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Wang J, Ye Y, Chen X, Hu X, Peng Y. Trends in statin use for the primary prevention of atherosclerotic cardiovascular disease among US adults by demographic characteristics, 1999-2020. Eur J Clin Pharmacol 2024:10.1007/s00228-024-03699-1. [PMID: 38802638 DOI: 10.1007/s00228-024-03699-1] [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: 03/29/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of mortality worldwide. Statins, which are effective in preventing ASCVD, are underused, particularly for primary prevention. This study examined trends in statin use for primary ASCVD prevention from 1999 to 2020, focusing on demographic variations. METHODS Utilizing data from the National Health and Nutrition Examination Survey, the present study includes individuals aged 18 years and older who had a greater than 10% risk of ASCVD over 10 years, and excluded patients with existing ASCVD. Subgroup analyses by demographic categories were performed. We calculated the changes in statin usage and used linear and quadratic tests to assess the linear and nonlinear trends in those changes. RESULTS A total of 10,037 participants were included. Statin usage increased from 16.16% in 1999 to 36.24% in 2010, and 41.74% in 2020 (quadratic P-value < 0.001). In the 18-44 years age group, statin usage increased from 2.52% in 1999 to 8.14% in 2020 (linear P-value = 0.322), showing no significant linear trend. In the "never-married" group, statin usage increased from 19.16% in 1999 to 30.05% in 2020 (linear P-value = 0.256). CONCLUSION Statin usage has shown a positive trend among populations requiring primary prevention for ASCVD. Currently, health policies are proving effective. However, the overall statin usage rate remains less than 50%. Additionally, young and never-married individuals should also receive special attention regarding statin usage as primary treatment for ASCVD.
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Affiliation(s)
- Junwen Wang
- Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Yuyang Ye
- Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Xuefeng Chen
- Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Xinru Hu
- Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China
| | - Yong Peng
- Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China.
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2
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Gettler LT, Rosenbaum S, Bechayda SA, McDade TW, Kuzawa CW. Men's physical health and life history transitions in the Philippines: Evidence for 'marital selection' but not protective effects of partnering and fatherhood. Soc Sci Med 2024; 346:116732. [PMID: 38452489 DOI: 10.1016/j.socscimed.2024.116732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
In Euro-American societies, married people typically have lower overall risks for total mortality and for certain chronic conditions compared to non-married people. However, people becoming partnered and parents also tend to gain weight in Euro-American settings. Few studies have tested whether links between physical health and life history status translate to other cultural contexts where the socio-ecological dynamics of family life may differ. This limits the application of these insights to men's well-being in global public health. To help address this gap, we drew on a large, long-running birth cohort study of Filipino men, using data collected at three waves between 2005 and 2014 when men were 21.5-30.5 years old (N = 607, obs. = 1760). We tested for the effects of the transition to partnering (marriage/cohabitation) and fatherhood on men's physical health (waist circumference, fat-free mass index, and grip strength). Men becoming partnered or partnered fathers (P/PF) had comparable longitudinal physical health trajectories to men remaining single non-fathers. However, men who became P/PF by their mid 20s had higher fat-free mass index values than single non-fathers at each wave, with the largest effect observed when all men were single non-fathers at baseline. Men who became P/PF by their early 30s were also stronger than the reference group at baseline. Thus, men who were more muscular and stronger at baseline were more likely to transition to P/PF status, consistent with a 'marital selection' model. In complementary analyses, men did not exhibit adverse health effects when they became partnered fathers as young adults or parents to infants, respectively. These findings suggest that links between health and life history transitions in this setting differ from those commonly observed in Euro-American societies. While transitions to marriage and fatherhood are promising windows for interventions to improve men's health, our results highlight the importance of tailoring such approaches to local dynamics.
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Affiliation(s)
- Lee T Gettler
- Department of Anthropology, University of Notre Dame, Notre Dame, IN, 46556, USA; Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
| | - Stacy Rosenbaum
- Department of Anthropology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Sonny Agustin Bechayda
- USC Office of Population Studies Foundation, and Department of Anthropology, Sociology, and History, University of San Carlos, Metro Cebu, 6016, Philippines
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, Evanston, IL, 60208, USA; Institute for Policy Research, Northwestern University, Evanston, IL, 60208, USA
| | - Christopher W Kuzawa
- Department of Anthropology, Northwestern University, Evanston, IL, 60208, USA; Institute for Policy Research, Northwestern University, Evanston, IL, 60208, USA
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3
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Strandberg G, Lipcsey M. Association of socioeconomic and demographic factors with limitations of life sustaining treatment in the intensive care unit. Intensive Care Med 2023; 49:1249-1250. [PMID: 37580572 DOI: 10.1007/s00134-023-07177-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/24/2023] [Indexed: 08/16/2023]
Affiliation(s)
- Gunnar Strandberg
- Department of Surgical Sciences, Cardiothoracic Surgery and Anesthesiology, Uppsala University, Uppsala, Sweden.
| | - Miklós Lipcsey
- Department of Surgical Sciences, Anesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
- Department of Surgical Sciences, Hedenstierna Laboratory, Uppsala University, Uppsala, Sweden
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4
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Girme YU, Park Y, MacDonald G. Coping or Thriving? Reviewing Intrapersonal, Interpersonal, and Societal Factors Associated With Well-Being in Singlehood From a Within-Group Perspective. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023; 18:1097-1120. [PMID: 36534959 PMCID: PMC10475216 DOI: 10.1177/17456916221136119] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Singlehood, defined as not being in a romantic relationship, is becoming increasingly common worldwide. Despite this, research on singlehood has not received remotely equivalent research attention as romantic relationships. Well-being research that has explicitly included singles has focused on whether coupled versus single people are more satisfied with their lives. However, these between-group comparisons have not attended to within-group variability among singles that can point to when and for whom singlehood is associated with thriving. In this review, we document findings from the emerging field of singlehood studies to highlight what is and is not known about factors that are associated with the well-being of single individuals from a within-group perspective. Our review examines (a) intrapersonal factors (characteristics of the individual), (b) interpersonal experiences (qualities of one's social relationships and experiences), and (c) societal influences (features related to one's broader social or cultural context) related to well-being in singlehood. We conclude by offering future directions for the conceptualization of and research on singlehood with the goal of promoting a thorough and inclusive perspective.
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Affiliation(s)
| | - Yoobin Park
- Center for Health & Community, University of California, San Francisco
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Hong J, Dembo RS, DaWalt LS, Baker MW, Berry-Kravis E, Mailick MR. Mortality in Women across the FMR1 CGG Repeat Range: The Neuroprotective Effect of Higher Education. Cells 2023; 12:2137. [PMID: 37681869 PMCID: PMC10486613 DOI: 10.3390/cells12172137] [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: 06/27/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/09/2023] Open
Abstract
Higher education has been shown to have neuroprotective effects, reducing the risk of Alzheimer's and Parkinson's diseases, slowing the rate of age-related cognitive decline, and is associated with lower rates of early mortality. In the present study, the association between higher education, fragile X messenger ribonucleoprotein 1 (FMR1) cytosine-guanine-guanine (CGG) repeat number, and mortality before life expectancy was investigated in a population cohort of women born in 1939. The findings revealed a significant interaction between years of higher education and CGG repeat number. Counter to the study's hypothesis, the effects of higher education became more pronounced as the number of CGG repeats increased. There was no effect of years of higher education on early mortality for women who had 25 repeats, while each year of higher education decreased the hazard of early mortality by 8% for women who had 30 repeats. For women with 41 repeats, the hazard was decreased by 14% for each additional year of higher education. The interaction remained significant after controlling for IQ and family socioeconomic status (SES) measured during high school, as well as factors measured during adulthood (family, psychosocial, health, and financial factors). The results are interpreted in the context of differential sensitivity to the environment, a conceptualization that posits that some people are more reactive to both negative and positive environmental conditions. Expansions in CGG repeats have been shown in previous FMR1 research to manifest such a differential sensitivity pattern.
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Affiliation(s)
- Jinkuk Hong
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (R.S.D.); (L.S.D.); (M.R.M.)
| | - Robert S. Dembo
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (R.S.D.); (L.S.D.); (M.R.M.)
- NORC at the University of Chicago, Chicago, IL 60603, USA
| | - Leann Smith DaWalt
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (R.S.D.); (L.S.D.); (M.R.M.)
| | - Mei Wang Baker
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA;
- Wisconsin State Laboratory of Hygiene, Madison, WI 53706, USA
| | - Elizabeth Berry-Kravis
- Department of Pediatrics, Rush University Medical Center, Chicago, IL 60612, USA;
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Anatomy and Cell Biology, Rush University Medical Center, Chicago, IL 60612, USA
| | - Marsha R. Mailick
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA; (R.S.D.); (L.S.D.); (M.R.M.)
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Jung J. Partnership trajectories and their consequences over the life course. Evidence from the German LifE Study. ADVANCES IN LIFE COURSE RESEARCH 2023; 55:100525. [PMID: 36942643 DOI: 10.1016/j.alcr.2022.100525] [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: 10/06/2021] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Following a life course perspective, this study examines the link between partnership trajectories and three dimensions of psychological well-being: psychological health, overall sense of self-worth and quality of life. BACKGROUND Assuming that life outcomes are the result of prior decisions, experiences and events, partnership histories can be seen as a resource for psychological well-being. Furthermore, advantages or disadvantages from living with or without a partner should accumulate over time. While previous cross-sectional research has mainly focused on the influence of partnership status or a status change on well-being, prior longitudinal studies could not control for reverse causality of well-being and partnership trajectories. This research addresses the question of how different patterns of partnership biographies are related to a person's well-being in middle adulthood. Selection effects of pre-trajectory well-being as well as current life conditions are also taken into account. METHOD Using data from the German LifE Study, the partnership trajectories between ages of 16 and 45 are classified by sequence and cluster analysis. OLS regression is then used to examine the link between types of partnership trajectories and depression, self-esteem and overall life satisfaction at age 45. RESULTS For women, well-being declined when experiencing unstable non-cohabitational union trajectories or divorce followed by unpartnered post-marital trajectories. Men suffered most from being long-term single. The results could not be explained by selection effects of pre-trajectory well-being. CONCLUSION While women seem to 'recover' from most of the negative effects of unstable partnership trajectories through a new partnership, for men it was shown that being mainly unpartnered has long-lasting effects on their psychological well-being.
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Affiliation(s)
- Jana Jung
- University of Potsdam, Department of Educational Sciences, Potsdam, Germany.
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Kravdal Ø, Wörn J, Reme BA. Mental health benefits of cohabitation and marriage: A longitudinal analysis of Norwegian register data. POPULATION STUDIES 2023; 77:91-110. [PMID: 35502948 DOI: 10.1080/00324728.2022.2063933] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim is to examine how mental health is affected by cohabitation and marriage. Individual fixed-effects models are estimated from Norwegian register data containing information about consultations with a general practitioner because of mental health conditions in 2006-19. Mental health, as indicated by annual number of consultations, improves over several years before cohabitation. For those marrying their cohabiting partner, there is a weak further reduction in consultations until the wedding, but no decline afterwards. In other words, formalization of the union does not seem to confer additional mental health benefits. However, marriage may be considered a marker of favourable earlier development in mental health. In contrast, there is further improvement after direct marriage, as well as stronger improvement over the years just preceding direct marriage. Patterns are quite similar for women and men. Overall, the results suggest that the mental health benefits of cohabitation and marriage are similar.Supplementary material for this article is available at: https://dx.doi.org/10.1080/00324728.2022.2063933. Note: numbers in brackets refer to supplementary notes that can be found at the end of the supplementary material.
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Marciano L, Schulz PJ, Camerini AL. How do depression, duration of internet use and social connection in adolescence influence each other over time? An extension of the RI-CLPM including contextual factors. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Changing associations of coronary heart disease incidence with current partnership status and marital history over three decades. SSM Popul Health 2022; 18:101080. [PMID: 35372659 PMCID: PMC8971638 DOI: 10.1016/j.ssmph.2022.101080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/01/2022] [Accepted: 03/22/2022] [Indexed: 12/16/2022] Open
Abstract
Married men and women have better health than non-married, but little is known about how cohabitation and marital history are associated with coronary heart disease (CHD) incidence and how these associations have changed over time. We analyzed these associations by fitting Cox regression models to register data covering the whole Finnish population aged 35 years or older (N = 4,415,590), who experienced 530,560 first time non-fatal or fatal CHD events during the years 1990–2018. Further, we used stratified Cox regression models to analyze CHD incidence within same-sex sibling pairs (N = 377,730 pairs). Married men and women without previous divorce had the lowest CHD incidence whereas cohabitation and a history of divorce were associated with higher CHD incidence. The associations were stronger in younger (35–64 years old) than older participants (65 years or older). These associations remained after adjusting for several indicators of social position, and the lower CHD incidence among those married without previous divorce was also observed within sibling pairs with a shared family background. The differences in CHD incidence between the categories generally widened over time; the largest and most systematic widening was observed among women in the younger age category. The long standing negative effect of divorce suggests that selection may partly explain the association between partnership status and CHD incidence. Partnership status is an increasingly important factor contributing to social inequalities in health. Married men and women without previous divorce history have the lowest CHD risk. Cohabitation is associated with higher CHD risk than marriage. The associations between partnership and CHD risk are not explained by social factors. These associations generally widened over time, especially among women.
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10
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Leung CY, Huang HL, Abe SK, Saito E, Islam MR, Rahman MS, Ikeda A, Sawada N, Tamakoshi A, Gao YT, Koh WP, Shu XO, Sakata R, Tsuji I, Kim J, Park SK, Nagata C, You SL, Yuan JM, Shin MH, Pan WH, Tsugane S, Kimura T, Wen W, Cai H, Ozasa K, Matsuyama S, Kanemura S, Sugawara Y, Shin A, Wada K, Chen CJ, Wang R, Ahn YO, Ahsan H, Boffetta P, Chia KS, Matsuo K, Qiao YL, Rothman N, Zheng W, Kang D, Inoue M. Association of Marital Status With Total and Cause-Specific Mortality in Asia. JAMA Netw Open 2022; 5:e2214181. [PMID: 35639382 PMCID: PMC9157263 DOI: 10.1001/jamanetworkopen.2022.14181] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE Marital status has been shown to be associated with mortality, but evidence in Asian populations is limited. OBJECTIVE To examine the association of marital status with total and cause-specific mortality. DESIGN, SETTING, AND PARTICIPANTS This cohort study included individual participant data from 16 prospective studies in the Asia Cohort Consortium conducted between 1963 and 2015. Asian participants with complete information on marital and vital status were included. Study-specific hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards model and then pooled using a random-effects meta-analysis. The analysis began in February 2021 and ended in August 2021. EXPOSURES Marital status. MAIN OUTCOMES AND MEASURES All-cause and cause-specific mortality. RESULTS Of 623 140 participants (326 397 women [52.4%] and 296 743 men [47.6%]; mean [SD] age, 53.7 [10.2] years; mean [SD] follow-up time, 15.5 [6.1] years), 123 264 deaths were ascertained. Compared with married individuals, those who were unmarried had pooled HRs of 1.15 (95% CI, 1.07-1.24) for total mortality, 1.12 (95% CI, 1.03-1.22) for cerebrovascular disease mortality, 1.20 (95% CI, 1.09-1.31) for coronary heart disease mortality, 1.17 (95% CI, 1.07-1.28) for circulatory system diseases mortality, 1.06 (95% CI, 1.01-1.11) for cancer mortality, 1.14 (95% CI, 1.05-1.23) for respiratory diseases mortality, and 1.19 (95% CI, 1.05-1.34) for external causes of death. Positive associations with total mortality were also observed for those who were single (HR, 1.62; 95% CI, 1.41-1.86), separated (HR, 1.35; 95% CI, 1.13-1.61), divorced (HR, 1.38; 95% CI, 1.13-1.69), and widowed (HR, 1.09; 95% CI, 1.04-1.13). In subgroup analyses, the positive association persisted across baseline health conditions, and the risk of death was more pronounced among men or people younger than 65 years. CONCLUSIONS AND RELEVANCE This large pooled cohort study of individual participant data provides strong evidence that being unmarried, as well as belonging to the unmarried subcategories, was positively associated with total and cause-specific mortality. Investment of targeted social support services might need to be considered in light of the mortality differences between married and unmarried individuals.
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Affiliation(s)
- Chi Yan Leung
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Hsi-Lan Huang
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Sarah Krull Abe
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan
| | - Md. Rashedul Islam
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Md. Shafiur Rahman
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Ai Ikeda
- Juntendo University, School of Medicine, Department of Public Health, Tokyo, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
| | - Xiao-Ou Shu
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ritsu Sakata
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - Ichiro Tsuji
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jeongseon Kim
- Graduate School of Science and Policy, National Cancer Center, Gyeonggi-do, Republic of Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - San-Lin You
- School of Medicine and Big Data Research Center, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Myung-Hee Shin
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Wen-Harn Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Wanqing Wen
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Hui Cai
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kotaro Ozasa
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - Sanae Matsuyama
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Seiki Kanemura
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Sugawara
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Chien-Jen Chen
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Renwei Wang
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yoon-Ok Ahn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Keitaro Matsuo
- Division Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - You-Lin Qiao
- Center for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland
| | - Wei Zheng
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Daehee Kang
- College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Manami Inoue
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Department of Cancer Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Holt-Lunstad J. Social Connection as a Public Health Issue: The Evidence and a Systemic Framework for Prioritizing the "Social" in Social Determinants of Health. Annu Rev Public Health 2022; 43:193-213. [PMID: 35021021 DOI: 10.1146/annurev-publhealth-052020-110732] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is growing interest in and renewed support for prioritizing social factors in public health both in the USA and globally. While there are multiple widely recognized social determinants of health, indicators of social connectedness (e.g., social capital, social support, social isolation, loneliness) are often noticeably absent from the discourse. This article provides an organizing framework for conceptualizing social connection and summarizes the cumulative evidence supporting its relevance for health, including epidemiological associations, pathways, and biological mechanisms. This evidence points to several implications for prioritizing social connection within solutions across sectors, where public health work, initiatives, and research play a key role in addressing gaps. Therefore, this review proposes a systemic framework for cross-sector action to identify missed opportunities and guide future investigation, intervention, practice, and policy on promoting social connection and health for all. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Cavazzotto TG, de Lima Stavinski NG, Queiroga MR, da Silva MP, Cyrino ES, Serassuelo Junior H, Vieira ER. Age and Sex-Related Associations between Marital Status, Physical Activity and TV Time. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:502. [PMID: 35010761 PMCID: PMC8744982 DOI: 10.3390/ijerph19010502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/31/2021] [Accepted: 01/01/2022] [Indexed: 02/04/2023]
Abstract
Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health effect of marriage or divorce is age-dependent and differs between women and men. The study aimed to identify the age and sex-related associations between marital status with PA and TV time. We used data from Vigitel, an annual telephone survey started in 2006 in Brazil. We applied a complex sample logistic regression model to estimate the odds for PA and TV time comparing marital statuses according to age and sex subgroups, independent of obesity, hypertension, diabetes, self-assessed poor health, and smoking. Our sample included 561,837 individuals from 18 to 99 years, with a TV time > 3 h/day (prevalence = 25.2%) and PA > 150 min/week (prevalence = 35%). Later, we divided our sample in seven age groups by marital status and sex. Compared to single individuals, married men and women were less likely to watch TV more than 3 h/day in participants >30 years old. When compared to single, married participants were less likely to do more than 150 min of PA/week at younger age groups. Married women older than 40 years were more likely to do more than 150 min of PA/week than the single ones, while there were no differences among married men by age group. In conclusion, our study suggests that the investments in public policies to encourage the practice of PA and reduction of TV time could be based on the marital status, sex, and age, prioritizing less active groups.
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Affiliation(s)
| | - Natã Gomes de Lima Stavinski
- Graduate Program in Health Sciences, Center of Health Sciences, State University of Londrina, Londrina 86039-440, PR, Brazil
| | - Marcos Roberto Queiroga
- Department of Physical Education, Midwestern Parana State University, Guarapuava 85040-167, PR, Brazil
| | - Michael Pereira da Silva
- Graduate Program in Public Health, Faculty of Medicine, Federal University of Rio Grande, Rio Grande 96203-900, RIG, Brazil
| | - Edilson Serpeloni Cyrino
- Department of Physical Education, Faculty of Physical Education and Sport, State University of Londrina, Londrina 86057-970, PR, Brazil
| | - Helio Serassuelo Junior
- Department of Sports Science at the State University of Londrina, Londrina 86057-970, PR, Brazil
| | - Edgar Ramos Vieira
- Department of Physical Therapy, Florida International University, Miami, FL 33179, USA
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13
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Vila J. Social Support and Longevity: Meta-Analysis-Based Evidence and Psychobiological Mechanisms. Front Psychol 2021; 12:717164. [PMID: 34589025 PMCID: PMC8473615 DOI: 10.3389/fpsyg.2021.717164] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/17/2021] [Indexed: 11/13/2022] Open
Abstract
Over the past 60 years, evidence has accumulated on the fundamental role of supportive social relationships in individual health and longevity. This paper first summarizes the results of 23 meta-analyses published between 1994 and 2021, which include 1,187 longitudinal and cross-sectional studies with more than 1,458 million participants. The effect sizes reported in these meta-analyses are highly consistent with regard to the predicted link between social support and reduced disease and mortality; the meta-analyses also highlight various theoretical and methodological issues concerning the multi-dimensionality of the social support concept and its measurements, and the need to control potential confounding and moderator variables. This is followed by an analysis of the experimental evidence from laboratory studies on psychobiological mechanisms that may explain the effect of social support on health and longevity. The stress-buffering hypothesis is examined and extended to incorporate recent findings on the inhibitory effect of social support figures (e.g., the face of loved ones) on fear learning and defensive reactions alongside evidence on the effect of social support on brain networks that down-regulate the autonomic nervous system, HPA axis, and immune system. Finally, the paper discusses the findings in the context of three emerging research areas that are helping to advance and consolidate the relevance of social factors for human health and longevity: (a) convergent evidence on the effects of social support and adversity in other social mammals, (b) longitudinal studies on the impact of social support and adversity across each stage of the human lifespan, and (c) studies that extend the social support framework from individual to community and societal levels, drawing implications for large-scale intervention policies to promote the culture of social support.
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Affiliation(s)
- Jaime Vila
- Human Psychophysiology and Health Laboratory, Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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14
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Flores M, Ruiz JM, Butler EA, Sbarra DA, Garcia DO, Kohler L, Crane TE, Corbie-Smith G, Benavente V, Kroenke CH, Saquib N, Thomson CA. Does the Hispanic Mortality Advantage Vary by Marital Status Among Postmenopausal Women in the Women's Health Initiative? Ann Behav Med 2021; 55:612-620. [PMID: 33449073 DOI: 10.1093/abm/kaaa113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Literature assessing the effect of marital status on mortality has underrepresented, or altogether omitted Hispanics and the potential moderating effect of Hispanic ethnicity on these relationships. Given cultural and network dynamics, marital advantages in older Hispanic women may be greater than other groups given their family-focused, collectivist orientation. PURPOSE The purpose of this study was to understand whether older Hispanic women exhibited a more pronounced marital advantage as compared with non-Hispanic Whites. METHODS We used longitudinal data from the Women's Health Initiative (WHI) Observational Study and Clinical Trials (N = 161,808) collected initially from 1993 to 1998 and followed until 2018. Our sample excluded those respondents indicating "other" as their race-ethnicity and those missing marital status and race-ethnicity variables (N = 158,814). We used Cox-proportional hazards models to assess the association between race-ethnicity, marital status, and the interactive effect of race-ethnicity and marital status on survival. RESULTS After controlling for socioeconomic status (SES) and health controls, we found a Hispanic survival advantage when compared with non-Hispanic Whites and all other racial-ethnic groups with the exception of Asian/Pacific Islander women (all significant HRs < 0.78, all ps ≤ 0.001). Hispanics had a higher rate of divorce when compared with non-Hispanic Whites. The interactive effect of race-ethnicity and marital status was not significant. CONCLUSIONS U.S. Hispanic, postmenopausal women exhibit a mortality advantage over and above marital status despite their high rates of divorce. Implications and potential explanations are discussed. CLINICAL TRIAL REGISTRATION NCT00000611.
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Affiliation(s)
- Melissa Flores
- Center for Border Health Disparities, Health Sciences, The University of Arizona, Tucson, AZ.,The Department of Psychology, College of Science, The University of Arizona, Tucson, AZ
| | - John M Ruiz
- The Department of Psychology, College of Science, The University of Arizona, Tucson, AZ
| | - Emily A Butler
- Norton School of Family and Consumer Sciences, College of Agricultural Life Sciences, The University of Arizona, Tucson, AZ
| | - David A Sbarra
- The Department of Psychology, College of Science, The University of Arizona, Tucson, AZ
| | - David O Garcia
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
| | - Lindsay Kohler
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
| | - Tracy E Crane
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ.,College of Nursing, The University of Arizona, Tucson, AZ
| | | | | | - Candyce H Kroenke
- Kaiser Permanente Northern California Division of Research, Oakland, CA
| | - Nazmus Saquib
- College of Medicine, Sulaiman Al-Rajhi Colleges Al Bukairiyah, Saudi Arabia
| | - Cynthia A Thomson
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ
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15
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Holt-Lunstad J. The Major Health Implications of Social Connection. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2021. [DOI: 10.1177/0963721421999630] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The influence of social relationships extends beyond emotional well-being to influence long-term physical-health outcomes, including mortality risk. Despite the varied measurement approaches used to examine social relationships within the health literature, the data can be synthesized using social connection as an organizing framework. This review discusses cumulative scientific evidence of links between various aspects of social connection and mortality, as well as supporting evidence for links with morbidity and plausible mechanisms. This evidence fulfills the criteria outlined in the Bradford Hill guidelines for establishing causality. Despite strong evidence currently available, several gaps remain and will need to be addressed if society is to rise to the challenge of developing effective interventions to reduce risk associated with social disconnection. This evidence has important broader implications for medical practice and public health.
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16
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The balance of giving versus receiving social support and all-cause mortality in a US national sample. Proc Natl Acad Sci U S A 2021; 118:2024770118. [PMID: 34099550 PMCID: PMC8214686 DOI: 10.1073/pnas.2024770118] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
While numerous studies exist on the benefits of social support (both receiving and giving), little research exists on how the balance between the support that individuals regularly give versus that which they receive from others relates to physical health. In a US national sample of 6,325 adults from the National Survey of Midlife Development in the United States, participants were assessed at baseline on hours of social support given and received on a monthly basis, with all-cause mortality data collected from the National Death Index over a 23-y follow-up period. Participants who were relatively balanced in the support they gave compared to what they received had a lower risk of all-cause mortality than those who either disproportionately received support from others (e.g., received more hours of support than they gave each month) or disproportionately gave support to others (e.g., gave many more hours of support a month than they received). These findings applied to instrumental social support (e.g., help with transportation, childcare). Additionally, participants who gave a moderate amount of instrumental social support had a lower risk of all-cause mortality than those who either gave very little support or those who gave a lot of support to others. Associations were evident over and above demographic, medical, mental health, and health behavior covariates. Although results are correlational, one interpretation is that promoting a balance, in terms of the support that individuals regularly give relative to what they receive in their social relationships, may not only help to strengthen the social fabric of society but may also have potential physical health benefits.
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17
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Estrup S, Thygesen LC, Poulsen LM, Gøgenur I, Mathiesen O. Health care use before and after intensive care unit admission-A nationwide register-based study. Acta Anaesthesiol Scand 2021; 65:381-389. [PMID: 33174207 DOI: 10.1111/aas.13737] [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: 04/07/2020] [Revised: 07/23/2020] [Accepted: 10/26/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to describe healthcare utilization of patients admitted to ICU before and after ICU admission. METHODS Register-based study including adult patients discharged from ICU between January 1st, 2011 and December 31st, 2014. Reference group was a sex- and age-matched population not admitted to an ICU in the study period. Outcomes were hospital admissions, contacts to general practitioner or emergency services and municipality services from 1 year before ICU admission and up to 3 years after. RESULTS The study included 82 384 patients and an equal number of reference persons. Of patients with ICU admission, 48% were married (reference group 57%), 48% had elementary school education (reference group 38%) and 18% had a Charlson co-morbidity score of 5+ (4% in reference group). We found that 51% of patients with an ICU admission had been admitted to hospital in the year before ICU admission (reference group 15%) and 97% had a contact to a general practitioner (reference group 89%) in the same period. CONCLUSIONS Patients admitted to an ICU had increased use of both primary and secondary health care both before and for years after ICU treatment, even after adjustment for comorbidities and socio-economic factors.
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Affiliation(s)
- Stine Estrup
- Department of Anaesthesiology Centre for Anaesthesiological Research Zealand University Hospital Køge Køge Denmark
| | - Lau C Thygesen
- National Institute of Public HealthUniversity of Southern Denmark København Denmark
| | - Lone M Poulsen
- Department of Anaesthesiology Centre for Anaesthesiological Research Zealand University Hospital Køge Køge Denmark
| | - Ismail Gøgenur
- Department of Gastrointestinal Surgery Center for Surgical ScienceZealand University Hospital Køge Køge Denmark
| | - Ole Mathiesen
- Department of Anaesthesiology Centre for Anaesthesiological Research Zealand University Hospital Køge Køge Denmark
- Department of Clinical Medicine Copenhagen University København Denmark
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18
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Harada K, Hino K, Iida A, Yamazaki T, Usui H, Asami Y, Yokohari M. How Does Urban Farming Benefit Participants' Health? A Case Study of Allotments and Experience Farms in Tokyo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E542. [PMID: 33440713 PMCID: PMC7826565 DOI: 10.3390/ijerph18020542] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 11/16/2022]
Abstract
In Japan, the world's most rapidly aging country, urban farming is attracting attention as an infrastructure for health activities. In Tokyo, urban residents generally participate in two types of farming programs: allotments and experience farms. The availability of regular interaction among participants distinguishes these two programs. We quantitatively examined the difference in changes in self-reported health status between participants in these two types of urban farming. We obtained retrospective cross-sectional data from questionnaire surveys of 783 urban farming participants and 1254 nonparticipants and analyzed the data using ordinal logistic regressions. As a result, compared with nonparticipants, participants in both types of urban farming reported significantly improved self-rated health (SRH) and mental health (MH). After controlling for changes in their physical activity (PA), although participants in allotments did not report significant improvement in SRH and MH, those in experience farms did, suggesting that their health improvement was not only caused by an increase in PA but also by social interaction among participants. From the perspective of health promotion, public support is needed not only for the municipality's allotments but also for the experience farms operated by the farmers themselves.
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Affiliation(s)
- Kentaro Harada
- Urban & Spatial Development Headquarters, Nippon Koei Co., Ltd., Tokyo 102-8539, Japan;
| | - Kimihiro Hino
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan; (A.I.); (T.Y.); (H.U.); (Y.A.); (M.Y.)
| | - Akiko Iida
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan; (A.I.); (T.Y.); (H.U.); (Y.A.); (M.Y.)
| | - Takahiro Yamazaki
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan; (A.I.); (T.Y.); (H.U.); (Y.A.); (M.Y.)
| | - Hiroyuki Usui
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan; (A.I.); (T.Y.); (H.U.); (Y.A.); (M.Y.)
| | - Yasushi Asami
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan; (A.I.); (T.Y.); (H.U.); (Y.A.); (M.Y.)
| | - Makoto Yokohari
- Department of Urban Engineering, Graduate School of Engineering, The University of Tokyo, Tokyo 113-8656, Japan; (A.I.); (T.Y.); (H.U.); (Y.A.); (M.Y.)
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19
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Patterson SE, Margolis R, Verdery AM. Family embeddedness and older adult mortality in the United States. POPULATION STUDIES 2020; 74:415-435. [PMID: 33016247 PMCID: PMC7642151 DOI: 10.1080/00324728.2020.1817529] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022]
Abstract
Do different operationalizations of family structure offer different understandings of the links between family structure and older adult mortality? Using the American Health and Retirement Study (N = 29,665), we examine mortality risks by three measures of family structure: whether respondents have different family statuses (e.g. married vs. unmarried), volume of family members available (e.g. having one vs. two living immediate family members), and family embeddedness (e.g. having neither spouse nor child vs. having spouse but no child). We focus on three kin types: partner/spouse, children, and siblings. We find that differences in empirical estimates across measures of family structure are not dramatic, but that family embeddedness can show some additional heterogeneity in mortality patterns over family status variables or the volume of ties. This paper tests different ways of operationalizing family structure to study mortality outcomes and advances our understanding of how family functions as a key social determinant of health.
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20
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Abstract
A health paradox exists in the United States. Men have worse health outcomes than women, but national offices exist for promoting women's but not men's health. Two factors that might contribute to this paradox are: underappreciation for the number of health issues that affect men more than women and unawareness that men's health receives less attention than women's health. Therefore, the aim of this article was to summarize the data related to these two factors. First, using mostly government data, an inventory of health issues that are more common in males than females was generated, with prevalence rates listed. Second, results from two new scientometric analyses are presented: (a) number of times "men's health" and "women's health" appeared in titles or abstracts of papers in PubMed from 1970 to 2018; and (b) number of journals currently indexed in MEDLINE that specialize in men's or women's health. The epidemiological data illustrate numerous health issues are more prevalent in men than women, and scientometric data reveal men's health has been given less attention as a distinct field of biomedical research than women's health. This information can help to educate legislators, health officials, journalists, and the general public about the current paradox surrounding men's health in the United States.
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Affiliation(s)
- James L Nuzzo
- Neuroscience Research Australia, Randwick, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
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21
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Lomia N, Berdzuli N, Pestvenidze E, Sturua L, Sharashidze N, Kereselidze M, Topuridze M, Antelava T, Stray-Pedersen B, Stray-Pedersen A. Socio-Demographic Determinants of Mortality from Chronic Noncommunicable Diseases in Women of Reproductive Age in the Republic of Georgia: Evidence from the National Reproductive Age Mortality Study (2014). Int J Womens Health 2020; 12:89-105. [PMID: 32161506 PMCID: PMC7051896 DOI: 10.2147/ijwh.s235755] [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: 10/23/2019] [Accepted: 01/27/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Worldwide, noncommunicable diseases (NCDs) are the leading cause of premature death of women, taking the highest toll in developing countries. This study aimed to identify key socio-demographic determinants of NCD mortality in reproductive-aged women (15-49 years) in Georgia. Materials and Methods The study employed the verbal autopsy data from the second National Reproductive Age Mortality Survey 2014. Univariate and multivariate logistic regression models were fitted to explore the association between each risk factor and NCD mortality, measured by crude and adjusted odds ratio (AOR) with respective 95% confidence intervals (95% CI). Results In the final sample of 843 women, 586 (69.5%) deaths were attributed to NCDs, the majority of which occurred outside a hospital (72.7%) and among women aged 45-49 years (46.8%), ethnic Georgians (85.2%), urban residents (60.1%), those being married (60.6%), unemployed (75.1%) or having secondary and higher education (69.5%), but with nearly equal distribution across the wealth quintiles. After multivariate adjustment, the odds of dying from NCDs were significantly higher in women aged 45-49 years (AOR=17.69, 95% CI= 9.35 to 33.50), those being least educated (AOR=1.55, 95% CI= 1.01 to 2.37) and unemployed (AOR=1.47, 95% CI= 1.01 to 2.14) compared, respectively, to their youngest (15-24 years), more educated and employed counterparts. Strikingly, the adjusted odds were significantly lower in "other" ethnic minorities (AOR=0.29, 95% CI= 0.14 to 0.61) relative to ethnic Georgians. Contrariwise, there were no significant associations between NCD mortality and women's marital or wealth status, place of residence (rural/urban) or place of death. Conclusion Age, ethnicity, education, and employment were found to be strong independent predictors of young women's NCD mortality in Georgia. Further research on root causes of inequalities in mortality across the socioeconomic spectrum is warranted to inform equity- and life course-based multisectoral, integrated policy responses that would be conducive to enhancing women's survival during and beyond reproduction.
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Affiliation(s)
- Nino Lomia
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nino Berdzuli
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ekaterine Pestvenidze
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lela Sturua
- Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Nino Sharashidze
- Department of Clinical and Research Skills, Faculty of Medicine, Iv. Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Maia Kereselidze
- Department of Medical Statistics, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | - Marina Topuridze
- Health Promotion Division, Department of Noncommunicable Diseases, National Center for Disease Control and Public Health, Tbilisi, Georgia
| | | | - Babill Stray-Pedersen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Obstetrics and Gynecology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Arne Stray-Pedersen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway
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22
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Cribbet MR, Smith TW, Uchino BN, Baucom BRW, Nealey-Moore JB. Autonomic influences on heart rate during marital conflict: Associations with high frequency heart rate variability and cardiac pre-ejection period. Biol Psychol 2020; 151:107847. [PMID: 31962138 DOI: 10.1016/j.biopsycho.2020.107847] [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: 06/04/2018] [Revised: 12/04/2019] [Accepted: 01/16/2020] [Indexed: 11/30/2022]
Abstract
Psychosocial factors predict the development and course of cardiovascular disease, perhaps through sympathetic and parasympathetic mechanisms. At rest, heart rate (HR) is under parasympathetic control, often measured as high-frequency heart rate variability (HF-HRV). During stress, HR is influenced jointly by parasympathetic and sympathetic processes, the latter often quantified as pre-ejection period (PEP). In studies of cardiovascular risk factors that involve social interaction (e.g. marital conflict), HF-HRV might be altered by speech artifacts, weakening its validity as a measure of parasympathetic activity. To evaluate this possibility, we tested associations of HF-HRV and PEP with HR at rest and across periods of marital conflict interaction that varied in experimentally-manipulated degrees of speech in 104 couples. At rest, only HF-HRV was independently related to HR, for both husbands and wives. During speaking, listening, and recovery periods, husbands' and wives' HF-HRV and PEP change independently predicted HR change. These findings support interpretation of HF-HRV as a parasympathetic index during stressful social interactions that may confer risk for cardiovascular disease.
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23
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Abstract
AbstractResearch shows consistently that social ties are important for longevity, and they may be particularly important during adolescence. An absence of social ties, or social isolation, during adolescence may adversely affect long-term health and wellbeing. While prior research has examined associations between isolation from friends and long-term health, and having no siblings and mortality, no study (of which we are aware) considers jointly both the role of having no friends and no siblings, nor more generally with whom adolescents spend time, and the risk of premature mortality. This paper extends the literature by drawing on data from the Stockholm Birth Cohort Study to examine the association between different types of social isolation during adolescence (i.e., an absence of friends, siblings, and time with other adolescents) and the risk of premature mortality by midlife. Results suggest that having no siblings, being unliked at school, and spending (mostly) no time with other adolescents, increases the risk of premature mortality. The association between being unliked and premature mortality was attenuated by demographic and adolescent characteristics. Consistent with our expectations, net of a robust set of covariates, adolescents who had no siblings and mostly spent no time with other adolescents (i.e., isolates) were the group most vulnerable to premature mortality by midlife. However, this was only true for females.
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24
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Holt-Lunstad J, Robles TF, Sbarra DA. Advancing social connection as a public health priority in the United States. ACTA ACUST UNITED AC 2018; 72:517-530. [PMID: 28880099 DOI: 10.1037/amp0000103] [Citation(s) in RCA: 404] [Impact Index Per Article: 67.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A robust body of scientific evidence has indicated that being embedded in high-quality close relationships and feeling socially connected to the people in one's life is associated with decreased risk for all-cause mortality as well as a range of disease morbidities. Despite mounting evidence that the magnitude of these associations is comparable to that of many leading health determinants (that receive significant public health resources), government agencies, health care providers and associations, and public or private health care funders have been slow to recognize human social relationships as either a health determinant or health risk marker in a manner that is comparable to that of other public health priorities. This article evaluates current evidence (on social relationships and health) according to criteria commonly used in determining public health priorities. The article discusses challenges for reducing risk in this area and outlines an agenda for integrating social relationships into current public health priorities. (PsycINFO Database Record
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25
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The increasing mortality advantage of the married: The role played by education. DEMOGRAPHIC RESEARCH 2018. [DOI: 10.4054/demres.2018.38.20] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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26
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Zandara M, Garcia-Lluch M, Villada C, Hidalgo V, Salvador A. Searching for a job: Cardiac responses to acute stress and the mediating role of threat appraisal in young people. Stress Health 2018; 34:15-23. [PMID: 28417549 DOI: 10.1002/smi.2757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 11/09/2022]
Abstract
Being unemployed and looking for a job has become a source of stress for many people in several European countries. However, little attention has been paid to the impact of this stressful situation on the individuals' psychophysiological stress responses. The aim of this study was to investigate the effect of being an unemployed job seeker on cognitive threat appraisal and cardiac responses to a psychosocial stressor. We exposed a group of unemployed job seekers (N = 42) and a matched group of unemployed non-job seekers (N = 40) to a standardized social stressor in form of job interview, the Trier Social Stress Test. Our results showed that unemployed job seekers manifest lower cardiac responses, along with a lower cognitive threat appraisal, compared to non-job seekers. Moreover, we observed a full mediating role of cognitive threat appraisal on the relationship between being an unemployed job seeker and cardiac responses to stress. These findings reveal that being unemployed and looking for a job has an effect on physiological responses to acute stress, as well as the importance of psychological process related to the situation. These responses might lead to negative health and motivational consequences. Theoretical and practical implications are discussed.
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Affiliation(s)
- M Zandara
- Research Institute on Personnel Psychology, Organizational Development and Quality of Working Life (IDOCAL), Department of Social Psychology, University of Valencia, Valencia, Spain
| | - M Garcia-Lluch
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain
| | - C Villada
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain.,Department of health psychology, Area of Psychobyology, Miguel Hernández de Elche University (UMH), Alicante, Spain
| | - V Hidalgo
- Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - A Salvador
- Research Institute on Personnel Psychology, Organizational Development and Quality of Working Life (IDOCAL), Department of Social Psychology, University of Valencia, Valencia, Spain.,Laboratory of Social Cognitive Neuroscience, Department of Psychobiology, IDOCAL, University of Valencia, Valencia, Spain
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Rimé B. Comment: Social Integration and Health: Contributions of the Social Sharing of Emotion at the Individual, the Interpersonal, and the Collective Level. EMOTION REVIEW 2018. [DOI: 10.1177/1754073917719330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Among the four components proposed by Sbarra and Coan (2018) to guide the research aimed at understanding the role of emotion in the connection between social relationship and health, I view the fourth one, labeled “transactional dimensions,” as offering particularly rich promises in this regard. To illustrate, I sketch the example of individual, interpersonal, and collective effects entailed by the process of social sharing of emotion. The example rests on the bidirectional flow of transactions that develops continuously between these three levels.
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Affiliation(s)
- Bernard Rimé
- Psychological Sciences Research Institute (IPSY), University of Louvain at Louvain-la-Neuve, Belgium
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Holt-Lunstad J. Why Social Relationships Are Important for Physical Health: A Systems Approach to Understanding and Modifying Risk and Protection. Annu Rev Psychol 2018; 69:437-458. [DOI: 10.1146/annurev-psych-122216-011902] [Citation(s) in RCA: 296] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Julianne Holt-Lunstad
- Departments of Psychology and Neuroscience, Brigham Young University, Provo, Utah 84602
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Holt-Lunstad J. The Potential Public Health Relevance of Social Isolation and Loneliness: Prevalence, Epidemiology, and Risk Factors. ACTA ACUST UNITED AC 2018. [DOI: 10.1093/ppar/prx030] [Citation(s) in RCA: 205] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Marital status integration and suicide: A meta-analysis and meta-regression. Soc Sci Med 2018; 197:116-126. [DOI: 10.1016/j.socscimed.2017.11.053] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 11/23/2017] [Accepted: 11/28/2017] [Indexed: 11/19/2022]
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Ironson G, Henry SM, Gonzalez BD. Impact of stressful death or divorce in people with HIV: A prospective examination and the buffering effects of religious coping and social support. J Health Psychol 2017; 25:606-616. [PMID: 28840762 DOI: 10.1177/1359105317726151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined the impact of a stressful death/divorce on psychological and immune outcomes in people with HIV. People with HIV with stressful death/divorce were examined from before the event to up to 12 months later (n = 45); controls were assessed at similar intervals (n = 112). Stressful deaths/divorces were associated with increased viral load and anxiety over time (ps ≤ .014), but not CD4+ or depression. Increased use of religious coping after the stressful death/divorce was associated with slower increases in viral load (p = .010). These data suggest people with HIV should consider the potentially elevated risk of transmission after such events and seek appropriate monitoring and care.
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J-Curve? A Meta-Analysis and Meta-Regression of Parity and Parental Mortality. POPULATION RESEARCH AND POLICY REVIEW 2016. [DOI: 10.1007/s11113-016-9421-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 10:227-37. [PMID: 25910392 DOI: 10.1177/1745691614568352] [Citation(s) in RCA: 2466] [Impact Index Per Article: 274.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.
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Affiliation(s)
| | - Timothy B Smith
- Department of Counseling Psychology, Brigham Young University
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Abstract
This cross-sectional study intended to assess the use of prenatal care according to the family structure in a population with free universal access to prenatal care. In 2005-2006, the Portuguese birth cohort was assembled by the recruitment of puerperae at public maternity wards in Porto, Portugal. In the current analysis, 7,211 were included. Data on socio-demographic characteristics, obstetric history, and prenatal care were self-reported. Single mothers were considered as those whose household composition did not include a partner at delivery. Approximately 6% of the puerperae were single mothers. These women were more likely to have an unplanned pregnancy (OR = 6.30; 95%CI: 4.94-8.04), an inadequate prenatal care (OR = 2.30; 95%CI: 1.32-4.02), and to miss the ultrasound and the intake of folic acid supplements during the first trimester of pregnancy (OR = 1.71; 95%CI: 1.30-2.27; and OR = 1.67; 95%CI: 1.32-2.13, respectively). The adequacy and use of prenatal care was less frequent in single mothers. Educational interventions should reinforce the use and early initiation of prenatal care.
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Affiliation(s)
- Elisabete Alves
- Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Susana Silva
- Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | | | - Henrique Barros
- Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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How much of the variation in mortality across Norwegian municipalities is explained by the socio-demographic characteristics of the population? Health Place 2015; 33:148-58. [DOI: 10.1016/j.healthplace.2015.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 02/27/2015] [Accepted: 02/27/2015] [Indexed: 11/19/2022]
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Kravdal Ø, Grundy E. Underuse of medication for circulatory disorders among unmarried women and men in Norway? BMC Pharmacol Toxicol 2014; 15:65. [PMID: 25420870 PMCID: PMC4280763 DOI: 10.1186/2050-6511-15-65] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 10/24/2014] [Indexed: 01/25/2023] Open
Abstract
Background It is well established that unmarried people have higher mortality from circulatory diseases and higher all-cause mortality than the married, and these marital status differences seem to be increasing. However, much remains to be known about the underlying mechanisms. Our objective was to examine marital status differences in the purchase of medication for circulatory diseases, and risk factors for them, which may indicate underuse of such medication by some marital status groups. Methods Using data from registers covering the entire Norwegian population, we analysed marital status differences in the purchase of medicine for eight circulatory disorders by people aged 50-79 in 2004-2008. These differences were compared with those in circulatory disease mortality during 2004-2007, considered as indicating probable differences in disease burden. Results The unmarried had 1.4-2.8 times higher mortality from the four types of circulatory diseases considered. However, the never-married in particular purchased less medicine for these diseases, or precursor risk factors of these diseases, primarily because of a low chance of making a first purchase. The picture was more mixed for the divorced and widowed. Both groups purchased less of some of these medicines than the married, but, especially in the case of the widowed, relatively more of other types of medicine. In contrast to the never-married, divorced and widowed people were as least as likely as the married to make a first purchase, but adherence rates thereafter, indicated by continuing purchases, were lower. Conclusion The most plausible interpretation of the findings is that compared with married people, especially the never-married more often have circulatory disorders that are undiagnosed or for which they for other reasons underuse medication. Inadequate use of these potentially very efficient medicines in such a large population group is a serious public health challenge which needs further investigation. It is possible that marital status differences in use of medicines for circulatory disorders combined with an increasing importance of these medicines have contributed to the widening marital status gap in mortality observed in several countries. This also requires further investigation.
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Noncancer-related mortality risks in adult survivors of pediatric malignancies: the childhood cancer survivor study. J Cancer Surviv 2014; 8:460-71. [PMID: 24719269 DOI: 10.1007/s11764-014-0353-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 03/11/2014] [Indexed: 12/21/2022]
Abstract
PURPOSE We sought to identify factors, other than cancer-related treatment and presence/severity of chronic health conditions, which may be associated with late mortality risk among adult survivors of pediatric malignancies. METHODS Using the Childhood Cancer Survivor Study cohort and a case-control design, 445 participants who died from causes other than cancer recurrence/progression or non-health-related events were compared with 7,162 surviving participants matched for primary diagnosis, age at baseline questionnaire, time from diagnosis to baseline questionnaire, and time at-risk. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated for overall/cause-specific mortality. Independent measures included number/severity of chronic conditions, medical care, health-related behaviors, and health perceptions/concerns. RESULTS Adjusting for education, income, chemotherapy/radiation exposures, and number/severity of chronic health conditions, an increased risk for all-cause mortality was associated with exercising fewer than 3 days/week (OR = 1.72, CI 1.27-2.34), being underweight (OR = 2.58, CI 1.55-4.28), increased medical care utilization (P < 0.001), and self-reported fair to poor health (P < 0.001). Physical activity was associated with a higher risk of death among males (OR = 3.26, CI 1.90-5.61) reporting no exercise compared to those who exercised ≥3 times per week. Ever consuming alcohol was associated with a reduced risk of all-cause (OR = 0.61, CI 0.41-0.89) and other nonexternal causes of death (OR = 0.40, CI 0.20-0.79). Concerns/worries about future health (OR = 1.54, CI 1.10-2.71) were associated with increased all-cause mortality. CONCLUSIONS Factors independent of cancer treatment and chronic health conditions modify the risk of death among adult survivors of pediatric cancer. IMPLICATIONS FOR CANCER SURVIVORS Continued cohort observation may inform interventions to reduce mortality.
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Smith TW, Baron CE, Grove JL. Personality, Emotional Adjustment, and Cardiovascular Risk: Marriage as a Mechanism. J Pers 2013; 82:502-14. [DOI: 10.1111/jopy.12074] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Siegler IC, Brummett BH, Martin P, Helms MJ. Consistency and timing of marital transitions and survival during midlife: the role of personality and health risk behaviors. Ann Behav Med 2013; 45:338-47. [PMID: 23299546 PMCID: PMC3644000 DOI: 10.1007/s12160-012-9457-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Marital status is associated with survival. PURPOSE The aims of this study are to evaluate marital history and timing on mortality during midlife, test the role of pre-marital personality, and quantify the role of health risk behaviors. METHODS Cox proportional hazard models were run with varying classifications of marital history and sets of covariates. RESULTS In fully adjusted models compared to the currently married, lifetime marital history predicts premature mortality with never married at 2.33 times risk of death and ever married at 1.64 risk of death. Midlife marital history shows that not having a partner during midlife (hazard ratio (HR) = 3.10 formerly married; HR = 2.59 remaining single) has the highest risk of death. Controlling for personality and health risk behaviors reduces but does not eliminate the impact of marital status. CONCLUSION Consistency of marital status during midlife suggests that lack of a partner is associated with midlife mortality.
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Affiliation(s)
- Ilene C Siegler
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
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Kravdal Ø. The poorer cancer survival among the unmarried in Norway: is much explained by comorbidities? Soc Sci Med 2013; 81:42-52. [PMID: 23422059 DOI: 10.1016/j.socscimed.2013.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 01/03/2013] [Accepted: 01/12/2013] [Indexed: 12/19/2022]
Abstract
Studies from Norway and other countries have shown that the unmarried have poorer cancer survival than the married, given age, tumor site and stage at diagnosis. The objective of this investigation was to assess the importance of comorbidities for this difference, using disease indicators derived from the Norwegian Prescription Database (NorPD) and information on cancer and sociodemographic characteristics from various other registers, all of which cover the entire Norwegian population. Discrete-time hazard models for cancer mortality up to 2007 were estimated for all 22,925 men and 21,694 women diagnosed with 13 common types of cancer in 2005-7. There were 4898 cancer deaths among men and 4187 among women. Controlling for sociodemographic factors and tumor characteristics, the odds of dying from cancer among never-married men relative to the married was 1.56 (CI 1.41-1.74). The corresponding estimates for widowed and divorced were 1.16 (CI 1.05-1.28) and 1.27 (CI 1.15-1.40). For women, the odds ratios for these three groups were 1.47 (CI 1.29-1.67), 1.10 (CI 1.01-1.20) and 1.14 (CI 1.02-1.27). Several of the 24 indicators of diseases in the year before diagnosis were associated with cancer survival, but their inclusion reduced the excess mortality of the unmarried by only 1-5 percentage points, or about 10% as an overall relative figure. Similar results were found when the four most common cancers were analyzed separately, though there were some differences between them in the role played by the comorbidities. It is possible that important comorbidities are inadequately captured by the included indicators, and perhaps especially for the unmarried. Such concerns aside, the results suggest that the marital status differences in cancer survival to little extent are due to comorbidities (and the few disease risk factors that are also captured), but rather to various other "host factors" or to treatment or care.
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Roelfs DJ, Shor E, Falzon L, Davidson KW, Schwartz JE. Meta-Analysis for Sociology - A Measure-Driven Approach. BULLETIN DE METHODOLOGIE SOCIOLOGIQUE : BMS 2013; 117:75-92. [PMID: 24163498 PMCID: PMC3806145 DOI: 10.1177/0759106312465554] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Meta-analytic methods are becoming increasingly important in sociological research. In this article we present an approach for meta-analysis which is especially helpful for sociologists. Conventional approaches to meta-analysis often prioritize "concept-driven" literature searches. However, in disciplines with high theoretical diversity, such as sociology, this search approach might constrain the researcher's ability to fully exploit the entire body of relevant work. We explicate a "measure-driven" approach, in which iterative searches and new computerized search techniques are used to increase the range of publications found (and thus the range of possible analyses) and to traverse time and disciplinary boundaries. We demonstrate this measure-driven search approach with two meta-analytic projects, examining the effects of various social variables on all-cause mortality.
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Affiliation(s)
| | - Eran Shor
- Corresponding Author: Eran Shor, Department of Sociology, McGill University, 855 Sherbrooke Street West, Montreal, Quebec, Canada H3A 2T7,
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Berntsen KN, Kravdal Ø. The relationship between mortality and time since divorce, widowhood or remarriage in Norway. Soc Sci Med 2012; 75:2267-74. [DOI: 10.1016/j.socscimed.2012.08.028] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Revised: 06/06/2012] [Accepted: 08/27/2012] [Indexed: 01/08/2023]
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Stimpson JP, Wilson FA, Watanabe-Galloway S, Peek MK. The effect of marriage on utilization of colorectal endoscopy exam in the United States. Cancer Epidemiol 2012; 36:e325-32. [PMID: 22633538 DOI: 10.1016/j.canep.2012.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 05/01/2012] [Accepted: 05/07/2012] [Indexed: 12/31/2022]
Abstract
PURPOSE This study examines the association between marriage and colorectal endoscopy exam, and whether this association varies by gender and financial benefits of marriage including improved access to health insurance and pooled family income. METHODS Representative survey data of the non-institutionalized United States population were used from the 2000, 2005, and 2008 National Health Interview Survey. Analyses targeted persons 50-85 years of age without a personal history of cancer and with complete information on all study variables (n=21,760). Multivariate logistic regression was used to model marital status differences in the probability of undergoing a colorectal endoscopy exam with interaction effects used to model variation over time by gender, health insurance, and poverty level. RESULTS Married persons were more likely than unmarried persons to report ever having undergone a colorectal endoscopy exam (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12-1.29), and the difference between married and unmarried persons in the probability of undergoing a colorectal endoscopy exam remained stable over time. Married persons were more likely than unmarried persons to report having undergone a colorectal endoscopy exam within the past 10 years (OR, 1.49; 95% CI, 1.15-1.95). For each survey year, married men were significantly more likely than women and unmarried men to report having undergone a colorectal endoscopy exam. For example, in 2008, 56% of married men reported having undergone a colorectal endoscopy exam, compared to 49% of unmarried men, 52% of married women, and 50% of unmarried women. Among persons with health insurance, married persons were significantly more likely than unmarried persons to have undergone a colorectal endoscopy exam. Among persons who were poor, there was no difference by marital status in the likelihood of having undergone a colorectal endoscopy exam. However, among persons who were not poor, married persons were more likely than unmarried persons to have undergone a colorectal endoscopy exam. CONCLUSION Given that colorectal endoscopy exams are a potentially life-saving procedure, persistently higher uptake of colorectal endoscopy for married persons over time may be an important health promoting benefit of marriage. Therefore, clinicians and policy makers should focus on improving the use of cancer prevention services among unmarried persons.
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Affiliation(s)
- Jim P Stimpson
- University of Nebraska Medical Center, 984350 Nebraska Medical Center, Omaha, NE 68198-4350, USA.
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Meta-analysis of marital dissolution and mortality: reevaluating the intersection of gender and age. Soc Sci Med 2012; 75:46-59. [PMID: 22534377 DOI: 10.1016/j.socscimed.2012.03.010] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 02/21/2012] [Accepted: 03/13/2012] [Indexed: 11/21/2022]
Abstract
The study of marital dissolution (i.e. divorce and separation) and mortality has long been a major topic of interest for social scientists. We conducted meta-analyses and meta-regressions on 625 mortality risk estimates from 104 studies, published between 1955 and 2011, covering 24 countries, and providing data on more than 600 million persons. The mean hazard ratio (HR) for mortality in our meta-analysis was 1.30 (95% confidence interval [CI], 1.23-1.37) among HRs adjusted for age and additional covariates. The mean HR was higher for men (HR, 1.37; 95% CI, 1.27-1.49) than for women (HR, 1.22; 95% CI: 1.13-1.32), but the difference between men and women decreases as the mean age increases. Other significant moderators of HR magnitude included sample size; being from Western Europe, Israel, the United Kingdom and former Commonwealth nations; and statistical adjustment for general health status.
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