1
|
Gesselman AN, Kaufman EM, Weeks LYS, Moscovici Z, Bennett-Brown M, Adams OR, Campbell JT, Piazza M, Bhuyan L, Dubé S, Hille JJ, Garcia JR. Exploring patterns in mental health treatment and interests of single adults in the United States: a secondary data analysis. Front Public Health 2024; 12:1292603. [PMID: 38711766 PMCID: PMC11073498 DOI: 10.3389/fpubh.2024.1292603] [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: 09/11/2023] [Accepted: 03/15/2024] [Indexed: 05/08/2024] Open
Abstract
Objective The objective of this study is to examine mental health treatment utilization and interest among the large and growing demographic of single adults in the United States, who face unique societal stressors and pressures that may contribute to their heightened need for mental healthcare. Method We analyzed data from 3,453 single adults, focusing on those with possible mental health treatment needs by excluding those with positive self-assessments. We assessed prevalence and sociodemographic correlates of mental health treatment, including psychotherapy and psychiatric medication use, and interest in attending psychotherapy among participants who had never attended. Results 26% were in mental health treatment; 17% were attending psychotherapy, 16% were taking psychiatric medications, and 7% were doing both. Further, 64% had never attended psychotherapy, of which 35% expressed interest in future attendance. There were differences in current psychotherapy attendance and psychiatric medication use by gender and sexual orientation, with women and gay/lesbian individuals more likely to engage in both forms of mental health treatment. Additionally, interest in future psychotherapy among those who had never attended varied significantly by age, gender, and race. Younger individuals, women, and Black/African-American participants showed higher likelihoods of interest in psychotherapy. Conclusion Our research highlights a critical gap in mental health treatment utilization among single adults who may be experiencing a need for those services. Despite a seemingly higher likelihood of engagement in mental health treatment compared to the general population, only a minority of single adults in our sample were utilizing mental health treatment. This underutilization and the observed demographic disparities in mental health treatment underscore the need for targeted outreach, personalized treatment plans, enhanced provider training, and policy advocacy to ensure equitable access to mental healthcare for single adults across sociodemographic backgrounds.
Collapse
Affiliation(s)
- Amanda N. Gesselman
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Ellen M. Kaufman
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Lee Y. S. Weeks
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender Studies, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Zoe Moscovici
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender Studies, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Margaret Bennett-Brown
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Communication Studies, College of Media and Communications, Texas Tech University, Lubbock, TX, United States
| | - Olivia R. Adams
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender, Sexuality, and Women’s Studies, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, United States
| | - Jessica T. Campbell
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Malia Piazza
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Anthropology, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Lucy Bhuyan
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Counseling and Educational Psychology, School of Education, Indiana University Bloomington, Bloomington, IN, United States
| | - Simon Dubé
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Psychology, Faculty of Arts and Science, Concordia University, Montreal, QC, Canada
| | - Jessica J. Hille
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Justin R. Garcia
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender Studies, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
| |
Collapse
|
2
|
Hämmig O. Overindebtedness, unemployment, and poor mental health - and the role of sense of control: a population-based Swiss study. Front Public Health 2024; 12:1324402. [PMID: 38711763 PMCID: PMC11073489 DOI: 10.3389/fpubh.2024.1324402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/01/2024] [Indexed: 05/08/2024] Open
Abstract
Background Both overindebtedness and unemployment are critical life events that can result in or lead to poor mental health. What is less known is that the two partly interrelated events frequently go along with a feeling of loss or lack of control in life, which could be the main reason why they are associated with poor mental health. This has not been examined in previous research, particularly not in this combination. Methods This study used and merged two cross-sectional data sets. Data collected in 2019 on 219 overindebted clients of the four official debt advisory centers in the Canton of Zurich were linked with a comparable subsample of 1,997 respondents from the Swiss Health Survey of 2017. The entire study population covered 2,216 adult individuals living in the Canton of Zurich. Results The prevalence of no or low sense of control, medium to high psychological distress, and moderate to major depression was much higher among the 44 solely unemployed (36/30/12%), the 189 solely overindebted (73/83/53%), and particularly among the 30 unemployed and overindebted (93/97/60%) than among all 1,953 other survey participants (21/13/7%). Unemployment, overindebtedness, and a (resulting) lack or loss of control were all found to be strong risk factors for the two mental health outcomes under study. Associations, or rather negative health effects, were partly but not fully mediated by the sense of control. Overindebtedness much more strongly predicted psychological distress (ß = -0.37) and depression (ß = 0.17) than unemployment (ß = -0.05/0.01). The sense of control turned out to be an independent explanatory factor for poor mental health and even the strongest of all (ß = 0.49/-0.59). Conclusion Improving a person's control beliefs could be a promising measure for preventing mental health disorders in general and in people who are unemployed and/or overindebted in particular.
Collapse
Affiliation(s)
- Oliver Hämmig
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zürich, Switzerland
| |
Collapse
|
3
|
Akram S, Baloch MYJ, Alrefaei AF, Almutairi MH, Idrees M, Al-Kubaisi HARA. Interface between mental health and the earthquake: considering humanitarian endeavor. Front Public Health 2024; 12:1326407. [PMID: 38481846 PMCID: PMC10935552 DOI: 10.3389/fpubh.2024.1326407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/29/2024] [Indexed: 05/09/2024] Open
Affiliation(s)
- Sara Akram
- School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou, China
| | | | | | - Mikhlid H. Almutairi
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Idrees
- Department of Rural Sociology, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | | |
Collapse
|
4
|
Wang Y, Deng H, Gao S, Li T, Wang F. A Fresh Perspective on Examining Population Emotional Well-Being Trends by Internet Search Engine: An Emerging Composite Anxiety and Depression Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:202. [PMID: 38397692 PMCID: PMC10888063 DOI: 10.3390/ijerph21020202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Traditional assessments of anxiety and depression face challenges and difficulties when it comes to understanding trends in-group psychological characteristics. As people become more accustomed to expressing their opinions online, location-based online media and cutting-edge algorithms offer new opportunities to identify associations between group sentiment and economic- or healthcare-related variables. Our research provides a novel approach to analyzing emotional well-being trends in a population by focusing on retrieving online information. We used emotionally enriched texts on social media to build the Public Opinion Dictionary (POD). Then, combining POD with the word vector model and search trend, we developed the Composite Anxiety and Depression Index (CADI), which can reflect the mental health level of a region during a specific time period. We utilized the representative external data by CHARLS to validate the effectiveness of CADI, indicating that CADI can serve as a representative indicator of the prevalence of mental disorders. Regression and subgroup analysis are employed to further elucidate the association between public mental health (measured by CADI) with economic development and medical burden. The results of comprehensive regression analysis show that the Import-Export index (-16.272, p < 0.001) and average cost of patients (4.412, p < 0.001) were significantly negatively associated with the CADI, and the sub-models stratificated by GDP showed the same situation. Disposable income (-28.389, p < 0.001) became significant in the subgroup with lower GDP, while the rate of unemployment (2.399, p < 0.001) became significant in the higher subgroup. Our findings suggest that an unfavorable economic development or unbearable medical burden will increase the negative mental health of the public, which was consistent across both the full and subgroup models.
Collapse
Affiliation(s)
- Yu Wang
- Center for Applied Statistics, Renmin University of China, Beijing 100872, China;
- School of Statistics, Renmin University of China, Beijing 100872, China; (H.D.); (S.G.); (T.L.)
| | - Heming Deng
- School of Statistics, Renmin University of China, Beijing 100872, China; (H.D.); (S.G.); (T.L.)
| | - Sunan Gao
- School of Statistics, Renmin University of China, Beijing 100872, China; (H.D.); (S.G.); (T.L.)
| | - Tongxu Li
- School of Statistics, Renmin University of China, Beijing 100872, China; (H.D.); (S.G.); (T.L.)
| | - Feifei Wang
- Center for Applied Statistics, Renmin University of China, Beijing 100872, China;
- School of Statistics, Renmin University of China, Beijing 100872, China; (H.D.); (S.G.); (T.L.)
| |
Collapse
|
5
|
Sternberg A, Fauser D, Banaschak H, Bethge M. Sequences of vocational rehabilitation services in Germany: a cohort study. BMC Health Serv Res 2024; 24:74. [PMID: 38225557 PMCID: PMC10788977 DOI: 10.1186/s12913-023-10499-3] [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: 05/09/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND This study aimed to describe sequences of vocational rehabilitation services among individuals with approved vocational rehabilitation in Germany and to identify typical service sequences. METHODS We used administrative data on vocational rehabilitation services and questionnaire data on health and work ability to describe frequencies and sequences of vocational rehabilitation services financed by the Federal German Pension Insurance. Through sequence analysis, we were able to map the service sequences. We did cluster analyses to identify typical different service sequences. RESULTS Our sample included 1,652 individuals with 2,584 services. Integration services and two-year vocational retraining were the most common services. We could identify three different service clusters around integration services: shorter ones, followed by employer benefits and without employer benefits. We found two different clusters around two-year vocational retraining: shorter and longer clusters. Two-year vocational retraining was more often initiated by preparatory services and followed by employer benefits than integration services. Longer services in both clusters were associated with better baseline data for physical health, work ability, risk of future work disability, and younger age than shorter services. People in two-year-vocational retraining reported at baseline better general health, better work ability, low risk of future work disability, and less mental illness compared to people in integration services. CONCLUSIONS Multiple services, that is, sequences of services, were more likely to occur among individuals with more complex services like two-year vocational retraining. Utilization of complex services and longer services was influenced by health, age, risk of future work disability, and education. TRIAL REGISTRATION German Clinical Trials Register DRKS00009910, registration 25/01/2016.
Collapse
Affiliation(s)
- Annika Sternberg
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - David Fauser
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Hannes Banaschak
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Matthias Bethge
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| |
Collapse
|
6
|
Hammer NM, Olsen M, Larsen HB, Wreford Andersen E, Oksbjerg Dalton S, Allerslev Horsbøl T, Envold Bidstrup P. Work-related consequences of losing a child with cancer: A nationwide population-based cohort study. Pediatr Blood Cancer 2024; 71:e30720. [PMID: 37837181 DOI: 10.1002/pbc.30720] [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: 07/03/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Parents who lose a child are at increased risk of impaired mental health, which may negatively affect their work ability. The aims of this study were to examine the risk for reduced labor market affiliation in parents who lost a child with cancer compared to a matched parent cohort, and factors associated with the bereaved parents' labor market affiliation. METHODS We conducted a nationwide population-based cohort study using Danish registry data. We followed bereaved parents (n = 1609) whose child died with cancer at age less than 30 during 1992-2020, and a matched, population-based sample of parents (n = 15,188) of children with no history of childhood cancer. Cox proportional hazard models and fractional logit models were performed separately for mothers and fathers. RESULTS Cancer-bereaved mothers had an overall increased risk of long-term sick leave (hazard ratio [HR] = 1.62; 95% confidence interval [CI]: 1.48-1.77), unemployment (HR = 1.53; CI: 1.37-1.70), and lower odds of working in the first 2 years following the loss (odds ratio [OR] = 0.44; CI: 0.39-0.49), while bereaved fathers had lower odds of working (OR = 0.65; CI: 0.53-0.79), and increased risk of permanently reduced work ability (HR = 1.29; 95% CI: 1.01-1.66), compared to the matched cohort of parents of cancer-free children. Younger parental age, lower education, and being a single parent were identified as the main determinants of the bereaved parents' reduced labor market affiliation. CONCLUSIONS Cancer-bereaved parents are at increased risk of reduced labor market affiliation, compared with a matched, population-based sample of parents. Certain groups of bereaved parents may be at particularly high risk, and targeted bereavement interventions are warranted.
Collapse
Affiliation(s)
- Nanna Maria Hammer
- Department of Paediatrics and Adolescent Medicine, Copenhagen Palliative Team for Children and Adolescents, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, Paediatric Oncology Research Laboratory, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
| | - Marianne Olsen
- Department of Paediatrics and Adolescent Medicine, Paediatric Oncology Research Laboratory, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Pediatrics and Adolescent Medicine, Section of Pediatric Hematology and Oncology, Aalborg University Hospital, Aalborg, Denmark
| | - Hanne Baekgaard Larsen
- Department of Paediatrics and Adolescent Medicine, Paediatric Oncology Research Laboratory, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Susanne Oksbjerg Dalton
- Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Naestved, Denmark
| | - Trine Allerslev Horsbøl
- Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
- Institute of Psychology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
7
|
Sigmund D, Loew V, Pawils S. Engaging Parents Affected by Mental Health Problems in Pediatric and Gynecologic Practices-Implications of the KID-PROTEKT Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1853. [PMID: 38136055 PMCID: PMC10741721 DOI: 10.3390/children10121853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/08/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023]
Abstract
Children of parents with mental illness are at higher risk of developing cognitive, mental health or physical health difficulties. Previous studies have described several barriers for reaching parents with mental health problems (MHPs) and their utilization of psychosocial services. We conducted a cluster randomized controlled study in 24 pediatric and gynecologic practices to evaluate KID-PROTEKT, a psychosocial healthcare intervention that comprises a psychosocial assessment to identify families with psychosocial needs and refer them to support services. In this paper, we analyzed whether psychosocially distressed parents with additional MHPs (identified by the PHQ-9 and GAD-7) had higher support needs, could be referred to support and utilized it in comparison to parents with psychosocial burden only. In total, 178 pregnant women and mothers with psychosocial burden were included, of whom 55 had MHPs. Participants with MHPs were distressed in their relationships more often and medical staff rated their level of support needs higher compared to parents without MHPs. There were no significant differences between the groups regarding whether they were referred to support services or utilized the recommended services. All participants were most frequently referred to family or parent counseling/care or childcare assistance. The results indicate that despite existing barriers, parents with MHPs could be reached and identified by the KID-PROTEKT psychosocial assessment. A psychosocial intervention like KID-PROTEKT can help to provide support for mentally ill parents.
Collapse
Affiliation(s)
| | | | - Silke Pawils
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany; (D.S.); (V.L.)
| |
Collapse
|
8
|
Hollederer A, Jahn HJ. Results from a Nationwide Evaluation Study of Labor Market-Integrative Health Promotion for the Unemployed: Impact of the JOBS Program Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6835. [PMID: 37835105 PMCID: PMC10572609 DOI: 10.3390/ijerph20196835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 10/15/2023]
Abstract
Compared to the employed, the unemployed suffer from poorer health, especially in terms of mental health. At the same time, health promotion rarely reaches unemployed people. The "JOBS Program" is an intervention to promote health and labor market integration and has shown positive effects in the USA and Finland. In this confirmatory study, we investigated whether the JOBS Program achieves similar effects in Germany. We applied a randomized controlled trial to compare an intervention group (IVG) with a waiting control group (WCG) before (T0; N = 94) and shortly after (T1; n = 65) the intervention. Concerning our primary outcomes, the JOBS Program Germany was beneficial: Compared to the WCG, the regression estimated that the IVG had (1) a 2.736 scale point higher level of life satisfaction (p = 0.049), (2) a 0.337 scale point higher level of general health (p = 0.025), and (3) a 14.524 scale point higher level of mental well-being (p = 0.004). Although not statistically significant, job search-specific self-efficacy also appeared to be positively associated with the intervention. This study provides evidence of the effectiveness of JOBS Program on the abovementioned outcomes, including for older and long-term unemployed people, supporting the benefits of regular implementation of this program for a wide range of unemployed people in Germany.
Collapse
Affiliation(s)
- Alfons Hollederer
- Section of Theory and Empirics of Health, Department of Social Work and Social Welfare, The Faculty of Human Sciences, University of Kassel, D-34109 Kassel, Germany;
| | | |
Collapse
|
9
|
Bolgeo T, Di Matteo R, Simonelli N, Molin AD, Lusignani M, Bassola B, Vellone E, Maconi A, Iovino P. Psychometric properties and measurement invariance of the 7-item General Anxiety Disorder scale (GAD-7) in an Italian coronary heart disease population. J Affect Disord 2023; 334:213-219. [PMID: 37149049 DOI: 10.1016/j.jad.2023.04.140] [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] [Received: 02/01/2023] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Generalized Anxiety Disorder is predominant in coronary heart disease (CHD) patients. 7-item Generalized Anxiety Disorder (GAD-7) scale psychometric properties have never been tested in CHD populations. This study aims to verify the GAD-7 psychometric properties and measurement invariance in an Italian CHD sample. METHOD A baseline data secondary analysis from HEARTS-IN-DYADS study. Several healthcare facilities enrolled an adult inpatient sample. Anxiety and depression data were collected using GAD-7 and Patient Health Questionnaire 9 (PHQ-9). Factorial validity was assessed with confirmatory factor analysis; construct validity was tested by correlating GAD-7 scores with PHQ-9 scores and other sociodemographic characteristics; internal consistency reliability was assessed using Cronbach's alpha and the composite reliability index, while confirmatory multigroup factor analysis was employed to investigate measurement invariance across gender and age (65 vs. 65). RESULTS We enrolled 398 patients (mean age 64.7 years; 78.9 % male; 66.8 % married). Factor structure was confirmed as unidimensional. Construct validity was confirmed with significant associations between GAD-7 and PHQ-9 scores, female gender, having a caregiver, and being employed. Cronbach's alpha and composite reliability index were 0.89 and 0.90, respectively. Measurement invariance across gender and age was confirmed at the scalar level. LIMITATIONS A convenience sample in one European country, a small female sample, validity testing against a single criterion. CONCLUSION Study results demonstrate adequate validity and reliability of the GAD-7 in an Italian CHD sample. It showed satisfactory invariance properties; GAD-7 is suitable for measuring anxiety in CHD while making significant comparisons of scores among stratified gender and age groups.
Collapse
Affiliation(s)
- Tatiana Bolgeo
- Research Training Innovation Infrastructure, Department of Research and Innovation, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Roberta Di Matteo
- Research Training Innovation Infrastructure, Department of Research and Innovation, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
| | - Niccolò Simonelli
- SC Cardiology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Health Professions' Direction, Maggiore della Carità Hospital, Novara, Italy
| | - Maura Lusignani
- Department of Biomedical Science for Health, University of Milan, Milan, Italy; School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Barbara Bassola
- School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Maconi
- Research Training Innovation Infrastructure, Department of Research and Innovation, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, (Italy)
| |
Collapse
|
10
|
Lin E, Wagner KJ, Trutner Z, Brinkman N, Koenig KM, Bozic KJ, Haynes AB, Jayakumar P. Association of Unmet Social Needs With Level of Capability in People With Persistent Knee Pain. Clin Orthop Relat Res 2023; 481:924-932. [PMID: 36735586 PMCID: PMC10097533 DOI: 10.1097/corr.0000000000002554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/19/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Musculoskeletal providers are increasingly recognizing the importance of social factors and their association with health outcomes as they aim to develop more comprehensive models of care delivery. Such factors may account for some of the unexplained variation between pathophysiology and level of pain intensity and incapability experienced by people with common conditions, such as persistent nontraumatic knee pain secondary to osteoarthritis (OA). Although the association of one's social position (for example, income, employment, or education) with levels of pain and capability are often assessed in OA research, the relationship between aspects of social context (or unmet social needs) and such symptomatic and functional outcomes in persistent knee pain are less clear. QUESTIONS/PURPOSES (1) Are unmet social needs associated with the level of capability in patients experiencing persistently painful nontraumatic knee conditions, accounting for sociodemographic factors? (2) Do unmet health-related social needs correlate with self-reported quality of life? METHODS We performed a prospective, cross-sectional study between January 2021 and August 2021 at a university academic medical center providing comprehensive care for patients with persistent lower extremity joint pain secondary to nontraumatic conditions such as age-related knee OA. A final 125 patients were included (mean age 62 ± 10 years, 65% [81 of 125] women, 47% [59 of 125] identifying as White race, 36% [45 of 125] as Hispanic or Latino, and 48% [60 of 125] with safety-net insurance or Medicaid). We measured patient-reported outcomes of knee capability (Knee injury and Osteoarthritis Outcome Score for Joint Replacement), quality of life (Patient-Reported Outcome Measure Information System [PROMIS] Global Physical Health and PROMIS Global Mental Health), and unmet social needs (Accountable Health Communities Health-Related Social Needs Survey, accounting for insufficiencies related to housing, food, transportation, utilities, and interpersonal violence), as well as demographic factors. RESULTS After controlling for demographic factors such as insurance status, education attained, and household income, we found that reduced knee-specific capability was moderately associated with experiencing unmet social needs (including food insecurity, housing instability, transportation needs, utility needs, or interpersonal safety) (standardized beta regression coefficient [β] = -4.8 [95% confidence interval -7.9 to -1.7]; p = 0.002 and substantially associated with unemployment (β = -13 [95% CI -23 to -3.8]; p = 0.006); better knee-specific capability was substantially associated with having Medicare insurance (β = 12 [95% CI 0.78 to 23]; p = 0.04). After accounting for factors such as insurance status, education attained, and household income, we found that older age was associated with better general mental health (β = 0.20 [95% CI 0.0031 to 0.39]; p = 0.047) and with better physical health (β = 0.004 [95% CI 0.0001 to 0.008]; p = 0.04), but effect sizes were small to negligible, respectively. CONCLUSION There is an association of unmet social needs with level of capability and unemployment in patients with persistent nontraumatic knee pain. This finding signals a need for comprehensive care delivery for patients with persistent knee pain that screens for and responds to potentially modifiable social risk factors, including those based on one's social circumstances and context, to achieve better outcomes. LEVEL OF EVIDENCE Level II, prognostic study.
Collapse
Affiliation(s)
- Eugenia Lin
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - K. John Wagner
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - Zoe Trutner
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - Niels Brinkman
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - Karl M. Koenig
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - Kevin J. Bozic
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - Alex B. Haynes
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| | - Prakash Jayakumar
- Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
11
|
Testa A, Gimeno Ruiz de Porras D. The association of employment status and unwanted job loss with maternal oral health experiences: findings from the pregnancy risk assessment monitoring system. BMC Oral Health 2023; 23:168. [PMID: 36964511 PMCID: PMC10039498 DOI: 10.1186/s12903-023-02869-4] [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: 11/09/2022] [Accepted: 03/08/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Oral health is an essential component of a healthy pregnancy. While most women work full-time while pregnant, research has overlooked the impact of occupational status and job loss on oral health experiences during pregnancy. To examine the impact of employment status and job loss on oral health experiences during pregnancy in the United States. DATA Data are from eight sites (Georgia, Massachusetts, Minnesota, Missouri, North Carolina, New York State, New York City, and Wisconsin) of the Pregnancy Risk Assessment Monitoring System (PRAMS) for the years 2016-2020 (n = 31,362). Multiple logistic regression is used to assess the relationship between occupational status (including employment status and unwanted job loss) during pregnancy and oral health. FINDINGS Women who experienced an unwanted job loss in the prenatal period were at elevated risk of not having dental insurance, not receiving a dental cleaning during pregnancy, having an oral health problem, and having unmet dental care needs. CONCLUSION Experiencing unwanted job loss around the time of pregnancy is an important life event that corresponds to worse oral health experiences. There is a need for greater focus on adverse life events, such as job loss, especially during pregnancy, as a mechanism for oral health issues and challenges with proper access to dental health systems.
Collapse
Affiliation(s)
- Alexander Testa
- Department of Management, Policy and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, 7411 John Smith Drive, Suite 1100, San Antonio, TX, 78229, USA.
| | - David Gimeno Ruiz de Porras
- Southwest Center for Occupational and Environmental Health, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
- Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| |
Collapse
|
12
|
Packness A, Sparle Christensen K, Simonsen E. Prevalence of anxiety disorders and association to socioeconomic position. Results from the Lolland Falster Health Study. Nord J Psychiatry 2023:1-8. [PMID: 36662161 DOI: 10.1080/08039488.2022.2154836] [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: 01/21/2023]
Abstract
PURPOSE The purpose of this study is to describe the prevalence of anxiety disorders in a general population and the association to socioeconomic position (SEP), which has not been described in a Danish context before. MATERIAL AND METHODS We present data on anxiety symptoms from respondents in the rural-provincial Lolland-Falster population Health Study (LOFUS). Analyses of the questionnaire responses to the Anxiety Symptom Scale were done by descriptive statistics and logistic regression analyses adjusted for sex and age. RESULTS 14,834 LOFUS respondents who completed the Anxiety Symptom Scale were included; According to the original algorithm 371 (2.5%) had an anxiety disorder. The adjusted odds ratios (aOR) for anxiety disorder were strongly associated to SEP. We found aOR for anxiety to be: 3.8 (confidence interval (CI 95%) 2.54 - 5.92) for respondents with no postsecondary education compared to those with 3+ years of postsecondary education; 11.9 (CI 8.89 - 16.01) for respondents temporarily out of a job compared to those working; 9.4 (CI 6.06 - 14.51) for those experiencing constant financial strain compared to those not experiencing financial strain. Relaxing the criteria for anxiety to item 10 > 1, the prevalence raised to 3.9%. The association was unchanged related to education; however, the aOR dropped to 9 and 8 respectively, for being temporally out of job, or in financial strain every month- when doing same comparisons. CONCLUSIONS The 14-day prevalence of anxiety disorder seems low but strongly associated to SEP especially for individuals temporarily out of a job or experiencing financial strain.
Collapse
Affiliation(s)
- Aake Packness
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark.,Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Odense, Denmark
| | - Kaj Sparle Christensen
- Department of Public Health, Research Unit for General Practice, Aarhus University, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Erik Simonsen
- Mental Health Services, Psychiatry East, Psychiatry Region Zealand, Slagelse, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
13
|
Chen CP, Zammit R. Career counselling for adults with newly acquired mobility disability. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04207-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
14
|
Melchior M, Florence AM, Davisse-Paturet C, Falissard B, Galéra C, Hazo JB, Vuillermoz C, Warszawski J, Dione F, Rouquette A. Labor market participation and depression during the COVID-19 pandemic among young adults (18 to 30 years): A nationally representative study in France. Front Public Health 2022; 10:904665. [PMID: 36353287 PMCID: PMC9638096 DOI: 10.3389/fpubh.2022.904665] [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: 03/25/2022] [Accepted: 09/26/2022] [Indexed: 01/22/2023] Open
Abstract
Objective To examine the relationship between young adults' labor force participation and depression in the context of the COVID-19 pandemic. Design setting participants Data come from the nationally-representative EPICOV cohort study set up in France, and were collected in 2020 and 2021 (3 waves of online or telephone interviews: 02/05/2020-12/06/2020; 26/10/2020-14/12/2020; 24/06/2021-09/08/2021) among 2,217 participants aged 18-30 years. Participants with prior mental health disorder (n = 50) were excluded from the statistical analyses. Results Using Generalized Estimating Equation (GEE) models controlled for participants' socio-demographic and health characteristics and weighted to be nationally-representative, we found that compared to young adults who were employed, those who were studying or unemployed were significantly more likely to experience depression assessed using the PHQ-9 (multivariable ORs, respectively: OR: 1.29, 95% CI 1.05-1.60 and OR: 1.50, 1.13-1.99). Stratifying the analyses by age, we observed that unemployment was more strongly associated with depression among participants 25-30 years than among those who were 18-24 years (multivariable ORs, respectively, 1.78, 95% CI 1.17-2.71 and 1.41, 95% CI 0.96-2.09). Being out of the labor force was, to the contrary, more significantly associated with depression among participants 18-24 years (multivariable OR: 1.71, 95% CI 1.04-2.82, vs. 1.00, 95% CI 0.53-1.87 among participants 25-30 years). Stratifying the analyses by sex, we found no significant differences in the relationships between labor market characteristics and depression (compared to participants who were employed, multivariable ORs associated with being a student: men: 1.33, 95% CI 1.01-1.76; women: 1.19, 95% CI 0.85-1.67, multivariable ORs associated with being unemployed: men: 1.60, 95% CI 1.04-2.45; women: 1.47, 95% CI 1.01-2.15). Conclusions and relevance Our study shows that in addition to students, young adults who are unemployed also experience elevated levels of depression in the context of the COVID-19 pandemic. These two groups should be the focus of specific attention in terms of prevention and mental health treatment. Supporting employment could also be a propitious way of reducing the burden of the COVID-19 pandemic on the mental health of young adults.
Collapse
Affiliation(s)
- Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France,*Correspondence: Maria Melchior
| | - Aline-Marie Florence
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - Camille Davisse-Paturet
- Université Paris-Saclay, Inserm, Université Versailles Saint-Quentin (UVSQ), Centre d'Epidémiologie et de Santé Publique (CESP), Paris, France
| | - Bruno Falissard
- Université Paris-Saclay, Inserm, Université Versailles Saint-Quentin (UVSQ), Centre d'Epidémiologie et de Santé Publique (CESP), Paris, France,AP-HP Paris-Saclay, Epidemiology and Public Health Department, Le Kremlin-Bicêtre, France
| | - Cédric Galéra
- INSERM, Bordeaux Population Health Center, UMR1219, Bordeaux, France
| | | | - Cécile Vuillermoz
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Faculté de Médecine St Antoine, Paris, France
| | - Josiane Warszawski
- Université Paris-Saclay, Inserm, Université Versailles Saint-Quentin (UVSQ), Centre d'Epidémiologie et de Santé Publique (CESP), Paris, France,AP-HP Paris-Saclay, Epidemiology and Public Health Department, Le Kremlin-Bicêtre, France
| | - Fallou Dione
- Université Paris-Saclay, Inserm, Université Versailles Saint-Quentin (UVSQ), Centre d'Epidémiologie et de Santé Publique (CESP), Paris, France
| | - Alexandra Rouquette
- Université Paris-Saclay, Inserm, Université Versailles Saint-Quentin (UVSQ), Centre d'Epidémiologie et de Santé Publique (CESP), Paris, France,AP-HP Paris-Saclay, Epidemiology and Public Health Department, Le Kremlin-Bicêtre, France
| |
Collapse
|
15
|
Bélanger SM, Stene-Larsen K, Magnus P, Reneflot A, Christiansen SG, Hauge LJ. Employment status and bereavement after parental suicide: a population representative cohort study. BMJ Open 2022; 12:e064379. [PMID: 36167366 PMCID: PMC9516068 DOI: 10.1136/bmjopen-2022-064379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To examine employment status among adults bereaved by parental suicide at the time of bereavement and 2 and 5 years after the loss and to explore the importance of the gender of the adult child and the deceased parent. DESIGN Population-based register study. SETTING Norwegian population-based registries linked using unique personal identifiers. PARTICIPANTS Norwegian residents aged 25-49 years in the period 2000-2014. Participants were divided into three groups: bereaved by parental suicide, bereaved by parental death of other causes and non-bereaved population controls. MAIN OUTCOME MEASURES ORs for the risk of non-employment at the time of bereavement and 2 and 5 years after the loss. RESULTS Those bereaved by parental suicide had a higher risk of non-employment already at the time of bereavement (OR 1.14, 95% CI 1.05 to 1.23). Stratified analyses showed that women accounted for this difference (OR 1.20, 95% CI 1.09 to 1.33), while no difference was found for men (OR 1.00, 95% CI 0.88 to 1.13). Looking at the gender of the parent, there was only a significant association of non-employment when losing a mother (OR 1.24, 95% CI 1.08 to 1.42), while not for losing a father (OR 1.09, 95% CI 0.99 to 1.20). Among those working at the time of bereavement, offspring bereaved by suicide were more likely to be non-employed at both 2 (OR 1.13, 95% CI 0.99 to 1.30) and 5 (OR 1.20, 95% CI 1.02 to 1.40) years after the loss compared with the general population. CONCLUSIONS Women bereaved by parental suicide and those losing a mother to suicide were found to have a weaker attachment to the labour market already before losing their parent. Those who were employed when bereaved by suicide were somewhat more likely to be non-employed 5 years after the event.
Collapse
Affiliation(s)
| | - Kim Stene-Larsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Lars Johan Hauge
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
16
|
Sharek D, Lally N, Brennan C, Higgins A. "These are people just like us who can work": Overcoming clinical resistance and shifting views in the implementation of Individual Placement and Support (IPS). ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2022; 49:848-860. [PMID: 35793011 PMCID: PMC9393135 DOI: 10.1007/s10488-022-01204-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/25/2022] [Indexed: 12/02/2022]
Abstract
Purpose Individual Placement and Support (IPS) is a recovery-based approach to support people with mental health difficulties back into employment. Embedding of IPS within the mental health Multi-Disciplinary Team (MDT) is a key component of IPS fidelity; however, few studies have examined how those involved with IPS implementation navigate this process. This article explores how IPS Employment Specialists (ES) and Occupational Therapist (OT) Managers integrated and embedded IPS within traditionally-oriented MDTs as part of a national reform program in the Republic of Ireland. Methods The study design was qualitative, descriptive with data collected through three focus groups with 17 IPS ESs and 11 OT Managers. Data were analyzed using thematic synthesis. Results Three key themes emerged from analysis. The first characterizes the context into which IPS landed, described as one marked by clinical resistance, doubt, and fear of risk. The second explores the strategies and factors that helped with the introduction of IPS into Irish mental health services. These included strategies, such as providing education and information about IPS and reassuring the MDT about IPS governance and IPS ES’ competencies. The evidenced-based nature of IPS and its attached accountabilities through IPS fidelity measures were perceived to be an important factor in its acceptance. The final theme encapsulates perceptions of how IPS impacted on the MDTs’ views of people with mental health difficulties. Findings suggest a shift in the ways in which MDTs view their clients. Initial fears about work capacity and risk shifted towards seeing people beyond the label of ‘service user’ and their diagnosis. Conclusions It is contended that IPS is an approach that allows practitioners to engage with real recovery-practice and may be one key to unlocking how a recovery approach can truly trickle down and embed itself within mental health service provision and support mental health system reform.
Collapse
Affiliation(s)
| | - Niamh Lally
- Centre for Social Innovation, Trinity Business School, Trinity College, Dublin, Ireland.
| | | | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|