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Wiemers EE, Lin IF, Wiersma Strauss A, Chin J, Hotz VJ, Seltzer JA. Age Differences Experiences of Pandemic-related Health and Economic Challenges among Adults Aged 55 and Older. Gerontologist 2024:gnae023. [PMID: 38446986 DOI: 10.1093/geront/gnae023] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The oldest adults faced the highest risk of death and hospitalization from COVID-19, but less is known about whether they also were the most likely to experience pandemic-related economic, health care, and mental health challenges. Guided by prior research on vulnerability versus resilience among older adults, the current study investigated age differences in economic hardship, delays in medical care, and mental health outcomes among adults aged 55 and older. RESEARCH DESIGN AND METHODS Data were from the COVID-19 module and Leave Behind Questionnaire in the 2020 Health and Retirement Study (HRS). We estimated linear probability models to examine differences in experiences of pandemic-related economic and health challenges by age group (55-64, 65-74, 75+) with and without controls for preexisting sociodemographic, social program, health, and economic characteristics from the 2018 HRS. Models accounting for differential mortality also were estimated. RESULTS Adults aged 65-74 and 75+ experienced fewer economic and mental health challenges and those aged 75+ were less likely to delay medical care than adults aged 55-64. Age gradients were consistent across a broad range of measures and were robust to including controls. For all age groups, economic challenges were less common than delays in medical care or experiences of loneliness, stress, or being emotionally overwhelmed. DISCUSSION AND IMPLICATIONS Even though the oldest adults were at the greatest risk of death and hospitalization from COVID-19, they experienced fewer secondary pandemic-related challenges. Future research should continue to explore the sources of this resilience for older adults.
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Affiliation(s)
- Emily E Wiemers
- Department of Public Administration and International Affairs, Syracuse University, Syracuse, NY, USA
| | - I-Fen Lin
- Department of Sociology, Bowling Green State University, Bowling Green, OH, USA
| | - Anna Wiersma Strauss
- Department of Public Administration and International Affairs, Syracuse University, Syracuse, NY, USA
| | - Janecca Chin
- Department of Sociology, Bowling Green State University, Bowling Green, OH, USA
| | - V Joseph Hotz
- Department of Economics, Duke University, Durham, NC, USA
| | - Judith A Seltzer
- Department of Sociology, University of California, Los Angeles, Los Angeles, CA, USA
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Abujaradeh H, Mazanec SR, Sereika SM, Connolly MC, Bender CM, Gordon BB, Rosenzweig M. Economic Hardship and Associated Factors of Women With Early-Stage Breast Cancer Prior to Chemotherapy Initiation. Clin Breast Cancer 2024; 24:36-44. [PMID: 37852896 PMCID: PMC10841408 DOI: 10.1016/j.clbc.2023.09.009] [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] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/07/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Economic hardship (EH) can negatively influence cancer outcomes. Little is known about the factors that are associated with higher levels of EH among patients with breast cancer (BC). This paper describes EH in women with early-stage BC prior to or at their first chemotherapy treatment (baseline) and explores whether there are differences by race, area deprivation, stress, symptom distress, and social support. PATIENTS AND METHODS A descriptive comparative/correlational design was employed using baseline data of a multisite, longitudinal, multimethod study comparing the symptom experience and management prior to prescribed chemotherapy for women with early-stage BC. Participants completed measures for EH, perceived stress, symptom distress, and social support. Race was measured by self-report. Area deprivation indices (ADI) measuring neighborhood economic factors were calculated from publicly available websites. RESULTS Participants (N = 248; age = 52.9 ± 12.3 years) were 62% White and 38% Black, 54% partnered, and 98% insured. Compared to White patients, Black patients reported higher (worse) EH (1.2 ± 3.0 vs. -0.7 ± 2.4), lived in areas of greater deprivation (80.1 ± 2.1 vs. 50.5 ± 23.5),and were more likely to report inadequate household income (Black: 30.5%; White: 11.1%). Adjusting for race and age, being Black (P< .001), living in an area of greater deprivation (P = .049), higher perceived stress (P = .008), lower perceived appraisal (P = .040), and less tangible support (P < .001) contributed to greater EH. Worse symptom distress trended toward greater EH (P = .07). CONCLUSIONS This study emphasizes the importance of incorporating baseline holistic assessment to identify patients most likely to experience EH during early-stage BC treatment.
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Affiliation(s)
- Hiba Abujaradeh
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Susan R Mazanec
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Susan M Sereika
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Mary C Connolly
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
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Kang Y, Colson-Fearon D, Kim M, Park S, Stephens M, Kim Y, Wetzler E. Socio-economic and psychosocial determinants of violent discipline among parents in Asia Pacific countries during COVID-19: Focus on disadvantaged populations. Child Abuse Negl 2023; 139:106059. [PMID: 36805614 PMCID: PMC9933874 DOI: 10.1016/j.chiabu.2023.106059] [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] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/11/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Mobility restrictions and economic downfall as a result of the COVID-19 pandemic may increase the risk of child maltreatment, including increased risk for violent discipline use by parents. OBJECTIVE We examined the socio-economic and psychosocial determinants of violent discipline among parents against children in Asia Pacific countries. PARTICIPANTS & SETTINGS This secondary data analysis included 7765 parents with children 6-18 years old in eight Asia Pacific countries. METHODS 24 potential determinants were identified, including household demographic factors, parents' psychosocial status, and livelihood changes. The dependent variable was parental use of violent discipline (physical, severe physical, psycho-social aggression, and any violent discipline). Univariate and multivariable logistic regression analysis was conducted. RESULTS A total of 41 % of households reported violent discipline. Parental demographic characteristics that were positively related to use of violent discipline were living in rural areas, not being a household head, female sex, age younger than 35 years, and large family size. Poor parental mental health status, loss of job or reduced income due to COVID-19, lack of food at household level, parent engagement in petty trade, and owning a business also predicted violent discipline. Mandatory curfew and receiving pandemic-related education materials were also positive predictors. CONCLUSION Some socio-demographic factors, economic hardship due to COVID-19, and poor mental health status of parents are associated with the use of violent discipline against children in the Asia Pacific region. These results highlight several potential target areas for child protection interventions by governmental and non-profit organizations, including economic, social, and mental health interventions.
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Affiliation(s)
- Yunhee Kang
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
| | - Darien Colson-Fearon
- Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Myungsun Kim
- Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Soim Park
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | | | - Yunseop Kim
- College of Medicine, Korea University, Seoul, South Korea
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Codner A, Zack RM, Liu X, Bangham C, Nelson E, Hicks JM, Greece JA. Socio-demographic factors associated with hunger among food pantry users in Eastern Massachusetts. J Nutr Sci 2023; 12:e53. [PMID: 37180481 PMCID: PMC10173085 DOI: 10.1017/jns.2022.118] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 05/16/2023] Open
Abstract
To assess the determinants of hunger among food pantry users, the present study used a cross-sectional survey that included a modified Household Hunger Scale to quantify hunger. Mixed-effects logistic regression models were used to assess the relationship between hunger categories and various household socio-demographic and economic characteristics, such as age, race, household size, marital status and experience of any economic hardship. The survey was administered to food pantry users from June 2018 to August 2018 at various food pantries across Eastern Massachusetts with 611 food pantry users completing the questionnaire at any of the 10 food pantry sites. One-fifth (20⋅13 %) of food pantry users experienced moderate hunger and 19⋅14 % experienced severe hunger. Food pantry users who were single, divorced or separated; had less than a high school education; working part-time, unemployed or retired; or, who earned incomes less than $1000 per month were most likely to experience severe or moderate hunger. Pantry users who experienced any economic hardship had 4⋅78 the adjusted odds of severe hunger (95 % CI 2⋅49, 9⋅19), which was much larger than the odds of moderate hunger (AOR 1⋅95; 95 % CI 1⋅10, 3⋅48). Younger age and participation in WIC (AOR 0⋅20; 95 % CI 0⋅05-0⋅78) and SNAP (AOR 0⋅53; 95 % CI 0⋅32-0⋅88) were protective against severe hunger. The present study illustrates factors affecting hunger in food pantry users, which can help inform public health programmes and policies for people in need of additional resources. This is essential particularly in times of increasing economic hardships recently exacerbated by the COVID-19 pandemic.
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Affiliation(s)
- Alyson Codner
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, USA
| | - Rachel M. Zack
- Greater Boston Food Bank, 70 S Bay Ave, Boston, MA 02118, USA
| | - Xinyang Liu
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, USA
| | - Candice Bangham
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, USA
| | - Eva Nelson
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, USA
| | - Jacqueline Milton Hicks
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118, USA
| | - Jacey A. Greece
- Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th Floor, Boston, MA 02118, USA
- Corresponding author: Jacey A. Greece, email
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Schuler BR, Vazquez CE, Kobulsky JM, Dumenci L. Adversity and child body mass index in Fragile Families over 15 years: Do type and timing matter? SSM Popul Health 2022; 19:101197. [PMID: 36033351 PMCID: PMC9399528 DOI: 10.1016/j.ssmph.2022.101197] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background Weight status has been linked to adverse childhood experiences. Existing research, however, is limited to unidimensional assessments of cumulative risk and does not account for the complex nature of adversity experienced by children in high-risk settings. We fill existing gaps by assessing how four subtypes of adversity across two primary dimensions of threat and deprivation-based adversity are associated with changes in body mass index (BMI) across child ages 3 through 15 years. Method U.S. mothers and fathers (n = 2412) in the Fragile Families and Child Wellbeing Study were interviewed when children were born, and again at ages 1, 3, 5, 9, and 15 years. Independent variables include interpersonal (e.g., domestic violence), family (e.g., mental health), economic (e.g., housing insecurity), and community (e.g., witness/victim of violence) adversity from ages 1 through 9 years. Path analysis regressed changes in BMIz from ages 3 through 15 on past adversity exposures. Results Increased interpersonal and community adversity subtypes from ages 3 to 5 were associated with decreased BMIz from ages 5–9 years. Increased economic adversity from age 3 to 5 was associated with increased BMIz from ages 5 to 9, adjusted for mother age, race, and education. Conclusion Findings highlight the differential influence of past adversity type and timing on child BMI. Interpersonal and community adversity were associated with decreased BMIz, and economic adversity with increased BMIz. Differences in directionality of associations suggest research should capture multiple dimensions of adversity in early childhood and possible positive and negative trends in effects on child weight as children grow from early to mid-childhood. We found positive and negative trends in BMIz, depending on adversity type. Interpersonal and community adversity types were associated with decrease BMIz. Economic adversity was associated with increased BMIz. BMIz from ages 5 to 9 was sensitive to adversity exposure from ages 3–5 years.
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Affiliation(s)
- Brittany R Schuler
- School of Social Work, College of Public Health, Temple University, 1311 Cecil B Moore Ave., Ritter Annex 5th floor, Philadelphia, PA, 19122, USA
| | - Christian E Vazquez
- School of Social Work, The University of Texas at Arlington, Arlington, TX, 6019, USA
| | - Julia M Kobulsky
- School of Social Work, College of Public Health, Temple University, 1311 Cecil B Moore Ave., Ritter Annex 5th floor, Philadelphia, PA, 19122, USA
| | - Levent Dumenci
- Department of Epidemiology and Biostatistics, Temple University, Philadelphia, PA, 19122, USA
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Roddy Á. Income and conversion handicaps: estimating the impact of child chronic illness/disability on family income and the extra cost of child chronic illness/child disability in Ireland using a standard of living approach. Eur J Health Econ 2022; 23:467-483. [PMID: 34499284 PMCID: PMC8426335 DOI: 10.1007/s10198-021-01371-4] [Citation(s) in RCA: 2] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
Child chronic illness/ disability can present significant challenges for children, families and society that require appropriate policy responses; yet little is known about the demands placed on families resources from an economics perspective in terms of its impact on household income and the extra income required to achieve the same standard of living as families who do not have a child with a chronic illness/disability. The paper uses data from the Growing Up in Ireland National survey dataset for nine year olds. It is the first study to empirically investigate the impact of child chronic illness/disability on earnings, standard of living and the extra cost of disability together. It is also the first study to explicitly address endogeneity in the standard of living model by using a two-stage process where residuals were harvested to provide efficient estimates. The findings show that families experience significant disadvantage and economic hardship due to reduced household income and a lower standard of living due to the extra cost of disability that would require considerable income to compensate. Policy implications of these findings suggest that a tiered approach to disability support payments which encompass broader criteria for inclusion based on varying severity levels be introduced to alleviate the financial hardship and compromised economic wellbeing of families affected. In addition, more innovative policies are required to implement appropriate timely access to health and social care services and flexi parental employment, which in turn requires the provision of adequate access to high quality educational and care facilities.
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Affiliation(s)
- Áine Roddy
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics & Political Science, London, UK.
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Bethell CD, Garner AS, Gombojav N, Blackwell C, Heller L, Mendelson T. Social and Relational Health Risks and Common Mental Health Problems Among US Children: The Mitigating Role of Family Resilience and Connection to Promote Positive Socioemotional and School-Related Outcomes. Child Adolesc Psychiatr Clin N Am 2022; 31:45-70. [PMID: 34801155 DOI: 10.1016/j.chc.2021.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Nearly 70% (67.6%) of US children with mental, emotional, and behavioral problems (MEB) experienced significant social health risks (SHR) and/or relational health risks (RHR). Shifts are needed in child mental health promotion, prevention, diagnosis, and treatment to address both RHR and SHR. Public health approaches are needed that engage families, youth, and the range of child-serving professionals in collaborative efforts to prevent and mitigate RHR and SHR and promote positive mental health at a community level. Building strong family resilience and connection may improve SR and, in turn, academic and social outcomes among all US children with or without MEB.
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Affiliation(s)
- Christina D Bethell
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Andrew S Garner
- Partners in Pediatrics and Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Narangerel Gombojav
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Courtney Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Laurence Heller
- NeuroAffective Relational Model Training Institute, Inc, Littleton, CO, USA
| | - Tamar Mendelson
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Sari E, Moilanen M, Sommerseth HL. Transgenerational health effects of in utero exposure to economic hardship: Evidence from preindustrial Southern Norway. Econ Hum Biol 2021; 43:101060. [PMID: 34509788 DOI: 10.1016/j.ehb.2021.101060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 08/18/2021] [Accepted: 08/30/2021] [Indexed: 06/13/2023]
Abstract
We studied whether in utero exposure to economic hardship during a grandmother's pregnancy has a transgenerational effect on her grandchildren's health condition. We used an individual-level three-generation data set covering people born between 1734 and 1840 in the municipality of Rendalen in Norway. We found a culling effect in which grandchildren whose grandmothers gave birth in years of economic hardship lived approximately ten years longer than grandchildren whose mothers were born in years of economic well-being. This impact was only observed among the grandmothers who belong to the lowest social classes. Our results also showed that in higher social classes, economic hardship during a grandmother's pregnancy deteriorated her grandchildren's health by "scarring" the mother's health.
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Affiliation(s)
- Emre Sari
- School of Business and Economics, Faculty of Biosciences Fisheries and Economics, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Mikko Moilanen
- School of Business and Economics, Faculty of Biosciences Fisheries and Economics, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Hilde Leikny Sommerseth
- Department of Archaeology, History, Religious Studies and Theology, Faculty of Humanities Social Sciences and Education, UiT The Arctic University of Norway, Tromsø, Norway.
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Hossain M. COVID-19 and gender differences in mental health in low- and middle-income countries: Young working women are more vulnerable. SSM Ment Health 2021; 1:100039. [PMID: 34746897 PMCID: PMC8560183 DOI: 10.1016/j.ssmmh.2021.100039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 11/01/2022] Open
Abstract
This study examines gender differences in the relationship between COVID-19-triggered economic hardship and mental health complaints, defined by self-reported anxiety/depression, of young people (17-29) in four low- and middle-income countries (LMICs). To do this, we use two waves of the Young Lives (YL) phone survey. Logistic regression results show that young women, on average, were more likely to report anxiety than men in Peru and Vietnam in the first survey wave (June-July 2020). However, this disparity continued to persist in all four countries in the second wave (August-October 2020) as the pandemic prolonged. Notably, we find that young women that faced economic hardship by losing job or income were more likely to report anxiety than their male counterparts. As COVID-19 cases remain consistently high in many LMICs, which limit economic activities, the vulnerability of young women may likely increase. This issue requires urgent policy attention by awareness-raising campaigns, more hotline services for emergency help, social security programs for women, and available women's sexual and reproductive health services at a specific section in hospitals.
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Affiliation(s)
- Mobarak Hossain
- Department of Social Policy and Intervention, Nuffield College, University of Oxford, New Road, Oxford, OX1 1NF, United Kingdom
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Park S, Park J, Kang E, Lee JW, Kim Y, Park M, Kim K, Kim HJ, Han M, Cho JH, Lee JP, Lee S, Kim SW, Park SM, Chae DW, Chin HJ, Kim YC, Kim YS, Choi I, Lee H. Economic Impact of Donating a Kidney on Living Donors: A Korean Cohort Study. Am J Kidney Dis 2021; 79:175-184.e1. [PMID: 34419516 DOI: 10.1053/j.ajkd.2021.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 10/13/2020] [Accepted: 07/04/2021] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Although existing studies have reported adverse health outcomes after kidney donation, its socioeconomic impact on living donors requires further study. STUDY DESIGN A retrospective observational cohort study including a matched comparison group. SETTING & PARTICIPANTS 1,285 living kidney donors from 7 tertiary hospitals between 2003 and 2016, and a matched comparison group consisting of the same number of health screening examinees with similar baseline clinical characteristics and socioeconomic status. All participants were receiving Korean national health insurance. EXPOSURE Kidney donation as reflected in the Korean National Health Insurance System (NHIS) database. OUTCOME Changes in household economic status estimated by Korean national health insurance fees and changes in employment status reflected in the NHIS database. ANALYTICAL APPROACH The outcomes of the donor group and matched control group were compared annually using multivariable logistic regression analyses adjusted for clinical and demographic characteristics. RESULTS The median ages of the donors and matched controls were 45 and 46 years, respectively; 44.6% of both groups were male. Compared to the comparison group, living donors were at higher risk of being unemployed or losing employment during the first 2 years after donation (eg, first-year loss of employment: odds ratio (OR), 2.27 [95% CI, 1.55-3.33]); however, this association did not persist. Donors also had a significantly lower odds of improvement in economic status (OR, 0.57 [95% CI, 0.47-0.71]) and a higher odds of deterioration in financial status (OR, 1.54 [95% CI, 1.23-1.93]) in the first year after transplantation and subsequently. LIMITATIONS Unmeasured differences between donors and matched controls creating residual selection bias and confounding. CONCLUSIONS Living kidney donors may suffer loss of employment and poor economic status after their voluntary donation. The socioeconomic impact on these donors should be considered in conjunction with the potential long-term adverse health outcomes after donation.
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Affiliation(s)
- Sehoon Park
- Department of Biomedical Science, College of Medicine, Seoul National University, Seoul, South Korea
| | - Jina Park
- Department of Biostatistics, College of Medicine, Korea University, Seoul, South Korea
| | - Eunjeong Kang
- Department of Internal Medicine, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul, South Korea
| | - Jang Wook Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University, Seoul, South Korea
| | - Yaerim Kim
- Department of Internal Medicine, School of Medicine, Keimyung University, Daegu, South Korea
| | - Minsu Park
- Department of Information and Statistics, Chungnam National University, Daejeon, Korea
| | - Kwangsoo Kim
- Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University, Seoul, South Korea
| | - Hyo Jeong Kim
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Miyeun Han
- Department of Internal Medicine, Pusan National University Hospital, Pusan, South Korea
| | - Jang-Hee Cho
- Department of Internal Medicine, Kyungpook National University, Daegu, South Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Boramae Medical Center, Seoul National University, Seoul, South Korea
| | - Sik Lee
- Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, South Korea
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Sang Min Park
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Dong-Wan Chae
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ho Jun Chin
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yong Chul Kim
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul National University, Seoul, South Korea
| | - Yon Su Kim
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul National University, Seoul, South Korea
| | - Insun Choi
- Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, South Korea
| | - Hajeong Lee
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea; Department of Internal Medicine, Seoul National University Hospital, Seoul National University, Seoul, South Korea.
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11
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Sutton TE, Simons LG. Examining Adolescent Family Experiences as Risks for Young Adulthood Intimate Partner Violence in Two Longitudinal Samples. J Youth Adolesc 2021; 50:1797-1810. [PMID: 34244921 DOI: 10.1007/s10964-021-01473-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 11/29/2022]
Abstract
Little research has examined multiple family risks that may act as precursors to the cycle of violence, or the link between child maltreatment and subsequent intimate partner violence perpetration. Scholarly work that addresses this gap has important implications for early prevention and intervention efforts aimed at reducing family violence in adolescence and young adulthood. Based upon the family stress model and the cycle of violence hypothesis, it was hypothesized that adolescent experiences of economic pressure, caregiver depressed mood, and caregiver conflict would increase risk for abusive parenting and that abusive parenting in adolescence would link these family experiences to partner violence perpetration in young adulthood. The model was tested using longitudinal data spanning 12 years from two studies: The Iowa Youth and Families Project (N = 306, 56.2% women), a sample of White, married-parent families, and the Family and Community Health Study (N = 213, 53.3% women), a sample of Black families diverse in terms of family structure. Path model analyses provided support for the proposed model in each sample, highlighting the importance of considering several adolescent family experiences in work on the etiology of partner violence. Policy and practice interventions are offered, such as the need for economic supports for families, accessible mental health care, and relationship education programming for youth.
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Affiliation(s)
- Tara E Sutton
- Mississippi State University, Mississippi State, MS, USA.
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12
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Bierman A, Upenieks L, Glavin P, Schieman S. Accumulation of economic hardship and health during the COVID-19 pandemic: Social causation or selection? Soc Sci Med 2021; 275:113774. [PMID: 33711676 DOI: 10.1016/j.socscimed.2021.113774] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/28/2021] [Accepted: 02/09/2021] [Indexed: 01/21/2023]
Abstract
This study examines whether economic hardship during the COVID-19 pandemic is deleteriously associated with psychological distress and self-rated health. A social causation perspective suggests that exposure to economic hardship will harm well-being, but a social selection perspective suggests that the appearance of health effects of hardship during the pandemic are attributable to the increased risk of exposure to hardship associated with poor well-being at the start of the pandemic. We also propose a third perspective, economic selection, which suggests that economic hardship prior to the pandemic negatively affects health and increases risk of exposure to hardship during the pandemic; consequently, an association between health and economic hardship during the pandemic may be spurious, and entirely due to pre-existing levels of hardship. To test these competing perspectives, we use a longitudinal study based in Canada that began in late March of 2020 and followed respondents monthly in April, May, and June. Baseline psychological distress and self-rated health, as well as economic hardship prior to the pandemic, independently predict the accumulation of monthly periods of hardship from April to June. The accumulation of periods of hardship from April to June is deleteriously associated with psychological distress and self-rated health in June. Controls for prior economic hardship and baseline health weaken the association between accumulation of periods of hardship and psychological distress, while also eliminating the association between accumulation of hardship and self-rated health. These findings favor a social causation perspective for psychological distress and a social selection perspective for self-rated health, with less evidence found in support of economic selection. This study took place during the first months of the COVID-19 pandemic, though, and associations with self-rated health may have become more evident as hardship further wore on individual well-being over a longer period of time.
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Affiliation(s)
- Alex Bierman
- University of Calgary, Calgary, Alberta, Canada.
| | | | - Paul Glavin
- McMaster University, Hamilton, Ontario, Canada
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Michas G, Magriplis E, Micha R, Chourdakis M, Chrousos GP, Roma E, Dimitriadis G, Panagiotakos D, Zampelas A. Sociodemographic and lifestyle determinants of depressive symptoms in a nationally representative sample of Greek adults: The Hellenic National Nutrition and Health Survey (HNNHS). J Affect Disord 2021; 281:192-198. [PMID: 33326892 DOI: 10.1016/j.jad.2020.12.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 11/08/2020] [Accepted: 12/05/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The aim of this study was to assess depressive symptomatology prevalence among Greek adults amidst the financial crisis and to explore the association between depressive symptoms and sociodemographic and lifestyle factors. METHODS The Hellenic National Nutrition and Health Survey including a nationally representative adult sample (3,675 adults; 48.7% males) was used. Trained personnel gathered information on sociodemographic and anthropometric characteristics and lifestyle status. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and clinically relevant depressive symptomatology was defined as PHQ-9 score≥10, or on anti-depressant medication. Associations between depressive symptoms and the assessed factors were estimated using stratified multivariable logistic regression. RESULTS The prevalence of clinically relevant depression was 9.4%. In the regression, female sex, marital status (widowed vs. married), financial difficulties (yes vs. no), professional status (employed vs. unemployed), body mass index status (overweight/obese vs. normal weight), and smoking status (current and ex-smokers vs. never smokers) were significant, with an increased likelihood for depressive symptomatology in all variables, other than employment. LIMITATIONS The cross-sectional nature of the study does not allow detection of changes over time. Furthermore, it does not allow determining the presence of a temporal relationship between depression and the sociodemographic and lifestyle variables that we tested. CONCLUSION This study estimates a high prevalence of depressive symptoms among adults during the Greek financial crisis and points out important associations of depressive symptoms with different sociodemographic determinants and lifestyle factors, and provides policy health makers valuable information in their efforts to deal with this epidemic.
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Affiliation(s)
- George Michas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Renata Micha
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece
| | - Michael Chourdakis
- Department of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54 124 Thessaloniki, Greece
| | - George P Chrousos
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27 Athens, Greece
| | - Eleftheria Roma
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27 Athens, Greece
| | - George Dimitriadis
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, National and Kapodistrian University of Athens, "Attikon" University Hospital, Haidari, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University, Athens, Eleftheriou Venizelou 70, 176 76 Athens, Greece
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera Odos 75, 118 55 Athens, Greece.
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Lin TK, Law R, Beaman J, Foster DG. The impact of the COVID-19 pandemic on economic security and pregnancy intentions among people at risk of pregnancy. Contraception 2021; 103:380-5. [PMID: 33587906 DOI: 10.1016/j.contraception.2021.02.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To understand how the COVID-19 pandemic affected women of reproductive age, specifically their economic conditions, desire for pregnancy, and access to contraceptive services during the pandemic. STUDY DESIGNS A total of 554 women respondents age 18 to 49 and reside in the United States were recruited using social media between May 16, 2020 and June 16, 2020. Logistic regression models assessed predictors of reporting pandemic-related changes in economic conditions, desire for pregnancy, and contraceptive access. RESULTS Compared to White/Caucasian respondents, Hispanics/Latinx and Black/African Americans have 4 times the odds of experiencing inability to afford food, transportation, and/or housing (p < 0.01) during the pandemic; Hispanics/Latinx have twice the odds of experiencing food insecurity (p < 0.05). Inability to afford food, transportation, and/or housing was associated with drop in desire to be pregnant (p < 0.01). Despite the 25% of participants who reported a drop in desire for pregnancy, 1 in 6 reported difficulty accessing contraceptives, particularly those who experienced reduced income (p < 0.01). CONCLUSIONS In our sample, the pandemic unevenly affected people from different socioeconomic groups. Many simultaneously experienced reduced income, difficulties in accessing contraception, and a greater desire to avoid a pregnancy. This combination of factors increases the chance that people will experience unintended pregnancies. IMPLICATIONS The pandemic caused economic hardship and an increased desire to postpone or prevent pregnancy at the same time that it created new barriers to contraceptive services. This pattern may lead to a potential net effect of an increase in unintended pregnancy, particularly among people who had difficulty affording food, transportation, and/or housing during the pandemic.
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Hossain M. Gender differences in experiencing coronavirus-triggered economic hardship: Evidence from four developing countries. Res Soc Stratif Mobil 2021; 71:100555. [PMID: 33041426 PMCID: PMC7537603 DOI: 10.1016/j.rssm.2020.100555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 06/11/2023]
Abstract
The effect of labor market inequalities during economic crises is a well-established topic. Yet, little is known about this in the context of developing countries. We use recently collected phone survey data by Young Lives (YL) from four countries-Ethiopia, India (Andhra Pradesh and Telangana State), Peru and Vietnam-to examine whether men and women suffer from coronavirus-triggered economic hardship differently. We find that men are more likely to lose jobs and income in Ethiopia and India-countries with a very high male-dominated formal sector. Conversely, gender effect is not significant in Peru and Vietnam with comparatively higher integration of women in formal employment. We further investigate whether gender effect varies by 'wealth' level. Findings suggest that only in India, in the wealthier group, men are more likely to face job and income loss than women, possibly indicating greater male concentration in higher-class occupations. However, the gender gap in facing hardship by wealth group is not significant for other countries.
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Affiliation(s)
- Mobarak Hossain
- Department of Social Policy and Intervention, Nuffield College, University of Oxford, United Kingdom
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16
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Abstract
OBJECTIVE To determine the temporal directionality of the association between food insecurity and maternal depression. DESIGN Food insecurity was measured at two time points using the eighteen-item USDA Food Security Scale. Maternal depression was measured at two time points using the fifteen-item Composite International Diagnostic Interview-Short Form. Two structural equation models were utilised to evaluate the impact of food insecurity on maternal depression (model 1) and the impact of maternal depression on food insecurity (model 2). Both models controlled for socio-demographic and parenting characteristics and child behaviour problems, along with prior measures of the dependent variable and concurrent measures of the independent variable. SETTING Fragile Families and Child Wellbeing (FFCW) study, twenty cities across the USA. PARTICIPANTS 4897 mothers who participated in two waves of the FFCW study. RESULTS On average, 17 % (time 1) and 15 % (time 2) of mothers experienced food insecurity and 21 % (time 1) and 17 % (time 2) of mothers experienced depression over time. Maternal depression at time 1 was associated with 53 % increased odds (OR = 1·53; B = 0·43; P < 0·001) of food insecurity at time 2, controlling for time 1 food insecurity, concurrent depression and covariates. Food insecurity at time 1 was associated with 36 % increased odds (OR = 1·36; B = 0·31; P < 0·001) of maternal depression at time 2, controlling for time 1 depression, concurrent food insecurity and covariates. CONCLUSIONS We found a bidirectional relationship between food insecurity and maternal depression. A holistic approach that combines food assistance and mental health services may be an efficacious approach to reducing both depressive symptoms and food insecurity among low-income mothers.
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Fallon B, Lefebvre R, Collin-Vézina D, Houston E, Joh-Carnella N, Malti T, Filippelli J, Schumaker K, Manel W, Kartusch M, Cash S. Screening for economic hardship for child welfare-involved families during the COVID-19 pandemic: A rapid partnership response. Child Abuse Negl 2020; 110:104706. [PMID: 32919762 PMCID: PMC7472971 DOI: 10.1016/j.chiabu.2020.104706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 05/13/2023]
Abstract
BACKGROUND Pandemics have a wide range of economic, health and social consequences related to both the spread of a disease and efforts made by government leaders to contain it which may be particularly detrimental for the child welfare-involved population. This is because child welfare agencies serve some of the highest needs children and families. A significant proportion of these families face economic hardship, and as a result of containment measures for COVID-19, more families inevitably will. OBJECTIVE Given the range of negative consequences related to the pandemic and the evolving supports available to families, child protection workers needed a clinical tool to guide and support work with families informed by an understanding of economic hardship. The objective of this paper is to report on the development and implementation strategy of a tool to be used for practice intervention during the pandemic. METHODS Action research methodology was utilized in the creation of the clinical tool. The tool's development and implementation occurred through an academic/child welfare sector partnership involving child welfare agencies representing diverse regions and populations in Ontario, Canada. Factor analysis of representative child welfare data from the Ontario Incidence Study of Reported Child Abuse and Neglect 2018 (OIS-2018) on economic hardship was used to inform the development of questions on the clinical tool. RESULTS The development and implementation strategy of the clinical tool are described, including the results from analyses of the OIS-2018. CONCLUSIONS Future directions for the project are discussed, including considerations for using this tool beyond the pandemic.
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Affiliation(s)
- Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada.
| | - Rachael Lefebvre
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada
| | | | - Emmaline Houston
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada
| | | | - Tina Malti
- Department of Psychology, University of Toronto, Canada
| | - Joanne Filippelli
- Factor-Inwentash Faculty of Social Work, University of Toronto, Canada
| | | | - Wendy Manel
- Catholic Children's Aid Society of Toronto, Canada
| | | | - Scottye Cash
- College of Social Work, The Ohio State University, USA
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Lee CY, Zhao X, Reesor-Oyer L, Cepni AB, Hernandez DC. Bidirectional Relationship Between Food Insecurity and Housing Instability. J Acad Nutr Diet 2021; 121:84-91. [PMID: 33060025 DOI: 10.1016/j.jand.2020.08.081] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/30/2020] [Accepted: 08/19/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Due to the commonality of material hardship, food insecurity and housing instability are highly correlated. There is a need to assess the bidirectional relationship between food insecurity and housing instability over time. OBJECTIVES To examine the potential bidirectional associations between food insecurity and housing instability over a 2-year period. DESIGN Two time points from the Fragile Families and Child Wellbeing Study were used to conduct an analysis on 2368 families. PARTICIPANTS/SETTING At baseline (1998-2000), researchers recruited primarily unmarried mothers after giving birth from 75 hospitals in 20 cities across the United States. Participants were followed up when the child was 3 years old (2001-2003) and 5 years old (2003-2005). MAIN OUTCOMES MEASURED Food insecurity was assessed using the 18-item US Department of Agriculture's Food Security Survey. Housing instability was assessed using 6 items that describe housing related hardship. STATISTICAL ANALYSES PERFORMED Cross-lagged path analyses using structural equation modeling were conducted to test bidirectional relationship of food insecurity and housing instability over time, controlling for sociodemographic characteristics. RESULTS Families who experienced food insecurity at time 1 were 62% higher odds of experiencing housing instability at time 2 (odds ratio: 1.624, B = 0.485, 95% confidence interval: 0.199, 0.778), controlling for time 1 housing instability, concurrent food insecurity, and covariates. Families who experienced housing instability at time 1 were 40% increased odds of experiencing food insecurity at time 2 (odds ratio: 1.404, B = 0.339, 95% confidence interval: 0.071, 0.619), controlling for food insecurity at time 1, concurrent housing instability, and covariates. CONCLUSIONS The relationships between food insecurity and housing instability were highly correlated over time, controlling for covariates that are associated with socioeconomic status. Currently, programs designed to reduce food insecurity and housing instability function in isolation. Consolidating antipoverty programs or increasing referrals to various programs may help to reduce these 2 types of economic hardships.
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Schuler BR, Daundasekara SS, Hernandez DC, Dumenci L, Clark M, Fisher JO, Miller AL. Economic hardship and child intake of foods high in saturated fats and added sugars: the mediating role of parenting stress among high-risk families. Public Health Nutr 2020; 23:2781-92. [PMID: 32713394 DOI: 10.1017/S1368980020001366] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Economic hardship (EH) may link to poorer child diet, however whether this association is due to resource limitations or effects on family functioning is unknown. This study examines whether parenting stress mediates the association between EH and child consumption of foods high in saturated fats and added sugars (SFAS). DESIGN Data were collected from the Fragile Families and Child Wellbeing study. EH was assessed using eight items collected when children were between 1-9 years old. Mothers reported parenting stress and frequency of child consumption of high SFAS foods when children were 9 years old. Latent growth curve modelling (LGCM) and structural equation modelling tested direct associations between the starting level/rate of change in EH and high SFAS food consumption, and parenting stress as a mediator of the association. SETTING Twenty US cities. PARTICIPANTS Mothers/children (n 3846) followed birth through age 9 years, oversampled 'high-risk', unmarried mothers. RESULTS LGCM indicated a curvilinear trend in EH from ages 1-9, with steeper increases from ages 3-9 years. EH did not directly predict the frequency of high SFAS foods. Average EH at 3 and 5 years and change in EH from ages 1-9 predicted higher parenting stress, which in turn predicted more frequent consumption of high SFAS foods. CONCLUSIONS Findings suggest it may be important to consider parenting stress in early prevention efforts given potential lasting effects of early life EH on child consumption of high SFAS foods. Future research should explore how supports and resources may buffer effects of EH-related stress on parents and children.
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Fegert JM, Vitiello B, Plener PL, Clemens V. Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: a narrative review to highlight clinical and research needs in the acute phase and the long return to normality. Child Adolesc Psychiatry Ment Health 2020; 14:20. [PMID: 32419840 PMCID: PMC7216870 DOI: 10.1186/s13034-020-00329-3] [Citation(s) in RCA: 812] [Impact Index Per Article: 203.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 05/06/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) is profoundly affecting life around the globe. Isolation, contact restrictions and economic shutdown impose a complete change to the psychosocial environment in affected countries. These measures have the potential to threaten the mental health of children and adolescents significantly. Even though the current crisis can bring with it opportunities for personal growth and family cohesion, disadvantages may outweigh these benefits. Anxiety, lack of peer contact and reduced opportunities for stress regulation are main concerns. Another main threat is an increased risk for parental mental illness, domestic violence and child maltreatment. Especially for children and adolescents with special needs or disadvantages, such as disabilities, trauma experiences, already existing mental health problems, migrant background and low socioeconomic status, this may be a particularly challenging time. To maintain regular and emergency child and adolescent psychiatric treatment during the pandemic is a major challenge but is necessary for limiting long-term consequences for the mental health of children and adolescents. Urgent research questions comprise understanding the mental health effects of social distancing and economic pressure, identifying risk and resilience factors, and preventing long-term consequences, including-but not restricted to-child maltreatment. The efficacy of telepsychiatry is another highly relevant issue is to evaluate the efficacy of telehealth and perfect its applications to child and adolescent psychiatry. CONCLUSION There are numerous mental health threats associated with the current pandemic and subsequent restrictions. Child and adolescent psychiatrists must ensure continuity of care during all phases of the pandemic. COVID-19-associated mental health risks will disproportionately hit children and adolescents who are already disadvantaged and marginalized. Research is needed to assess the implications of policies enacted to contain the pandemic on mental health of children and adolescents, and to estimate the risk/benefit ratio of measures such as home schooling, in order to be better prepared for future developments.
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Affiliation(s)
- Jörg M. Fegert
- grid.6582.90000 0004 1936 9748Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5, 89073 Ulm, Germany
| | - Benedetto Vitiello
- grid.7605.40000 0001 2336 6580Division of Child Neurology and Psychiatry, Regina Margherita Pediatric Hospital, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Paul L. Plener
- grid.6582.90000 0004 1936 9748Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5, 89073 Ulm, Germany ,grid.22937.3d0000 0000 9259 8492Department for Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Vera Clemens
- grid.6582.90000 0004 1936 9748Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5, 89073 Ulm, Germany
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Spivak S, Cullen B, Eaton WW, Rodriguez K, Mojtabai R. Financial hardship among individuals with serious mental illness. Psychiatry Res 2019; 282:112632. [PMID: 31690462 DOI: 10.1016/j.psychres.2019.112632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 11/21/2022]
Abstract
This study explored financial hardship, defined as difficulty in obtaining food, shelter, or medicine in the past 12 months and its personal and clinical correlates in individuals with serious mental illness (SMI) in a sample of 271 adults with SMI newly admitted to two inner city community mental health centers. The study found that 59 percent (n = 161) reported experiencing financial hardship in the past 12 months. Patients with financial hardship were more likely to be female, to experience self-stigma, to experience medical care delays, and to use emergency services. Patients who experienced financial hardship typically had more severe psychiatric symptoms, including depressive symptoms, emotional lability, and interpersonal problems. Financial hardship persisted in nearly half of those with hardship interviewed a year later. The findings highlight the role of multiple social and economic challenges that the SMI patients face in recovery from serious mental illness and the importance of awareness of such challenges by providers treating this population. Though mental health treatment may help alleviate the psychiatric symptoms it alone is not sufficient in addressing persistent hardship. These findings highlight the need for multidisciplinary interventions in order to better serve this vulnerable population.
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Liming KW. Examining the Differing Effects of Economic Hardship and Poor Maternal Wellbeing on Cumulative Exposure to Adverse Childhood Experiences. J Child Adolesc Trauma 2019; 12:307-321. [PMID: 32318201 PMCID: PMC7163802 DOI: 10.1007/s40653-018-0230-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Extensive research supports a strong and cumulative relationship between adverse childhood experiences (ACEs) and risky adult behaviors, mental health disorders, diseases, and health status. Additional factors, such as poor maternal wellbeing and economic hardship, compound the detrimental health and wellbeing implications associated with childhood exposure to ACEs. However, limited research has explored the differentiating effects of economic hardship and maternal wellbeing on a child's cumulative ACE exposure. This study examined the differing effects of poor maternal wellbeing and economic hardship on a child's exposure to ACEs. This study used a random sub-sample (n = 4000) from the 2011 to 2012 National Survey on Children's Health (NSCH), a nationally representative cross-sectional study of children (N = 95,677) between birth and 17 years old. Confirmatory factor analysis results revealed greater economic hardship had a significant direct effect on a child's ACE exposure and poorer maternal wellbeing. Poor maternal wellbeing had a significant mediation-like effect on the relationship between economic hardship and a child's cumulative ACE exposure. Practice and policy implications include early ACE assessments tailored to identify children and families experiencing adversity across multiple domains.
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Affiliation(s)
- Kiley W. Liming
- School of Social Welfare, University of Kansas, 1545 Lilac Lane, Lawrence, KS 66045 USA
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Foverskov E, Petersen GL, Pedersen JLM, Rod NH, Mortensen EL, Bruunsgaard H, Lund R. Economic hardship over twenty-two consecutive years of adult life and markers of early ageing: physical capability, cognitive function and inflammation. Eur J Ageing 2020; 17:55-67. [PMID: 32158372 DOI: 10.1007/s10433-019-00523-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
This study assesses the associations between annual measures of economic hardship (EH) across 22 years of adulthood and objective measures of early ageing in a Danish late-middle-aged population (N = 5575). EH (years < 60% of the National median equivalized household disposable income) was experienced by 18% during 1987-2008. Four or more years in EH (reference = null years in EH) was related to poorer physical capability (chair rise: - 1.49 counts/30 s [95% confidence interval (CI) - 2.36, - 0.61], hand grip strength: - 1.22 kg [95% CI - 2.38, - 0.07], jump height: - 1.67 cm [95% CI - 2.44, - 0.91] and balance: 18% [95% CI 9, 28]), poorer cognitive function (Intelligenz-Struktur-Test: - 1.50 points [95% CI - 2.89, - 0.12]) and higher inflammatory levels (C-reactive protein: 22% [95% CI 4, 44], and Interleukin-6: 23% [95% CI 10, 39]). Comparing four EH trajectories, people with a high versus low probability of EH over time had poorer physical capability (chair rise: - 1.70 counts/30 s [95% CI - 3.38, - 0.01], grip: - 4.33 kg [95% CI - 6.50, - 2.16], jump: - 1.68 cm [95% CI - 3.12, - 0.25] and balance: 31% [95% CI 12, 52]). No associations were observed with tumour necrosis factor-α. Results were adjusted for sex, age, long-term parental unemployment/financial problems, education, baseline income and cohort. This study suggested EH for four or more years to be associated with poorer physical capability, cognitive function and increased inflammatory levels in midlife. High probability of EH across adulthood was similarly related to poorer physical capability and CRP, but not cognitive function and the remaining inflammatory markers. In conclusion, preventive initiatives focusing on reducing the burden of sustained economic hardship may lead to increased healthy ageing.
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Frost DM, Fine M, Torre ME, Cabana A. Minority Stress, Activism, and Health in the Context of Economic Precarity: Results from a National Participatory Action Survey of Lesbian, Gay, Bisexual, Transgender, Queer, and Gender Non-Conforming Youth. Am J Community Psychol 2019; 63:511-526. [PMID: 30989666 DOI: 10.1002/ajcp.12326] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Lesbian, gay, bisexual, transgender, queer, and gender non-conforming (LGBTQ & GNC) youth experience more economic hardship and social stress than their heterosexual and cisgender peers. However, the ways that LGBTQ & GNC youth resist these damaging social factors and the corresponding implications for their health have not been addressed. Data were analyzed from a national participatory survey of LGBTQ & GNC youth ages 14-24 (N = 5,860) living in the United States. Structural equation models indicated that economic precarity was associated with experiences of health problems. This association was mediated by the negative influence of minority stress on health as well as by activism, which had a positive association with health. Findings suggest that minority stress explanations of health inequalities among LGBTQ & GNC youth can benefit from including a focus on economic precarity; both in terms of its deleterious impact on health and its potential to provoke resistance to structural oppression in the form of activism.
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Affiliation(s)
| | - Michelle Fine
- The Graduate Center, City University of New York, New York, NY, USA
| | | | - Allison Cabana
- The Graduate Center, City University of New York, New York, NY, USA
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25
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King C. Food insecurity and child behavior problems in fragile families. Econ Hum Biol 2018; 28:14-22. [PMID: 29197238 DOI: 10.1016/j.ehb.2017.11.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 10/31/2017] [Accepted: 11/08/2017] [Indexed: 06/07/2023]
Abstract
Food insecurity remains a persistent problem in the United States. Several studies have shown that food insecurity is associated with child externalizing and internalizing behavior problems. However, some potential methodological limitations remain. For example, most studies use a household measure of food insecurity while there is evidence that children, especially younger ones, tend to be shielded by their parents from experiencing food insecurity. In addition, the mechanisms through which food insecurity affects children are not well understood. This study uses longitudinal data from the Fragile Families and Child Wellbeing Study to address these limitations. Fixed-effects models show that the association is even larger using a measure of child food insecurity instead of a household one. Correlated-random effects models show a large difference in child behavior problems between food secure and food insecure children due to unobserved heterogeneity. In addition, the association between child food insecurity and child externalizing behaviors remains largely unexplained while food insecurity among adults explains almost all the variation in the association with child internalizing behaviors. Food insecure children and parents are at risk of micronutrient deficiencies, which may lead to behavior problems in young children. These findings underscore the need for greater focus on reducing the risk of food insecurity, especially for children in fragile families, in order to reduce behavior problems and improve their educational attainment.
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Affiliation(s)
- Christian King
- University of Central Florida, Department of Health Management and Informatics, 4364 Scorpius Street, HPA II Suite 210, Orlando, FL 32816-2205, United States.
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Economou M, Angelopoulos E, Peppou LE, Souliotis K, Tzavara C, Kontoangelos K, Madianos M, Stefanis C. Enduring financial crisis in Greece: prevalence and correlates of major depression and suicidality. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1015-24. [PMID: 27178432 DOI: 10.1007/s00127-016-1238-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 05/08/2016] [Indexed: 01/24/2023]
Abstract
PURPOSE A series of repeated cross-sectional surveys conducted in 2008, 2009, 2011 and 2013 were conducted with the aim of estimating the prevalence of major depression and suicidality as well as of investigating its risk factors. The present report concentrates on the 2013 survey. METHODS A random and representative sample of 2.188 people was telephone interviewed with regard to various socio-economic indicators and the presence of major depression and suicidality, which were assessed with the germane module of the Structured Clinical Interview. RESULTS Findings suggest a rise in 1-month prevalence of major depression (12.3 %) and a decline in prevalence of suicidality (2.8 %). Female gender, residence in rural area, low educational attainment, unemployment and economic hardship were found to increase the odds of suffering from major depression. The influence of economic hardship and unemployment on suicidality was also substantial and independent of major depression. CONCLUSIONS Results stress the imperative need for the design and implementation of social policies and interventions that would offset the dire impact of the sustained recession in Greece.
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Abstract
PURPOSE The purpose of this study was to use pooled data from two independent studies of rural African-American youths to test the moderation effect of the corticotropin-releasing hormone receptor 1 gene (CRHR1) on the link between family economic hardship and trajectories of depressive symptoms. METHODS Two longitudinal studies were conducted involving African-Americans, aged 16 (N = 474) and 18 (N = 419) years, who were randomly recruited in rural Georgia. Family economic hardship and youths' depressive symptoms were assessed four times across 2.5 years. Genetic data also were collected. Haplotype analysis was performed on single-nucleotide polymorphisms of CRHR1; two haplotypes were aggregated to form a CRHR1 index. Growth curve models were executed to determine whether CRHR1 moderated the link between Wave 1 family economic hardship and youths' development of depression. RESULTS CRHR1 × family economic hardship interactions significantly predicted youths' depressive symptoms. When exposed to family economic hardship 1 standard deviation above the mean at Wave 1, youths who scored 0 on the CRHR1 index showed high and increasing depressive symptoms across time, whereas those who scored 2 on the index showed a decrease in depressive symptoms. CONCLUSIONS The CRHR1 gene reduces the risk for depressive symptoms among youths living in families undergoing high levels of economic hardship.
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Affiliation(s)
- Yi-fu Chen
- Department of Sociology, National Taipei University, New Taipei City, Taiwan.
| | - Gene H. Brody
- University of Georgia, Center for Family Research, 1095 College Station Road, Athens, GA 30602-4527, USA
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28
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Hernandez DC. The impact of cumulative family risks on various levels of food insecurity. Soc Sci Res 2015; 50:292-302. [PMID: 25592937 DOI: 10.1016/j.ssresearch.2014.12.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 08/11/2014] [Accepted: 12/05/2014] [Indexed: 05/11/2023]
Abstract
The study uses the Fragile Families and Child Well-being Study (N=2025) to examine the relationship between four cumulative family risk indices and refined measures of food hardship: marginal food security, low food security, and very low food security. Regression analyses indicate that cumulative family risk indices are useful in differentiating various levels of food insecurity. Specifically, the maternal poor health and risky health behaviors index is pertinent for distinguishing (1) food insecure from marginal food secure households and (2) very low food secure from low food secure households. In addition, the financial strain index is pertinent for differentiating between marginal food secure families from food secure families among non-poor households. Connecting food assistance programs with established social services may decrease the negative impact that cumulative family-level risk factors have on families' varying levels of food insecurity.
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Affiliation(s)
- Daphne C Hernandez
- University of Houston, Texas Obesity Research Center and the Department of Health and Human Performance, 3855 Holman St., Garrison Gymnasium Rm 104, Houston, TX 77204-6015, United States.
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