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Schrock JM. Accelerated aging in people living with HIV: The neuroimmune feedback model. Brain Behav Immun Health 2024; 36:100737. [PMID: 38356933 PMCID: PMC10864877 DOI: 10.1016/j.bbih.2024.100737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/02/2024] [Accepted: 02/04/2024] [Indexed: 02/16/2024] Open
Abstract
People living with HIV (PLWH) experience earlier onset of aging-related comorbidities compared to their counterparts without HIV. This paper lays out a theoretical model to explain why PLWH experience accelerated aging. Briefly, the model is structured as follows. PLWH experience disproportionately heavy burdens of psychosocial stress across the life course. This psychosocial stress increases risks for depressive symptoms and problematic substance use. Depressive symptoms and problematic substance use interfere with long-term adherence to antiretroviral therapy (ART). Lower ART adherence, in turn, exacerbates the elevated systemic inflammation stemming from HIV infection. This inflammation increases risks for aging-related comorbidities. Systemic inflammation also reduces connectivity in the brain's central executive network (CEN), a large-scale brain network that is critical for coping with stressful circumstances. This reduced capacity for coping with stress leads to further increases in depressive symptoms and problematic substance use. Together, these changes form a neuroimmune feedback loop that amplifies the impact of psychosocial stress on aging-related comorbidities. In this paper, I review the existing evidence relevant to this model and highlight directions for future research.
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Affiliation(s)
- Joshua M. Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, United states
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Schrock JM, Nusslock R, McDade TW, Mustanski B. Trauma History Predicts Decoupling of C-Reactive Protein and Somatic Symptoms: Results From a Cohort Study of Sexual and Gender Minority Youth. Psychosom Med 2023; 85:397-407. [PMID: 37097108 PMCID: PMC10730330 DOI: 10.1097/psy.0000000000001209] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
OBJECTIVE Systemic inflammation can induce somatic symptoms (e.g., pain, nausea, fatigue) through neuroimmune signaling pathways. Previous research suggests that early-life adversity amplifies signaling between peripheral inflammation and the brain. We therefore hypothesized that greater lifetime trauma exposure at baseline would predict stronger associations between systemic inflammation and somatic symptoms at 2.5-year follow-up in a cohort study of sexual and gender minority youth assigned male at birth ( n = 694). METHODS We measured prior trauma exposure (lifetime count of traumatic event types reported at baseline), somatic symptoms (Brief Symptom Inventory somatization score), and systemic inflammation (C-reactive protein, interleukin 6, interleukin 1β, and tumor necrosis factor α). All models included age, gender, education, recent trauma exposure, substance use, body mass index, and HIV status as covariates. RESULTS Higher C-reactive protein concentrations were associated with greater somatic symptoms in the main effects model ( β = 0.019, 95% confidence interval [CI] = 0.006 to 0.031). Contrary to our hypothesis, we observed a negative interaction between prior trauma exposure and C-reactive protein levels in predicting somatic symptoms ( β = -0.017, 95% CI = -0.030 to -0.004). Higher C-reactive protein was associated with greater somatic symptoms only in participants without prior trauma exposure at baseline ( β = 0.044, 95% CI = 0.026 to 0.062). Specificity analyses revealed similar patterns when nonsomatic depressive symptoms were used as the outcome variable. CONCLUSIONS These results suggest that sexual and gender minority youth assigned male at birth who have a history of prior trauma exposure may experience decoupling of systemic inflammation and somatic symptoms. The absence of inflammation-related symptoms may prevent individuals from seeking necessary medical care by reducing interoceptive awareness of pathological states.
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Affiliation(s)
- Joshua M. Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL, USA 60611
| | - Robin Nusslock
- Department of Psychology, Northwestern University, 2029 Sheridan Rd, Evanston, IL USA 60208
- Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL, USA 60208
| | - Thomas W. McDade
- Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL, USA 60208
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL, USA 60208
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL, USA 60611
- Department of Medical Social Sciences, Northwestern University, 625 N Michigan Ave, 21st Floor, Chicago, IL, USA 60611
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Schrock JM, McDade TW, D'Aquila RT, Mustanski B. Does body mass index explain the apparent anti-inflammatory effects of cannabis use? Results From a cohort study of sexual and gender minority youth. Drug Alcohol Depend 2022; 233:109344. [PMID: 35182843 PMCID: PMC8988174 DOI: 10.1016/j.drugalcdep.2022.109344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/28/2022] [Accepted: 01/29/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cannabis use has been linked to lower systemic inflammation, but the pathways connecting cannabis use and systemic inflammation are unclear. Here we investigate whether body mass index (BMI) accounts for the association between cannabis use and systemic inflammation in a cohort of sexual and gender minority youth assigned male at birth (n = 712). METHODS Substance use was assessed across six biannual visits. Cannabis use was measured using the Cannabis Use Disorders Identification Test-Revised (CUDIT-R) and urine screening for tetrahydrocannabinol (THC). At the final visit, BMI was measured, and a plasma sample was collected to measure biomarkers of systemic inflammation: C-reactive protein (CRP), interleukin-6, interleukin-1β, and tumor necrosis factor-α. Inflammatory markers were log2-transformed. Age, gender, race/ethnicity, education, HIV status, cigarette use, alcohol use, and polydrug use were included as covariates. RESULTS In models including all covariates except BMI, greater cumulative CUDIT-R score was associated with lower CRP (β = -0.14; 95% CI: -0.22,-0.05) and lower interleukin-6 (β = -0.12; 95% CI: -0.21,-0.04). These associations were attenuated when BMI was added to the model. Mediation analyses revealed an indirect effect of cumulative CUDIT-R score on CRP (β = -0.08; 95% CI: -0.12,-0.05) and interleukin-6 (β = -0.08; 95% CI: -0.12,-0.05), mediated by BMI. Models using urine THC or self-reported frequency to operationalize cannabis use produced similar results. We found no clear evidence that HIV status moderates these associations. CONCLUSIONS These results suggest that BMI may partially account for the apparent anti-inflammatory effects of cannabis use. Research on the mechanisms linking cannabis use, adiposity, and inflammation may uncover promising intervention targets.
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Affiliation(s)
- Joshua M Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL 60611, USA; Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA.
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA; Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
| | - Richard T D'Aquila
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Street, Arkes Suite 2330, Chicago, IL 60611, USA.
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 14, Chicago, IL 60611, USA; Department of Medical Social Sciences, Northwestern University, 625 N Michigan Ave, 21st Floor, Chicago, IL 60611, USA.
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Mustanski B, Saber R, Ryan DT, Benbow N, Madkins K, Hayford C, Newcomb ME, Schrock JM, Vaught LA, Reiser NL, Velez MP, Hsieh RR, Demonbreun AR, D'Aquila R, McNally EM, McDade TW. Geographic disparities in COVID-19 case rates are not reflected in seropositivity rates using a neighborhood survey in Chicago. Ann Epidemiol 2022; 66:44-51. [PMID: 34728335 PMCID: PMC8557112 DOI: 10.1016/j.annepidem.2021.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 10/10/2021] [Accepted: 10/22/2021] [Indexed: 12/27/2022]
Abstract
To date, COVID-19 case rates are disproportionately higher in Black and Latinx communities across the US, leading to more hospitalizations, and deaths in those communities. These differences in case rates are evident in comparisons of Chicago neighborhoods with differing race and/or ethnicities of their residents. Disparities could be due to neighborhoods with more adverse health outcomes associated with poverty and other social determinants of health experiencing higher prevalence of SARS-CoV-2 infection or due to greater morbidity and mortality resulting from equivalent SARS-CoV-2 infection prevalence. We surveyed five pairs of adjacent ZIP codes in Chicago with disparate COVID-19 case rates for highly specific and quantitative serologic evidence of any prior infection by SARS-CoV-2 to compare with their disparate COVID-19 case rates. Dried blood spot samples were self-collected at home by internet-recruited participants in summer 2020, shortly after Chicago's first wave of the COVID-19 pandemic. Pairs of neighboring ZIP codes with very different COVID-19 case rates had similar seropositivity rates for anti-SARS-CoV-2 receptor binding domain IgG antibodies. Overall, these findings of comparable exposure to SARS-CoV-2 across neighborhoods with very disparate COVID-19 case rates are consistent with social determinants of health, and the co-morbidities related to them, driving differences in COVID-19 rates across neighborhoods.
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Affiliation(s)
- Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Rana Saber
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Daniel T Ryan
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Nanette Benbow
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Krystal Madkins
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Christina Hayford
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Joshua M Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Lauren A Vaught
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Nina L Reiser
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Matthew P Velez
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Ryan R Hsieh
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Alexis R Demonbreun
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Richard D'Aquila
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Elizabeth M McNally
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Thomas W McDade
- Department of Anthropology, Northwestern University Weinberg College of Arts and Sciences, Evanston, IL; Institute for Policy Research, Northwestern University, Evanston, IL
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Schrock JM, Sugiyama LS, Naidoo N, Kowal P, Snodgrass JJ. Greater chronic morbidity is associated with greater fatigue in six countries. Evol Med Public Health 2022; 10:156-169. [PMID: 35480567 PMCID: PMC9036556 DOI: 10.1093/emph/eoac011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/15/2022] [Indexed: 11/15/2022] Open
Abstract
Background and objectives Human susceptibility to chronic non-communicable disease may be explained, in part, by mismatches between our evolved biology and contemporary environmental conditions. Disease-induced fatigue may function to reduce physical activity during acute infection, thereby making more energy available to mount an effective immune response. However, fatigue in the context of chronic disease may be maladaptive because long-term reductions in physical activity increase risks of disease progression and the acquisition of additional morbidities. Here, we test whether cumulative chronic morbidity is associated with subjective fatigue. Methodology We constructed a cumulative chronic morbidity score using self-reported diagnoses and algorithm-based assessments, and a subjective fatigue score based on four questionnaire items using cross-sectional survey data from the Study on global AGEing and adult health, which features large samples of adults from six countries (China, Ghana, India, Mexico, Russia and South Africa). Results In a mixed-effects linear model with participants nested in countries (N = 32 455), greater cumulative chronic morbidity is associated with greater subjective fatigue (β = 0.34, SE = 0.005, P < 2e−16). This association replicates within each country and is robust to adjustment for key sociodemographic and physical covariates (sex, age, household wealth, physical function score, habitual physical activity, BMI and BMI2). Conclusions and implications Fatigue is a common but perhaps maladaptive neuropsychological response to chronic morbidity. Disease-induced fatigue may mediate a self-perpetuating cycle, in which chronic morbidity reduces physical activity, and less physical activity increases cumulative chronic morbidity. Longitudinal research is needed to test whether chronic morbidity, fatigue and physical activity form a cyclical feedback loop. Lay Summary: Fatigue during acute illness may promote recovery, but persistent fatigue in the context of chronic disease may make matters worse. We present evidence from six countries that more chronic disease is associated with more fatigue. This fatigue may reduce physical activity, which increases risks of acquiring additional chronic health problems.
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Affiliation(s)
- Joshua M Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Avenue, Suite 14, Chicago, IL 60611, USA
- Department of Anthropology, Northwestern University, 1810 Hinman Avenue, Evanston, IL 60208, USA
- Department of Anthropology, 1218 University of Oregon, 308 Condon Hall, Eugene, OR 97403, USA
- Corresponding author. Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Avenue, Suite 14, Chicago, IL 60611, USA. Tel: (312) 503-5408; E-mail:
| | - Lawrence S Sugiyama
- Department of Anthropology, 1218 University of Oregon, 308 Condon Hall, Eugene, OR 97403, USA
| | - Nirmala Naidoo
- Study on global AGEing and adult health (SAGE), World Health Organization, Avenue Appia 20, Geneva 1211, Switzerland
| | - Paul Kowal
- Study on global AGEing and adult health (SAGE), World Health Organization, Avenue Appia 20, Geneva 1211, Switzerland
- Centre for Women’s Health Research, University Drive, Callaghan, NSW 2308, Australia
| | - J Josh Snodgrass
- Department of Anthropology, 1218 University of Oregon, 308 Condon Hall, Eugene, OR 97403, USA
- Center for Global Health, University of Oregon, 1585 E 13th Avenue, Eugene, OR 97403, USA
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Schrock JM, McDade TW, Carrico AW, D'Aquila RT, Mustanski B. Traumatic events and mental health: The amplifying effects of pre-trauma systemic inflammation. Brain Behav Immun 2021; 98:173-184. [PMID: 34391815 PMCID: PMC8588867 DOI: 10.1016/j.bbi.2021.08.208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Traumatic experiences are strongly predictive of adverse mental health outcomes. Experimental studies have demonstrated that systemic inflammation can increase reactivity to threatening stimuli. It is not known whether naturally occurring inflammation amplifies the impact of traumatic experiences on mental health. Here we test whether incident traumatic events are more predictive of adverse mental health outcomes for individuals with greater pre-trauma systemic inflammation in a racially and ethnically diverse cohort study of youth assigned male at birth who identify as sexual or gender minorities (ages 16-29, n = 518), a group at high risk for trauma exposure. METHODS Measures of inflammation, depression symptom severity, and perceived stress were measured at baseline. One year later, depression symptom severity and perceived stress were measured again, and participants reported the traumatic events they had experienced in the intervening year. RESULTS In a model adjusted for baseline depression symptom severity and other key covariates, we found that higher baseline levels of interleukin-1β amplified the effect of incident trauma exposure on depression symptom severity at follow-up (β = 0.234, SE = 0.080, P = 0.004). In a model adjusted for baseline perceived stress and other key covariates, we found that higher baseline scores on a multi-marker inflammatory index amplified the effect of incident trauma exposure on perceived stress at follow-up (β = 0.243, SE = 0.083, P = 0.003). CONCLUSIONS These findings suggest that greater pre-trauma inflammation may predict poorer mental health following trauma exposure. Understanding how inflammation interacts with trauma to shape mental health may generate novel insights for preventing and treating the debilitating psychological consequences of trauma.
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Affiliation(s)
- Joshua M Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, Evanston, IL, USA; Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
| | - Richard T D'Aquila
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA; Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA; Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA.
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Schrock JM, Ryan DT, Saber R, Benbow N, Vaught LA, Reiser N, Velez MP, Hsieh R, Newcomb M, Demonbreun AR, Mustanski B, McNally EM, D’Aquila R, McDade TW. Cohabitation With a Known Coronavirus Disease 2019 Case Is Associated With Greater Antibody Concentration and Symptom Severity in a Community-Based Sample of Seropositive Adults. Open Forum Infect Dis 2021; 8:ofab244. [PMID: 34316503 PMCID: PMC8302857 DOI: 10.1093/ofid/ofab244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 05/11/2021] [Indexed: 01/12/2023] Open
Abstract
In a community-based sample of seropositive adults (n = 1101), we found that seropositive individuals who lived with a known coronavirus disease 2019 (COVID-19) case exhibited higher blood anti-severe acute respiratory syndrome coronavirus 2 spike receptor-binding domain immunoglobulin G concentrations and greater symptom severity compared to seropositive individuals who did not live with a known COVID-19 case.
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Affiliation(s)
- Joshua M Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Daniel T Ryan
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rana Saber
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nanette Benbow
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lauren A Vaught
- Center for Genetic Medicine, Northwestern University, Chicago, Illinois, USA
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nina Reiser
- Center for Genetic Medicine, Northwestern University, Chicago, Illinois, USA
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Matthew P Velez
- Center for Genetic Medicine, Northwestern University, Chicago, Illinois, USA
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ryan Hsieh
- Center for Genetic Medicine, Northwestern University, Chicago, Illinois, USA
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Michael Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Alexis R Demonbreun
- Center for Genetic Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Elizabeth M McNally
- Center for Genetic Medicine, Northwestern University, Chicago, Illinois, USA
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Biochemistry and Molecular Genetics, Northwestern University, Chicago, Illinois, USA
| | - Richard D’Aquila
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Thomas W McDade
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
- Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
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DeLouize AM, Liebert MA, Madimenos FC, Urlacher SS, Schrock JM, Cepon-Robins TJ, Gildner TE, Blackwell AD, Harrington CJ, Amir D, Bribiescas RG, Snodgrass JJ, Sugiyama LS. Low prevalence of anemia among Shuar communities of Amazonian Ecuador. Am J Hum Biol 2021; 34:e23590. [PMID: 33749068 DOI: 10.1002/ajhb.23590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Anemia is an important global health challenge. We investigate anemia prevalence among Indigenous Shuar of Ecuador to expand our understanding of population-level variation, and to test hypotheses about how anemia variation is related to age, sex, and market integration. METHODS Hemoglobin levels were measured in a total sample of 1650 Shuar participants (ages 6 months to 86 years) from 46 communities between 2008 and 2017 to compare anemia prevalence across regions characterized by different levels of market integration. RESULTS Shuar anemia rates among children under 15 years (12.2%), adult women (10.5%), and adult men (5.3%) were less than half of those previously documented in other neo-tropical Indigenous populations. Anemia prevalence did not vary between more traditional and market integrated communities (OR = 0.47, p = .52). However, anemia was negatively associated with body mass index (OR = 0.47, p = .002). CONCLUSIONS Compared to other South American Indigenous populations, anemia prevalence is relatively low among Shuar of Ecuador and invariant with market integration. Understanding this pattern can provide valuable insights into anemia prevention among at-risk populations.
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Affiliation(s)
- Alicia M DeLouize
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA
| | - Melissa A Liebert
- Department of Anthropology, Northern Arizona University, Flagstaff, Arizona, USA
| | - Felicia C Madimenos
- Department of Anthropology, Queens College (CUNY), Flushing, New York, USA.,New York Consortium in Evolutionary Primatology (NYCEP), New York, New York, USA
| | - Samuel S Urlacher
- Department of Anthropology, Baylor University, Waco, Texas, USA.,Child and Brain Development Program, CIFAR, Toronto, Canada
| | - Joshua M Schrock
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA
| | - Tara J Cepon-Robins
- Department of Anthropology, University of Colorado-Colorado Springs, Colorado Springs, Colorado, USA
| | - Theresa E Gildner
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Aaron D Blackwell
- Department of Anthropology, Washington State University, Pullman, WA, USA
| | | | - Dorsa Amir
- Department of Psychology, Boston College, Chestnut Hill, Massachusetts, USA
| | | | - James Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA.,Center for Global Health, University of Oregon, Eugene, Oregon, USA
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Schrock JM, Ryan DT, Saber R, Benbow N, Vaught LA, Reiser N, Velez MP, Hsieh R, Newcomb M, Demonbreun AR, Mustanski B, McNally EM, D’Aquila R, McDade TW. Exposure to SARS-CoV-2 within the household is associated with greater symptom severity and stronger antibody responses in a community-based sample of seropositive adults. medRxiv 2021:2021.03.11.21253421. [PMID: 33758903 PMCID: PMC7987062 DOI: 10.1101/2021.03.11.21253421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Magnitude of SARS-CoV-2 virus exposure may contribute to symptom severity. In a sample of seropositive adults (n=1101), we found that individuals who lived with a known COVID-19 case exhibited greater symptom severity and IgG concentrations compared to individuals who were seropositive but did not live with a known case (P<0.0001).
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Affiliation(s)
- Joshua M. Schrock
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
- Department of Anthropology, Northwestern University
| | - Daniel T. Ryan
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Rana Saber
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Nanette Benbow
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine
| | - Lauren A. Vaught
- Center for Genetic Medicine, Northwestern University
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine
| | - Nina Reiser
- Center for Genetic Medicine, Northwestern University
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine
| | - Matthew P. Velez
- Center for Genetic Medicine, Northwestern University
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine
| | - Ryan Hsieh
- Center for Genetic Medicine, Northwestern University
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine
| | - Michael Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Alexis R. Demonbreun
- Center for Genetic Medicine, Northwestern University
- Department of Pharmacology, Northwestern University Feinberg School of Medicine
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Elizabeth M. McNally
- Center for Genetic Medicine, Northwestern University
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine
- Department of Biochemistry and Molecular Genetics, Northwestern University
| | - Richard D’Aquila
- Division of Infectious Diseases, Dept. of Medicine, Northwestern University Feinberg School of Medicine
| | - Thomas W. McDade
- Department of Anthropology, Northwestern University
- Institute for Policy Research, Northwestern University
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Gildner TE, Cepon-Robins TJ, Liebert MA, Urlacher SS, Schrock JM, Harrington CJ, Madimenos FC, Snodgrass JJ, Sugiyama LS. Market integration and soil-transmitted helminth infection among the Shuar of Amazonian Ecuador. PLoS One 2020; 15:e0236924. [PMID: 32735608 PMCID: PMC7394393 DOI: 10.1371/journal.pone.0236924] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 07/17/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Soil-transmitted helminth (STH) infections have many negative health outcomes (e.g., diarrhea, nutritional deficiencies) that can also exacerbate poverty. These infections are generally highest among low-income populations, many of which are also undergoing market integration (MI; increased participation in a market-based economy). Yet the direct impact of MI-related social and environmental changes on STH infection patterns is poorly understood, making it unclear which lifestyle factors should be targeted to better control disease spread. This cross-sectional study examines if household infrastructure associated with greater MI is associated with lower STH burdens among Indigenous Ecuadorian Shuar. METHODS Kato-Katz fecal smears were used to determine STH infection status and intensity (n = 620 participants; 308 females, 312 males, aged 6 months-86 years); Ascaris lumbricoides (ascarid) and Trichuris trichiura (whipworm) were the primary infection types detected. Structured interviews assessing lifestyle patterns (e.g., measures of household infrastructure) measured participant MI. Multilevel regression analyses and zero-inflated negative binomial regression models tested associations between MI measures and STH infection status or intensity, controlling for individual and community characteristics. RESULTS Participants residing in more market-integrated households exhibited lower infection rates and intensities than those in less market integrated households. Parasite infection status and T. trichiura infection intensity were lower among participants living in houses with wood floors than those with dirt floors, while individuals using well or piped water from a spring exhibited lower A. lumbricoides infection intensities compared to those using river or stream water. Unexpectedly, latrine type was not significantly related to STH infection status or intensity. These results suggest that sources of exposure differ between the two helminth species. CONCLUSIONS This study documents associations between household measures and STH infection among an Indigenous population undergoing rapid MI. These findings can help healthcare programs better target interventions and reduce STH exposure among at-risk populations.
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Affiliation(s)
- Theresa E. Gildner
- Department of Anthropology, Dartmouth College, Hanover, New Hampshire, United States of America
| | - Tara J. Cepon-Robins
- Department of Anthropology, University of Colorado, Colorado Springs, Colorado, United States of America
| | - Melissa A. Liebert
- Department of Anthropology, Northern Arizona University, Flagstaff, Arizona, United States of America
| | - Samuel S. Urlacher
- Department of Anthropology, Baylor University, Waco, Texas, United States of America
| | - Joshua M. Schrock
- Department of Anthropology, University of Oregon, Eugene, Oregon, United States of America
| | | | - Felicia C. Madimenos
- Department of Anthropology, Queens College (CUNY), Flushing, New York, United States of America
| | - J. Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, United States of America
- Center for Global Health, University of Oregon, Eugene, Oregon, United States of America
| | - Lawrence S. Sugiyama
- Department of Anthropology, University of Oregon, Eugene, Oregon, United States of America
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11
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Schrock JM, McClure HH, Snodgrass JJ, Liebert MA, Charlton KE, Arokiasamy P, Naidoo N, Kowal P. Food insecurity partially mediates associations between social disadvantage and body composition among older adults in india: Results from the study on global AGEing and adult health (SAGE). Am J Hum Biol 2017; 29. [PMID: 28681406 DOI: 10.1002/ajhb.23033] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 05/18/2017] [Accepted: 06/08/2017] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Our objective was to test whether food insecurity mediates cross-sectional associations between social disadvantage and body composition among older adults (aged 50+) in India (n = 6556). METHODS Adjusting for key sociodemographic and dietary variables, we examined whether markers of social disadvantage (lower educational attainment, lower household wealth, belonging to a disadvantaged caste/tribe, and belonging to a minority religion) were associated with food insecurity. We then examined whether food insecurity, in turn, was associated with anthropometric measures of body composition, body mass index (BMI), and waist circumference (WC). We also tested whether food insecurity mediated the relationship between social disadvantage and body composition. RESULTS In adjusted models, lower household wealth [lowest quintile (Q5) vs highest quintile (Q1): odds ratio (OR) = 13.57, P < .001], having less than a high-school education (OR = 2.12. P < .005), being Muslim (OR = 1.82, P < .001), and being in a scheduled caste (historically marginalized) (OR = 1.49, P < .005) were associated with greater food insecurity. Those who were severely food insecure had greater odds of being underweight (OR = 1.36, P < .01) and lower odds of high WC (OR = 0.70, P < .01). Mediation analyses estimated that food insecurity explained 4.7%-29.7% of the relationship between social disadvantage and body composition, depending on the variables considered. CONCLUSIONS Our results are consistent with the hypothesis that food insecurity is a mechanism linking social disadvantage and body composition among older adults in India. These analyses contribute to a better understanding of processes leading to variation in body composition, which may help enhance the design of interventions aimed at improving population nutritional status.
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Affiliation(s)
- Joshua M Schrock
- Department of Anthropology, University of Oregon, Eugene, Oregon, 97403
| | - Heather H McClure
- Center for Equity Promotion, College of Education, University of Oregon, Eugene, Oregon, 97403
| | - J Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, 97403
| | - Melissa A Liebert
- Department of Anthropology, University of Oregon, Eugene, Oregon, 97403
| | - Karen E Charlton
- School of Medicine, University of Wollongong, Wollongong, New South Wales, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, 2522, Australia
| | - Perianayagam Arokiasamy
- Department of Development Studies, International Institute for Population Sciences, Mumbai, 400088, India
| | - Nirmala Naidoo
- Study on global AGEing and adult health (SAGE), World Health Organization, Geneva, 1211, Switzerland
| | - Paul Kowal
- Study on global AGEing and adult health (SAGE), World Health Organization, Geneva, 1211, Switzerland.,Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, 2308, Australia
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12
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Schrock JM, Adler NE, Epel ES, Nuru-Jeter AM, Lin J, Blackburn EH, Taylor RJ, Chae DH. Socioeconomic Status, Financial Strain, and Leukocyte Telomere Length in a Sample of African American Midlife Men. J Racial Ethn Health Disparities 2017. [PMID: 28634877 DOI: 10.1007/s40615-017-0388-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND African American men in the USA experience poorer aging-related health outcomes compared to their White counterparts, partially due to socioeconomic disparities along racial lines. Greater exposure to socioeconomic strains among African American men may adversely impact health and aging at the cellular level, as indexed by shorter leukocyte telomere length (LTL). This study examined associations between socioeconomic factors and LTL among African American men in midlife, a life course stage when heterogeneity in both health and socioeconomic status are particularly pronounced. METHODS Using multinomial logistic regression, we examined associations between multiple measures of SES and tertiles of LTL in a sample of 92 African American men between 30 to 50 years of age. RESULTS Reports of greater financial strain were associated with higher odds of short versus medium LTL (odds ratio (OR)=2.21, p = 0.03). Higher income was associated with lower odds of short versus medium telomeres (OR=0.97, p = 0.04). Exploratory analyses revealed a significant interaction between educational attainment and employment status (χ 2 = 4.07, p = 0.04), with greater education associated with lower odds of short versus long telomeres only among those not employed (OR=0.10, p = 0.040). CONCLUSION Cellular aging associated with multiple dimensions of socioeconomic adversity may contribute to poor aging-related health outcomes among African American men. Subjective appraisal of financial difficulty may impact LTL independently of objective dimensions of SES. Self-appraised success in fulfilling traditionally masculine gender roles, including being an economic provider, may be a particularly salient aspect of identity for African American men and have implications for cellular aging in this population.
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Affiliation(s)
- Joshua M Schrock
- Department of Anthropology, University of Oregon, 1218 University of Oregon, Eugene, OR, 97403, USA.
| | - Nancy E Adler
- Department of Psychiatry and Center for Health and Community, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Elissa S Epel
- Department of Psychiatry and Center for Health and Community, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Amani M Nuru-Jeter
- Divisions of Community Health Sciences and Epidemiology, University of California, Berkeley, Berkeley, CA, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Elizabeth H Blackburn
- Department of Biochemistry and Biophysics, University of California, San Francisco, School of Medicine, San Francisco, CA, USA.,Department of Microbiology and Immunology, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | | | - David H Chae
- Department of Human Development & Family Studies, College of Human Sciences, Auburn University, Auburn, AL, USA
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Barrett TM, Liebert MA, Schrock JM, Cepon-Robins TJ, Mathur A, Agarwal H, Kowal P, Snodgrass JJ. Physical function and activity among older adults in Jodhpur, India. Ann Hum Biol 2015; 43:488-91. [DOI: 10.3109/03014460.2015.1103901] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
| | | | | | | | | | | | - Paul Kowal
- Study on Global AGEing and Adult Health, World Health Organisation, Geneva, Switzerland, and
- University of Newcastle Research Centre for Gender, Health, and Ageing, Newcastle, NSW, Australia
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Lin L, Brown KB, Yu F, Yang J, Wang J, Schrock JM, Bodomo AB, Yang L, Yang B, Nehl EJ, Tucker JD, Wong FY. Health Care Experiences and Perceived Barriers to Health Care Access: A Qualitative Study Among African Migrants in Guangzhou, Guangdong Province, China. J Immigr Minor Health 2015; 17:1509-17. [PMID: 25294415 PMCID: PMC4390408 DOI: 10.1007/s10903-014-0114-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants.
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Affiliation(s)
- Lavinia Lin
- Emory University Rollins School of Public Health, 1518 Clifton Road, N.E., Atlanta, GA, 30322, USA,
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15
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Lin L, Brown KB, Hall BJ, Yu F, Yang J, Wang J, Schrock JM, Bodomo AB, Yang L, Yang B, Nehl EJ, Tucker JD, Wong FY. Overcoming barriers to health-care access: A qualitative study among African migrants in Guangzhou, China. Glob Public Health 2015; 11:1135-47. [PMID: 26400191 DOI: 10.1080/17441692.2015.1076019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Guangzhou is China's third most populous city, and the region's burgeoning manufacturing economy has attracted many young African businessmen and entrepreneurs to the city. The aims of this study were to examine strategies that African migrants in Guangzhou have adopted in response to health-care barriers, and explore their perceptions of how to address their needs. Twenty-five semi-structured interviews and two focus groups were conducted among African migrants residing in Guangzhou, China. Facing multiple barriers to care, African migrants have adopted a number of suboptimal and unsustainable approaches to access health care. These included: using their Chinese friends or partners as interpreters, self-medicating, using personal connections to medical doctors, and travelling to home countries or countries that offer English-speaking doctors for health care. Health-care providers and health organisations in Guangzhou have not yet acquired sufficient cultural competence to address the needs of African migrants residing in the city. Introducing linguistically and culturally competent health-care services in communities concentrated with African migrants may better serve the population. With the growing international migration to China, it is essential to develop sustainable approaches to improving health-care access for international migrants, particularly those who are marginalised.
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Affiliation(s)
- Lavinia Lin
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Katherine B Brown
- b College of Physicians and Surgeons, Columbia University , New York , NY , USA
| | - Brian J Hall
- c Department of Psychology, Faculty of Social Sciences , University of Macau , Taipa, Macau (SAR) , People's Republic of China
| | - Fan Yu
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Jingqi Yang
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Jason Wang
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Joshua M Schrock
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Adams B Bodomo
- d African Studies Department , Global African Diaspora Studies (GADS) Research Platform, University of Vienna , Vienna , Austria
| | - Ligang Yang
- e Guangdong Provincial Center for Skin Diseases and STD Control , Guangzhou , Guangdong Province , People's Republic of China
| | - Bin Yang
- e Guangdong Provincial Center for Skin Diseases and STD Control , Guangzhou , Guangdong Province , People's Republic of China
| | - Eric J Nehl
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Joseph D Tucker
- f UNC Project-China , Guangzhou , Guangdong Province , People's Republic of China
| | - Frank Y Wong
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
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