Ssm-Population Health最新文献

英文中文

Technology for sustainable living: The impact of digital inclusion on the health of China's elderly living alone

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-01-09 DOI: 10.1016/j.ssmph.2025.101751

Yong Yan , Huixia Xing

Enhancing elderly health has become an important measure for coping with population ageing and building a healthy China. Among them, older adults living alone seem to suffer from greater loneliness and psychological stress. We analyzed data from the China Health and Retirement Longitudinal Study in 2015, 2018, and 2020, and carried out an empirical investigation into the impact of digital inclusion on the health of elderly individuals living alone, using two-way fixed effects models and two-stage least squares. The findings suggest that digital inclusion could positively impact the health of older people living alone. Specifically, for a one-standard-deviation increase in digital inclusion, the depression scale score decreases by 0.48 (α = −0.21, p < 0.01); the cognitive function score increases by 0.27(α = 0.12, p < 0.01); the instrumental activities of daily living score would decrease by 0.11 (α = −0.05, p < 0.01). An increase of 1 in the digital inclusion score decreases the self-rated health score by 0.02 (α = −0.02, p < 0.01). It can significantly enhance the health status of elderly people who live alone through mechanisms of improving life satisfaction, increasing the utilization of preventive health care services, and promoting social participation. Subsequent analyses identified varying effects of digital inclusion on older adults living alone, influenced by their income and education levels. In particular, digital inclusion substantially enhanced instrument activities of daily living among the aged who lived alone and with higher income and educational backgrounds. However it had no significant effect on older people living alone with lower incomes and educational backgrounds. The insights from this study could be invaluable for policymakers in promoting broader adoption of digital technologies among older adults living alone.

提高老年人健康水平已成为应对人口老龄化、建设健康中国的重要举措。其中，独居老年人似乎承受着更大的孤独感和心理压力。我们分析了2015年、2018年和2020年的中国健康与退休纵向研究数据，采用双向固定效应模型和两阶段最小二乘法对数字普惠对独居老年人健康的影响进行了实证调查。研究结果表明，数字包容性会对独居老年人的健康产生积极影响。具体而言，数字包容性每增加一个标准差，抑郁量表得分就会降低 0.48（α = -0.21，p＜0.05）。

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引用次数: 0

Data impacts of changes in U.S. Census Bureau procedures for race and ethnicity data

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-01-09 DOI: 10.1016/j.ssmph.2024.101742

Elizabeth Arias , Carolyn A. Liebler , Marc A. Garcia , Rogelio Sáenz

Beginning with the 2020 decennial census and the 2020 American Community Survey (ACS), the U.S. Census Bureau implemented changes in question design, data processing, and coding procedures for the race and ethnicity data they collect that appear to have resulted in major data discontinuity. However, the Census Bureau has not released nor plans to release research showing the impact of these changes. We explore the impact of the Census Bureau's procedural changes on the racial and ethnic distributions of the Hispanic (generally and by country of origin) and the American Indian and Alaska Native populations, the two populations most impacted by these changes. We use the 2019 and 2021 one-year ACS public-use microdata and 2019 and 2021 NCHS mortality data to compare racial distributions and estimate and compare select demographic and socioeconomic characteristics, and mortality measures across the two years. Our results show that changes the Census Bureau implemented beginning with the 2020 decennial census and ACS appear to have had a significant impact on the comparability of Census Bureau race and ethnicity data. We find a significant data discontinuity impacting a wide variety of demographic, socioeconomic, and mortality statistics and analyses that rely on U.S. Census Bureau data as input for calculations. To mitigate these effects, methods that bridge race and ethnicity data between pre- and post-2020 census data are needed. Our research brings new attention and clarity to the race and ethnicity data discontinuity in Census Bureau data that started in 2020.

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引用次数: 0

Intergenerational mobility, race, and allostatic load: Diminished health returns for Black older adults?

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-01-08 DOI: 10.1016/j.ssmph.2025.101750

Mallory J. Bell , Kenneth F. Ferraro

Although socioeconomic status is salient for health and well-being across the life course, previous research indicates that the social gradient in health is racialized and that Black adults experience diminishing health returns on higher socioeconomic status. We extend this literature by examining whether there are diminishing physiological health returns on intergenerational mobility groups for Black adults and, if so, whether diminishing health returns vary across age. We use six waves of data from the Health and Retirement Study (N = 11,846) and mixed effects models; and average marginal effects are used to interpret the race by intergenerational mobility interaction. We found evidence of racial disparities in allostatic load and that Black respondents with stable high socioeconomic status experienced diminished health returns that did not vary across age. Future research is needed to undercover practices and policies to ameliorate diminishing health returns for Black adults.

引用次数: 0

Association between family economic decision-making power and survival outcomes among older adults in China: A population-based longitudinal study

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-01-04 DOI: 10.1016/j.ssmph.2025.101749

Liyong Lu , Ting Chen , Sicheng Li , Tianjiao Lan

Objective

This study examines the association between family economic decision-making power and survival outcomes among older adults.

Methods

Data were drawn from the China Longitudinal Healthy Longevity Survey (CLHLS) from 2005 to 2018. Family economic decision-making power was assessed based on participants’ self-reported influence over household financial matters, categorized as: “making decisions on almost all household expenditures”, “deciding on non-essential spending”, “only deciding on personal expenditures”, and “having no decision-making power over household spending”. Survival status and date of death were determined through interviews with close family members during each survey round. Cox proportional hazards regression models were used to analyze the relationship between family economic decision-making authority and survival outcomes among older adults using longitudinal follow-up data. Subgroup analyses were conducted to identify vulnerable populations.

Results

The study included 10,443 older adults, of whom 5606 (53.68%) died during the follow-up period, with a median survival time of 7 years. Compared to those with full decision-making authority, the hazard ratios (95% CI) were 1.02 (0.87–1.20) for those with authority over non-essential spending, 1.22 (1.07–1.38) for those with authority over personal spending, and 1.24 (1.04–1.47) for those with no decision-making power. The impact of low decision-making authority on survival was modified by factors such as gender, occupation before age 60, household economic status, experience of child loss, and physical labor.

Conclusions

Low family economic decision-making power is associated with an increased risk of mortality. Promoting active participation in financial decisions may enhance health outcomes. However, the study is limited by its focus on Chinese data, challenges in establishing causal relationships, and the measurement of decision-making power at a single point in time.

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引用次数: 0

Trends in educational inequalities in all-course mortality and deaths of despair in Swedish youths 1990–2018

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-01-04 DOI: 10.1016/j.ssmph.2025.101748

Björn Högberg , Simone Scarpa , Solveig Petersen

Bakground

Growing educational disparities in mortality due to suicide, drug overdose, or alcohol-related liver disease – or “deaths of despair” (DoD) – have received increased attention in research and public debate. However, no study has investigated educational differences in despair-related mortality outside of North America. Thus, the aim this study was to investigate changes in the association between academic achievement in compulsory school and subsequent all-cause mortality (ACM) and DoD between 1990 and 2018 in Swedish youths.

Data and methods

Register data on all students graduating from compulsory school in Sweden between 1990 and 2010 were used (N = 2 252 938). Students were followed for a maximum of 8 years using discrete time proportional hazard models. Academic achievement was measured by grades at the end of compulsory school.

Results

ACM declined for medium/high achieving but not for low-achieving youths, while DoD increased slightly for medium/high achieving and markedly for low-achieving youths, resulting in growing achievement-related disparities in both types of mortality. The trends were primarily driven by native-born youth and girls.

Conclusions

The trends in Swedish youths resemble the trends in the American working-age population, but partly contrasts with corresponding trends in other European countries. Future research should investigate if the underlying causes that have been emphasized in the American context – socio-economic transformations and a greater supply of drugs – have also contributed to the Swedish trends.

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引用次数: 0

Broadband internet access as a social determinant of health in the early COVID-19 pandemic in U.S. counties

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2025-01-03 DOI: 10.1016/j.ssmph.2025.101747

Spencer Allen

Recent work suggests that internet access was key in delivering life-saving health information about the COVID-19 pandemic. This paper expands on these findings by focusing on the early pandemic in the United States to examine the role of internet access on masking and COVID-19 incidence and mortality. Using county-level data from the American Community Survey, The New York Times, and other sources, weighted OLS regression models with state fixed-effects were used to predict the association of internet access on self-reported masking in July 2020 and COVID-19 incidence and mortality during multiple periods from July–October 2020. Results suggest that internet access is associated with a substantial decrease in a county's COVID-19 incidence and mortality. Most strikingly, models predict that counties with the highest internet access had less than 50% of the COVID-19 mortality as counties with the lowest internet access from July–October 2020. Meanwhile, though the association between internet access and masking is positive and significant, the effect size net of control variables is small. In sum, this paper finds that internet access is associated with COVID-19 outcomes in ways beyond information about masking alone.

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引用次数: 0

Maternal media exposure and child anthropometric failures across 40 low- and middle-income countries

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2024-12-31 DOI: 10.1016/j.ssmph.2024.101746

Sohee Jung , Hwa-Young Lee , Seung-ah Choe , Hannah Oh , S.V. Subramanian , Rockli Kim

Objective

To examine the association between maternal exposure to various types of media and child anthropometric failures, and whether this association varies by mothers’ socioeconomic status (SES) in low- and middle-income countries (LMICs).

Methods

This study analyzed Demographic and Health Survey data from 40 LMICs (2010–2024). The independent variable was defined as exposure to any mass media (i.e., newspapers/magazines, radio, television) at least once a week for the primary analysis, and mobile phone ownership and internet access were considered for secondary analyses. Three types of child anthropometric failures (i.e., stunting, underweight, wasting) were constructed based on the WHO child growth standards. Multivariable logistic regression models were conducted to examine the association between maternal media exposure and child anthropometric failures, as well as the moderating effects of mothers’ socioeconomic status.

Results

Among 439,639 children aged under five, 13% were stunted, 23% were underweight, and 13% had wasting. Overall, 53% of mothers were exposed to any mass media, which was significantly associated with reduced odds of child stunting (OR = 0.90, 95% CI = 0.88–0.92), underweight (OR = 0.89, 95% CI = 0.87–0.91), and wasting (OR = 0.93, 95% CI = 0.90–0.96). The same was true for maternal mobile phone ownership and internet access. For specific types of media, the association was more pronounced among uneducated women and wealthier households.

Conclusions

This study underscores the potential importance of media-based interventions in improving child undernutrition in LMICs. Media exposure is an important channel for health information dissemination and empowerment especially for women with no education. At the same time, improvements in the overall living standards are necessary to induce and sustain healthy behaviors to ensure optimal growth among children.

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引用次数: 0

Neighborhood income inequality, maternal relative deprivation and neonatal health in Sweden: A cross-sectional study using individually defined multi-scale contexts

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2024-12-29 DOI: 10.1016/j.ssmph.2024.101745

Per Kåks , Mats Målqvist , Håkan Forsberg , Andreas Alm Fjellborg

引用次数: 0

The association between total social exposure and incident multimorbidity: A population-based cohort study

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2024-12-28 DOI: 10.1016/j.ssmph.2024.101743

Ingrid Giesinger , Emmalin Buajitti , Arjumand Siddiqi , Peter M. Smith , Rahul G. Krishnan , Laura C. Rosella

Background

Multimorbidity, the co-occurrence of two or more chronic conditions, is associated with the social determinants of health. Using comprehensive linked population-representative data, we sought to understand the combined effect of multiple social determinants on multimorbidity incidence in Ontario, Canada.

Methods

Ontario respondents aged 20–55 in 2001–2011 cycles of the Canadian Community Health Survey were linked to administrative health data ascertain multimorbidity status until 2022. Additive total social exposure (TSE) was generated by summing 12 measures of social disadvantage captured from the survey. Weighted-additive TSE included 15 measures of social disadvantage summed across 5 equally weighted domains. Hazard ratios for the association between each TSE measure and multimorbidity were estimated using competing risk Cox-proportional hazards models. All analyses were sex-stratified.

Results

Both additive and weighted-additive TSE were associated with an increased risk of multimorbidity among females and males. A social gradient was observed for multimorbidity risk in all models. While adjusted models were attenuated, an increased risk of multimorbidity was observed among those experiencing the most social disadvantage, compared to those with the least social disadvantage in additive (HR Females = 2.16; 95%CI = 1.63, 2.86; HR Males = 1.90; 95%CI = 1.52, 2.38) and weighted-additive (HR Females = 1.94; 95%CI = 1.49, 2.53; HR Males = 1.72; 95%CI = 1.41, 2.10) models. The observed social gradient was retained.

Conclusions

These findings demonstrate the importance of considering the cumulative effects of multiple social determinants of health on multimorbidity.

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Exploring the association between emergency hospital services and homicide incidents in Pennsylvania

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health

Pub Date : 2024-12-28 DOI: 10.1016/j.ssmph.2024.101744

Mingean Park , Sujeong Park , Youngeun Lee , Jonathan Lee

Homicide is a significant measure of quality of life and serves as a reference point for a comparison between neighborhoods. Despite its unique relevance to homicide, the role of medical resources, specifically emergency hospital services, has been underexplored in the literature. This study addresses this gap by examining the relationship between emergency hospital availability and homicide rates across counties in Pennsylvania, using advanced spatiotemporal modeling techniques. While controlling for socio-economic characteristics and spatial autocorrelation, the analysis suggests that greater access to emergency hospital services is associated with lower homicide rates. These findings call for the importance of medical resources in both future homicide research and health policy.

引用次数: 0

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