an associated reduction in GCSE score equivalent to three and a half grades in one examination, or reduced odds of attaining five or more A*-C grades of 75%. CONCLUSION Engagement in adolescent MRB is strongly associated with poorer educational attainment at 16 years. Preventing MRB could improve educational attainment and thereby directly and indirectly improve longer-term health.
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Affiliation(s)
- Caroline Wright
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ruth Kipping
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rona Campbell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Grigsby TJ, Forster M, Tsai J, Rohrbach LA, Sussman S. Negative Substance Use Consequences Associated With Noncondom Use Among Male, but Not Female, Alternative High School Students. THE JOURNAL OF SCHOOL HEALTH 2018; 88:531-537. [PMID: 29864204 PMCID: PMC5992488 DOI: 10.1111/josh.12640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 09/19/2017] [Accepted: 09/19/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Alternative (or continuation) high schools are institutions designed for students at risk for not graduating due to behavioral, educational, or medical problems. The present study explored the relationship between negative substance use consequences (eg, having trouble at school or work) and noncondom use in this at-risk population and whether these associations varied by sex. METHODS Participants (N = 1101; 62.9% Hispanic; Mage = 16.85) were sampled from 24 alternative high schools in California, and data were analyzed using cross-sectional multivariate logistic regression models. RESULTS We observed a relationship between the number of negative substance use consequences and probability of noncondom use at the last sexual encounter for boys (p < .001) but not girls (p > .05). There were significant associations between specific social consequences (missing school/work) and dependence symptoms (selling personal items to get alcohol or drugs) with noncondom use for boys only. There was a similar association between substance use frequency and noncondom use for boys. CONCLUSIONS These findings suggest that substance use consequences may be a useful and advantageous indicator of risky sexual behaviors such as noncondom use for boys, but not girls, in alternative high school settings. Future research and intervention programming recommendations are discussed.
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Affiliation(s)
- Timothy J Grigsby
- Department of Kinesiology, Health, and Nutrition, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249
| | - Myriam Forster
- Department of Health Sciences, University of California, Northridge, 18111 Nordhoff St, Northridge, CA 91330
| | - Jennifer Tsai
- Department of Preventive Medicine, University of Southern California, 2001 North Soto Street, 3rd Floor, Los Angeles, CA 90032
| | - Louise A Rohrbach
- Department of Preventive Medicine, University of Southern California, 2001 North Soto Street, 3rd Floor, Los Angeles, CA 90032
| | - Steve Sussman
- Department of Preventive Medicine, University of Southern California, 2001 North Soto Street, 3rd Floor, Los Angeles, CA 90032
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Zajacova A, Lawrence EM. The Relationship Between Education and Health: Reducing Disparities Through a Contextual Approach. Annu Rev Public Health 2018; 39:273-289. [PMID: 29328865 PMCID: PMC5880718 DOI: 10.1146/annurev-publhealth-031816-044628] [Citation(s) in RCA: 372] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Adults with higher educational attainment live healthier and longer lives compared with their less educated peers. The disparities are large and widening. We posit that understanding the educational and macrolevel contexts in which this association occurs is key to reducing health disparities and improving population health. In this article, we briefly review and critically assess the current state of research on the relationship between education and health in the United States. We then outline three directions for further research: We extend the conceptualization of education beyond attainment and demonstrate the centrality of the schooling process to health; we highlight the dual role of education as a driver of opportunity but also as a reproducer of inequality; and we explain the central role of specific historical sociopolitical contexts in which the education-health association is embedded. Findings from this research agenda can inform policies and effective interventions to reduce health disparities and improve health for all Americans.
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Affiliation(s)
- Anna Zajacova
- Department of Sociology, Western University, London, Ontario N6A 5C2, Canada;
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Mollborn S, Lawrence E. Family, Peer, and School Influences on Children's Developing Health Lifestyles. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2018; 59:133-150. [PMID: 29298103 PMCID: PMC5898799 DOI: 10.1177/0022146517750637] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Health lifestyles are important for health and social identity, yet little is known about their development in early life. We use data from the Early Childhood Longitudinal Study-Kindergarten Cohort of 1998-99 (ECLS-K; N = 8,786) to track children's health lifestyles and assess a theoretical model of health lifestyle development. Latent class analyses identify health lifestyles at four time points from first to eighth grade, and multivariate models investigate their interrelationships and social contextual influences. Health lifestyles are multidimensional and dynamic, and children demonstrate distinct combinations of risks and protections. Family factors, such as resources and parenting, shape earlier health lifestyles, which influence later lifestyles. Results show that development and contexts drive changes in health lifestyles, as family factors decrease in influence with age while some school and peer influences appear to emerge. Policy makers and researchers interested in shaping health behaviors should consider the multidimensional and dynamic nature of health lifestyles.
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Saint Onge JM, Krueger PM. Health Lifestyle Behaviors among U.S. Adults. SSM Popul Health 2017; 3:89-98. [PMID: 28785602 PMCID: PMC5544030 DOI: 10.1016/j.ssmph.2016.12.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/14/2016] [Accepted: 12/13/2016] [Indexed: 12/13/2022] Open
Abstract
Existing research that studies individual health behaviors and conceive of behaviors as simplistically reflecting narrow intentions toward health may obscure the social organization of health behaviors. Instead, we examine how eight health behaviors group together to form distinct health behavior niches. Using nationally-representative data from U.S. adults aged 18 and over from the 2004-2009 National Health Interview Survey (NHIS), we use Latent Class Analysis to identify classes of behavior based on smoking status, alcohol use, physical activity, physician visits, and flu vaccination. We identify 7 distinct health behavior classes including concordant health promoting (44%), concordant health compromising (26%), and discordant classes (30%). We find significant race/ethnic, sex, regional, and age differences in class membership. We show that health behavior classes are associated with prospective mortality, suggesting that they are valid representations of health lifestyles. We discuss the implications of our results for sociological theories of health behaviors, as well as for multiple behavior interventions seeking to improve population health.
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Affiliation(s)
| | - Patrick M. Krueger
- University of Colorado at Denver | Anschutz Medical Campus, Denver, CO, USA
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Lawrence EM, Mollborn S, Hummer RA. Health lifestyles across the transition to adulthood: Implications for health. Soc Sci Med 2017; 193:23-32. [PMID: 28992538 PMCID: PMC5659920 DOI: 10.1016/j.socscimed.2017.09.041] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 09/08/2017] [Accepted: 09/22/2017] [Indexed: 01/20/2023]
Abstract
Research has long established the importance of individual health behaviors such as cigarette smoking for adult morbidity and mortality. However, we know little about how health behaviors cluster into health lifestyles among adolescents and young adults in the United States, or in turn, how such health lifestyles are associated with young adult health outcomes. This study establishes health lifestyles as distinct group phenomena at three developmental time points in a single cohort: late adolescence (ages 15-17), early adulthood (ages 20-24), and young adulthood (ages 26-31). We then identify the associations between these health lifestyles and young adult health outcomes. We use the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative sample of U.S. adolescents followed into adulthood, and latent class analysis and regression models. We uncover diverse health lifestyles among adolescents, early adults, and young adults; however, few individuals engaged in a consistently salubrious lifestyle at any developmental stage. People with less healthy lifestyles also tended to exhibit poorer health in young adulthood. Our results showed that young adult health lifestyles were significantly associated with young adult cardiovascular risk. Moreover, health lifestyles in each of the three developmental stages were associated with young adult self-rated health, and accounting for lifestyles in later stages explained some of these associations. Overall, this study suggests a portrait of problematic health lifestyles among a nationally representative cohort of young Americans, with associated patterns of relatively poor physical health among those with poor health lifestyles.
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Affiliation(s)
- Elizabeth M Lawrence
- Carolina Population Center, University of North Carolina, Chapel Hill, United States.
| | - Stefanie Mollborn
- Institute of Behavioral Science, University of Colorado Boulder, United States; Department of Sociology, University of Colorado Boulder, United States
| | - Robert A Hummer
- Carolina Population Center, University of North Carolina, Chapel Hill, United States; Department of Sociology, University of North Carolina, Chapel Hill, United States
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Olson JS, Hummer RA, Harris KM. Gender and Health Behavior Clustering among U.S. Young Adults. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2017; 63:3-20. [PMID: 28287308 PMCID: PMC5351770 DOI: 10.1080/19485565.2016.1262238] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
U.S. trends in population health suggest alarming disparities among young adults, who are less healthy across most measureable domains than their counterparts in other high-income countries; these international comparisons are particularly troubling for women. To deepen our understanding of gender disparities in health and underlying behavioral contributions, we document gender-specific clusters of health behavior among U.S. young adults using nationally representative data from the National Longitudinal Study of Adolescent to Adult Health. We find high levels of poor health behavior, but especially among men; 40 percent of men clustered into a group characterized by unhealthy behavior (e.g., poor diet, no exercise, substance use), compared to only 22 percent of women. Additionally, women tend to age out of unhealthy behaviors in young adulthood more than men. Further, we uncover gender differences in the extent to which sociodemographic position and adolescent contexts inform health behavior clustering. For example, college education was more protective for men, whereas marital status was equally protective across gender. Parental drinking mattered for health behavior clustering among men, whereas peer drinking mattered for clustering among women. We discuss these results in the context of declining female advantage in U.S. health and changing young adult social and health contexts.
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Affiliation(s)
- Julie Skalamera Olson
- Population Research Center and Department of Sociology, University of Texas at Austin
| | - Robert A. Hummer
- Carolina Population Center and Department of Sociology, University of North Carolina at Chapel Hill
| | - Kathleen Mullan Harris
- Carolina Population Center and Department of Sociology, University of North Carolina at Chapel Hill
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Hernandez EM, Margolis R, Hummer RA. Educational and Gender Differences in Health Behavior Changes After a Gateway Diagnosis. J Aging Health 2016; 30:342-364. [PMID: 27940641 DOI: 10.1177/0898264316678756] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Hypertension represents a gateway diagnosis to more serious health problems that occur as people age. We examine educational differences in three health behavior changes people often make after receiving this diagnosis in middle or older age, and test whether these educational differences depend on (a) the complexity of the health behavior change and (b) gender. METHOD We use data from the Health and Retirement Study and conduct logistic regression analysis to examine the likelihood of modifying health behaviors post diagnosis. RESULTS We find educational differences in three behavior changes-antihypertensive medication use, smoking cessation, and physical activity initiation-after a hypertension diagnosis. These educational differences in health behaviors were stronger among women compared with men. DISCUSSION Upon receiving a hypertension diagnosis, education is a more important predictor of behavior changes for women compared with men, which may help explain gender differences in the socioeconomic gradient in health in the United States.
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Zajacova A, Johnson-Lawrence V. Anomaly in the education-health gradient: Biomarker profiles among adults with subbaccalaureate attainment levels. SSM Popul Health 2016; 2:360-364. [PMID: 28580414 PMCID: PMC5450821 DOI: 10.1016/j.ssmph.2016.05.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
This Short Communication builds on recent findings that documented an anomaly in the education–health gradient: adults who attended college but did not earn a BA (the subbaccalaureate group) reported an equal or higher level of health problems than adults with high school (HS) diploma. Our aim is to test whether this anomaly holds when we eliminate potential reporting differences, by examining biomarker levels in the subbaccalaureate vs HS groups. Using the restricted 1999–2012 NHANES, we estimate models of biomarkers for cardiovascular and metabolic diseases as a function of educational attainment, including three subbaccalaureate levels: “some college”, vocational associate degree (AA), and academic AA. The data show that adults with “some college” or vocational AA have no systematic advantage over HS graduates in most biomarker indices while academic AA is associated with a significantly better risk profile compared to HS. The findings indicate that the adults with some college and vocational AA degrees do not benefit from their college experience in terms of improved physiological risk profile. This pattern underscores the need to understand and explain the anomalous health pattern that concerns 28% of American adults in the subbaccalaureate group among whom many reap little health payoffs to postsecondary schooling.
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Affiliation(s)
- Anna Zajacova
- University of Wyoming, Department of Sociology, Dept. 3293, 1000 E University Ave., Laramie, WY 82071, United States
- Corresponding author.
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Green PP, McKnight-Eily LR, Tan CH, Mejia R, Denny CH. Vital Signs: Alcohol-Exposed Pregnancies--United States, 2011-2013. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2016; 65:91-7. [PMID: 26845520 DOI: 10.15585/mmwr.mm6504a6] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Alcohol is a teratogen.* Prenatal alcohol exposure is associated with a range of adverse reproductive outcomes and can cause fetal alcohol spectrum disorders (FASDs) characterized by lifelong physical, behavioral, and intellectual disabilities. FASDs are completely preventable if a woman does not drink alcohol while pregnant. METHODS CDC analyzed data from the 2011-2013 National Survey of Family Growth to generate U.S. prevalence estimates of risk for an alcohol-exposed pregnancy for 4,303 nonpregnant, nonsterile women aged 15-44 years, by selected demographic and behavioral factors. A woman was considered at risk for an alcohol-exposed pregnancy during the past month if she had sex with a male, drank any alcohol, and did not (and her partner did not with her) use contraception in the past month; was not sterile; and had a partner (or partners) not known to be sterile. RESULTS The weighted prevalence of alcohol-exposed pregnancy risk among U.S. women aged 15-44 years was 7.3%. During a 1-month period, approximately 3.3 million women in the United States were at risk for an alcohol-exposed pregnancy. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE Alcohol use in pregnancy is associated with low birthweight, preterm birth, birth defects, and developmental disabilities. Women of reproductive age should be informed of the risks of alcohol use during pregnancy, and contraception should be recommended, as appropriate, for women who do not want to become pregnant. Women wanting a pregnancy should be advised to stop drinking at the same time contraception is discontinued. Health care providers should advise women not to drink at all if they are pregnant or there is any chance they might be pregnant. Alcohol misuse screening and behavioral counseling (also known as alcohol screening and brief intervention) is recommended for all adults in primary care, including reproductive-aged and pregnant women, as an evidenced-based approach to reducing alcohol consumption among persons who consume alcohol in excess of the recommended guidelines.
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Affiliation(s)
- Patricia P Green
- Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, CDC
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