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Ito S, Asakura K, Sugiyama K, Takakura M, Todoriki H. Association between sodium and potassium excretion estimated from spot urine and socioeconomic status among primary school children and their mothers in Okinawa, Japan. Hypertens Res 2024; 47:1175-1183. [PMID: 38177286 DOI: 10.1038/s41440-023-01564-9] [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: 08/27/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024]
Abstract
Hypertension is the greatest and the most preventable risk factor for cardiovascular disease. Excessive sodium (Na) intake and insufficient potassium (K) intake have been identified as risk factors for hypertension. Socioeconomic status (SES) may be related to diet quality. In Japan, few studies have examined the relationship between urinary Na and K excretion and SES in adults, and there are no studies in children. In 2014, 1944 children (1382 households) in all public elementary schools in Yaese town, Okinawa, Japan were recruited to participate in a study. Casual urine specimens were collected to estimate 24-h urinary Na and K excretion and urinary Na/K ratio. Mother's educational background and household incomes were assessed and used as indicators of SES. A total of 236 pairs of children and their mothers were analyzed in this study. Urinary Na and K excretion were not significantly related to educational levels of mothers and household incomes in children. On the other hand, in mothers, lower household income group had higher 24-h estimated urinary Na excretion and urinary Na/K ratio than other groups. There was no significant difference between urinary excretion and educational levels in mothers. Household income disparities in urinary levels seen in mothers were not seen in children. There may be some factors that moderate the dietary inequalities in children.
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Affiliation(s)
- Sanae Ito
- School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Uehara 207, Nishihara, Okinawa, 903-0215, Japan.
| | - Keiko Asakura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Omorinishi 5-21-16, Ota-ku, Tokyo, 143-8540, Japan
| | - Kemmyo Sugiyama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Seiryo-machi 4-1, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Minoru Takakura
- School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Uehara 207, Nishihara, Okinawa, 903-0215, Japan
| | - Hidemi Todoriki
- School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Uehara 207, Nishihara, Okinawa, 903-0215, Japan
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Wossenseged F, Franklin K, Gordon T, Buscetta A, Wallen GR, Bonham VL, Farmer N. Bidirectional Relationship Between Sickle Cell Disease and Food Insecurity: Scoping Review. Health Equity 2024; 8:238-248. [PMID: 38595934 PMCID: PMC11002324 DOI: 10.1089/heq.2023.0147] [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] [Accepted: 01/08/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction In the United States, sickle cell disease (SCD)-the homozygous inheritance of a point mutation within the beta-globin chain of hemoglobin-affects between 80,000 and 100,000 people. Adequate nutrition can influence the pathophysiology of SCD, and individuals with SCD who are undernourished are more likely to have impaired immune function and disease exacerbation. Undernourishment is often caused by food insecurity (FI), which is defined as "a household-level economic and social condition of limited or uncertain access to adequate food" by the USDA. FI disproportionately affects African Americans, a population disproportionately affected by SCD in the United States. Objectives We performed a scoping review to better understand the relationship between FI and SCD severity. Methods A comprehensive search for peer-reviewed research articles and meeting abstracts was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Selected studies were reviewed for descriptive analysis by three independent reviewers. Results In total, 72 studies were identified, 62 were excluded for meeting inclusion criteria. The remaining 10 studies, 5 of which were meeting abstracts, were reviewed. Although limited evidence is available, the results of this scoping review suggest a bidirectional relationship between SCD and FI. Seven key themes were identified to help elucidate this relationship: 1) prevalence of FI among individuals with SCD, 2) child versus caregiver experiences of FI, 3) psychosocial factors, 4) food assistance benefits, 5) dietary intake, 6) external spending, 7) healthcare utilization. Conclusion Findings from this scoping review suggest how SCD and FI work in tandem to exacerbate each other. Furthermore, the findings illustrate current gaps in the literature and opportunities for actions to address FI among individuals living with SCD.
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Affiliation(s)
- Faeben Wossenseged
- Social and Behavioral Research Branch, National Institutes of Health, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Kristina Franklin
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, Maryland, USA
| | - Talya Gordon
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, Maryland, USA
| | - Ashley Buscetta
- Social and Behavioral Research Branch, National Institutes of Health, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Gwenyth R. Wallen
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, Maryland, USA
| | - Vence L. Bonham
- Social and Behavioral Research Branch, National Institutes of Health, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Nicole Farmer
- Translational Biobehavioral and Health Disparities Branch, National Institutes of Health, Clinical Center, Bethesda, Maryland, USA
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Benes Matos da Silva H, Ribeiro-Silva RDC, Freitas de Mello E Silva J, Chis Ster I, Rebouças P, Goes E, Ichihara MY, Ferreira A, M Pescarini J, Leovigildo Fiaccone R, S Paixão E, L Barreto M. Ethnoracial disparities in childhood growth trajectories in Brazil: a longitudinal nationwide study of four million children. BMC Pediatr 2024; 24:103. [PMID: 38341551 PMCID: PMC10858530 DOI: 10.1186/s12887-024-04550-3] [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: 07/31/2023] [Accepted: 01/10/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The literature contains scarce data on inequalities in growth trajectories among children born to mothers of diverse ethnoracial background in the first 5 years of life. OBJECTIVE We aimed to investigate child growth according to maternal ethnoracial group using a nationwide Brazilian database. METHODS A population-based retrospective cohort study employed linked data from the CIDACS Birth Cohort and the Brazilian Food and Nutrition Surveillance System (SISVAN). Children born at term, aged 5 years or younger who presented two or more measurements of length/height (cm) and weight (kg) were followed up between 2008 and 2017. Prevalence of stunting, underweight, wasting, and thinness were estimated. Nonlinear mixed effect models were used to estimate childhood growth trajectories, among different maternal ethnoracial groups (White, Asian descent, Black, Pardo, and Indigenous), using the raw measures of weight (kg) and height (cm) and the length/height-for-age (L/HAZ) and weight-for-age z-scores (WAZ). The analyses were also adjusted for mother's age, educational level, and marital status. RESULTS A total of 4,090,271 children were included in the study. Children of Indigenous mothers exhibited higher rates of stunting (26.74%) and underweight (5.90%). Wasting and thinness were more prevalent among children of Pardo, Asian, Black, and Indigenous mothers than those of White mothers. Regarding children's weight (kg) and length/height (cm), those of Indigenous, Pardo, Black, and Asian descent mothers were on average shorter and weighted less than White ones. Regarding WAZ and L/HAZ growth trajectories, a sharp decline in average z-scores was evidenced in the first weeks of life, followed by a period of recovery. Over time, z-scores for most of the subgroups analyzed trended below zero. Children of mother in greater social vulnerability showed less favorable growth. CONCLUSION We observed racial disparities in nutritional status and childhood growth trajectories, with children of Indigenous mothers presenting less favorable outcomes compared to their White counterparts. The strengthening of policies aimed at protecting Indigenous children should be urgently undertaken to address systematic ethnoracial health inequalities.
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Affiliation(s)
- Helena Benes Matos da Silva
- School of Nutrition, Federal University of Bahia, Salvador, BA, Brazil.
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil.
| | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Salvador, BA, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Juliana Freitas de Mello E Silva
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Irina Chis Ster
- Infection and Immunity Research Institute, St George's University of London, London, UK
| | - Poliana Rebouças
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Emanuelle Goes
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
| | - Andrêa Ferreira
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
- The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Dornsife School of Public Health, Drexel University, Philadelphia, USA
| | - Julia M Pescarini
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Enny S Paixão
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maurício L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Edf. Tecnocentro, Sl. 315. Rua Mundo, 121. Trobogy, Salvador, BA, 41745-715, Brazil
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Tzeng CFT, Swoboda T, Huggins C, D’Etienne J, Wang H. Risks Associated with Quality Care among Hispanic and White Populations-A Cross-Sectional Comparison Study. Healthcare (Basel) 2024; 12:250. [PMID: 38275530 PMCID: PMC10815774 DOI: 10.3390/healthcare12020250] [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: 12/11/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Quality care in healthcare is a multifaceted concept that encompasses the execution of effective medical treatments and the patient's overall experience. It involves a multitude of factors, including effectiveness, safety, timeliness, equity, and patient centeredness, which are important in shaping the healthcare landscape. This cross-sectional study used the data from the Health Information National Trends Survey 6 (HINTS 6), which collects data on various aspects of health communication and information-seeking behaviors, to investigate the factors associated with quality care among White and Hispanic populations. All adults who participated in HINTS 6 and visited healthcare service at least once in the past 12 months were included in this study. Multivariable logistic regression was used to determine the association between quality care and delay or discriminated care with the adjustment of all other sociodemographic variables. We analyzed a total of 3611 participants. Poor social determinants of health (SDOHs) (OR 0.61, CI 0.43-0.88, p = 0.008), delayed needed medical care (OR 0.34, CI 0.26-0.43, p < 0.001), and discriminated care (OR 0.29, CI 0.15-0.54, p < 0.001) were all negatively associated with optimal quality care. Negative SDOHs could also be positively associated with delayed care and discriminated care.
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Affiliation(s)
- Ching-Fang Tiffany Tzeng
- Department of Emergency Medicine, Baylor & Scott White All Saints Medical Center, 1400 8th Ave., Fort Worth, TX 76104, USA
| | - Thomas Swoboda
- Department of Emergency Medicine, The Valley Health System, Touro University Nevada School of Osteopathic Medicine, 657 N. Town Center Drive, Las Vegas, NV 89144, USA
| | - Charles Huggins
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA (J.D.)
| | - James D’Etienne
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA (J.D.)
| | - Hao Wang
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA (J.D.)
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Lucas A, Mlawer S, Weaver K, Caldwell J, Baig A, Zasadazinski L, Saunders M. Chicago Neighborhood Context and Racial/Ethnic Disparities in Maternal Diabetes. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01892-z. [PMID: 38157197 DOI: 10.1007/s40615-023-01892-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES To determine if rates of maternal diabetes vary by race, ethnicity, and neighborhood hardship. METHODS We conducted a secondary analysis of live births in Chicago from 2010 to 2017. Our sample was restricted to Non-Hispanic White, Non-Hispanic Black, Mexican, Non-Hispanic Asian, and Other Hispanic mothers between the ages of 15 and 50, with singleton births. The addresses of mothers were geocoded to specific neighborhoods, which we stratified into tertiles using the Economic Hardship Index. We used generalized logit mixed models to examine the interaction between race/ethnicity, neighborhood economic hardship, and maternal diabetes. RESULTS In our cohort of 299,053 mothers, 4.75% were diagnosed with gestational diabetes. Asian mothers had the highest frequency of gestational diabetes (8.3%), followed by Mexican mothers (6.8%). Within their respective racial/ethnic groups, Asian and Mexican mothers living in medium hardship neighborhoods had the highest odds of gestational diabetes compared to the reference group (OR 2.80, 95%CI 2.53, 3.19; OR 2.30, 95%CI 2.12, 2.49 respectively). Overall rates of preexisting diabetes were 0.9% and were highest among Mexican and Black mothers (1.26% and 1.06%, respectively). Asian mothers in medium hardship neighborhoods had the greatest odds of preexisting diabetes, among all Asian mothers and compared to the reference (OR 4.71 95% CI 3.60, 6.16). CONCLUSIONS For racial and ethnic minoritized mothers, gestational and preexisting diabetes do not increase in a step-wise fashion with neighborhood hardship; rates were often higher in low and medium hardship neighborhoods.
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Affiliation(s)
- Anika Lucas
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
- Durham Veterans Affairs Medical Center, Durham, NC, USA.
| | - Sophia Mlawer
- Data Science and Analytics, University of Chicago Medicine, Chicago, IL, USA
| | | | - Julia Caldwell
- Department of Public Health Los Angeles County, Los Angeles, CA, USA
| | - Arshiya Baig
- General Internal Medicine, University of Chicago Medicine, Chicago, IL, USA
| | | | - Milda Saunders
- General Internal Medicine, University of Chicago Medicine, Chicago, IL, USA
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Verma H, Verma A, Bettag J, Kolli S, Kurashima K, Manithody C, Jain A. Role of Effective Policy and Screening in Managing Pediatric Nutritional Insecurity as the Most Important Social Determinant of Health Influencing Health Outcomes. Nutrients 2023; 16:5. [PMID: 38201835 PMCID: PMC10780641 DOI: 10.3390/nu16010005] [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: 11/15/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
Social Determinants of Health (SDOH) impact nearly half of health outcomes, surpassing the influence of human behavior, clinical care, and the physical environment. SDOH has five domains: Economic Stability, Education Access and Quality, Health Care Access and Quality, Neighborhood and Built Environment, and Social and Community Context. Any adversity arising out of these interlinked domains predominantly affects children due to their greater susceptibility, and the adverse outcomes may span generations. Unfavorable SDOH may cause food insecurity, malnutrition, unbalanced gut microbiome, acute and chronic illnesses, inadequate education, unemployment, and lower life expectancy. Systematic screening by health care workers and physicians utilizing currently available tools and questionnaires can identify children susceptible to adverse childhood experiences, but there is a deficiency with respect to streamlined approach and institutional support. Additionally, current ameliorating supplemental food programs fall short of pediatric nutritional requirements. We propose a nutrition-based Surveillance, Screening, Referral, and Reevaluation (SSRR) plan encompassing a holistic approach to SDOH with a core emphasis on food insecurity, coupled with standardizing outcome-based interventions. We also propose more inclusive use of Food Prescription Programs, tailored to individual children's needs, with emphasis on education and access to healthy food.
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Affiliation(s)
- Hema Verma
- SLU College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Arun Verma
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
| | - Jeffery Bettag
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
| | - Sree Kolli
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
| | - Kento Kurashima
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
| | - Chandrashekhara Manithody
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
| | - Ajay Jain
- Department of Pediatrics, Saint Louis University School of Medicine, Saint Louis, MO 63103, USA; (A.V.); (J.B.); (S.K.)
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Arjvand F, Moeeni M, Najafi B, Nosratnejad S. Factors Affecting Inequality in the Quality Diets: A Scoping Review. Value Health Reg Issues 2023; 37:105-112. [PMID: 37423079 DOI: 10.1016/j.vhri.2023.05.003] [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: 01/18/2023] [Revised: 04/15/2023] [Accepted: 05/03/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVES the current dietary pattern is found increasingly unsafe, unstable, and unequal for a huge part of the populations. Disadvantaged populations were usually known by less healthy diets and were at a higher risk of disease in comparison with high socioeconomic groups. The current scoping review study aims at indicating the effective factors on inequality in the quality of diets. METHODS the academic databases, including Scopus, Web of science, PubMed, Scientific Information Database, Islamic World Science Citation Center, Google scholar search engine, World Health Organization, and the website of the European Union, until April 2021, were systematically reviewed. We used vote counting technique to identify the effective factors causing inequality in the quality of diets. RESULTS The factors that have caused inequality in the quality of diets were divided into 3 categories of demographic, lifestyle, and socioeconomic. It was found that any increase in age, income, education, different ethnic groups, smoking, and occupational statues increased inequality in diet quality. Also, as a factor physical activity, could reduce inequality in diet quality. Moreover, type of residence in terms of access to food, dominant available food, and culture of the area could cause inequality in diet quality. CONCLUSIONS According to the results of this study, the effective factors on inequality in the quality of diet are demographic and socioeconomic factors that cannot be manipulated by policy makers. Nevertheless, increasing the knowledge of individuals, improving their lifestyle, and providing subsidies to poorer individuals reduce inequality in the quality of the diets.
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Affiliation(s)
- Faezeh Arjvand
- Department of Health Economics, Tabriz University of Medical Sciences, Tabriz, East_Azarbaijan, Iran
| | - Maryam Moeeni
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behzad Najafi
- Iranian Center of Excellence in Health Management, Department of Health Economics, Tabriz University of Medical Sciences, Tabriz, East_Azarbaijan, Iran
| | - Shirin Nosratnejad
- Tabriz Health Services Management Research Center, Department of Health Economics, Tabriz University of Medical Sciences, Tabriz, East_Azarbaijan, Iran.
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