Ssm-Population Health最新文献

Background

Comorbid overweight/obesity (OWO) and depression is emerging as a public health problem among adolescents. Income inequality is a structural determinant of health that independently increases the risk for both OWO and depression among youth. However, no study has examined the association between income inequality and comorbid OWO and depression or tested potential mechanisms involved. We aimed to identify the association between income inequality and comorbid OWO and depression and to test whether social cohesion mediates this relationship.

Methods

We used data from the 2018–2019 Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking and Sedentary behavior (COMPASS) project. Our sample was composed of 46,171 adolescents from 136 schools distributed in 43 census divisions in 4 provinces in Canada (Ontario, Alberta, British Columbia, and Quebec). Gender-stratified multilevel path analyses models were used to examine whether income inequality (Gini coefficient) was associated with comorbid OWO and depression and whether the association was mediated by school connectedness, a proxy measure for social cohesion.

Results

The direct effect between income inequality and OWO-depression comorbidity was not significant. However, income inequality was significantly associated with increased risk of comorbidity via social cohesion. One standard deviation increase in the Gini coefficient was associated with a 9% and 8% increase in the odds of comorbidity in females (OR=1.09; 95% CI=1.03, 1.16) and males (OR=1.08; 95% CI=1.03, 1.13).

Conclusion

Policies aimed at reducing income inequality, and interventions to improve social cohesion, may contribute to reducing the risk of OWO-depression comorbidity among adolescents.

Objective

To estimate the association between food needs and diabetes outcomes.

Research design and methods

Longitudinal cohort study, using a target trial emulation approach. 96,792 adults with type 2 diabetes mellitus who underwent food need assessment in a network of community-based health centers were followed up to 36 months after initial assessment. We used targeted minimum loss estimation to estimate the association between not experiencing food needs, compared with experiencing food needs, and hemoglobin a1c (HbA1c), systolic and diastolic blood pressure (SBP and DBP), and LDL cholesterol. The study period was June 24th, 2016 to April 30th, 2023.

Results

We estimated that not experiencing food needs, compared with experiencing food needs, would be associated with 0.12 percentage points lower (95% Confidence Interval [CI] −0.16% to −0.09%, p = < 0.0001) mean HbA1c at 12 months. We further estimated that not experiencing food needs would be associated with a 12-month SBP that was 0.67 mm Hg lower (95%CI -0.97 to −0.38 mm Hg, p < .0001), DBP 0.21 mm Hg lower (95%CI -0.38 to −0.04 mm Hg, p = .01). There was no association with lower LDL cholesterol. Results were similar at other timepoints, with associations for HbA1c, SBP, and DBP of similar magnitude, and no difference in LDL cholesterol.

Conclusions

We estimated that not experiencing food needs may be associated with modestly better diabetes outcomes. These findings support testing interventions that address food needs as part of their mechanism of action.

Objective

This study investigates geographic variations in ADRD mortality in the US. By considering both state of residence and state of birth, we aim to discern the relative importance of these geospatial factors.

Methods

We conducted a secondary data analysis of the National Longitudinal Mortality Study (NLMS), that has 3.5 million records from 1973 to 2011 and over 0.5 million deaths. We focused on individuals born in or before 1930, tracked in NLMS cohorts from 1979 to 2000. Employing multi-level logistic regression, with individuals nested within states of residence and/or states of birth, we assessed the role of geographical factors in ADRD mortality variation.

Results

We found that both state of birth and state of residence account for a modest portion of ADRD mortality variation. Specifically, state of residence explains 1.19% of the total variation in ADRD mortality, whereas state of birth explains only 0.6%. When combined, both state of residence and state of birth account for only 1.05% of the variation, suggesting state of residence could matter more in ADRD mortality outcomes.

Conclusion

Findings of this study suggest that state of residence explains more variation in ADRD mortality than state of birth. These results indicate that factors in later life may present more impactful intervention points for curbing ADRD mortality. While early-life environmental exposures remain relevant, their role as primary determinants of ADRD in later life appears to be less pronounced in this study.

Background

– Coal mining areas in the UK continue to suffer worse health outcomes despite the industry disappearing by the early 1990s. Unemployment and deprivation are cited as key explanations. However, as the health effects of hazardous working environments continue after the industry's closure, it is unclear to what extent this ongoing health deficit is due to the legacy health effect of coal mining versus socioeconomic factors, including unemployment and deprivation.

Methods

– I isolate the legacy health effect of coal mining using a matching research design. Coal mining areas are paired with non-mining areas using propensity score matching. This creates a sample of socioeconomically similar local authority districts in England and Wales. I estimate the effect of coal mining on male and female age-standardised period mortality rates for 1981–2019, analysing temporal dynamics and testing for convergence.

Results

– I find an initial coal mining effect in 1981 on male (female) mortality rates of 122.6 (66.5) deaths per 100,000. This effect decreases by 91% (70%) during this period, indicating convergence in mortality rates. The timing of this convergence is consistent with that of the industry's closure, with higher convergence rates observed during the 1990s.

Conclusions

– These results provide evidence for a legacy health effect on mortality from coal mining and convergence in mortality rates between 1981 and 2019. This effect is important when explaining the health deficit experienced by coal mining areas. Furthermore, as coal mining areas tend to be more deprived, these results also shed light on relevant mechanisms driving recent health inequality in the UK.

This article highlights the effect of the COVID-19 pandemic on immigration.

and immigrant wellbeing in the United States by focusing on all categories of migrants, documented and undocumented. We argue that in the wake of the pandemic, immigrants disproportionately experienced higher rates of unemployment, greater losses of income, more exposure occupational risks, and higher rates of food and housing insecurity, all of which exacerbated preexisting differentials in access to health and health care to generate higher rates of COVID infection, morbidity, and mortality among adults and stunted educational outcomes for their children. The prospects for a full post-pandemic recovery of immigrants' wellbeing are dampened by the severe nature of COVID's negative effects on immigrants; the unusually hostile context of reception immigrants face after the pandemic; the large number of immigrants lacking legal status or holding tenuous documentation; and the formidable deportation regime that prevails in the United States that puts a great strain on immigrant communities. Undocumented migration has surged to restart undocumented population growth, further clouding the future for immigrants in the country. It is unclear whether reforms proposed by the Biden Administration be enacted and successful in improving their prospects. In general, this article aims to contribute to the broader discussion about migration and health policies.

With the accelerating pace of population aging in China and the implementation of the smart city pilot policy, whether the middle-aged and elderly population can integrate and adapt to this “smart” society has become an urgent problem that needs to be solved. In this context, exploring the impact of smart city pilot policies on the social adaptation health and mental health of middle-aged and elderly people has become a top priority for China to implement a national strategy to actively respond to population aging. Thus, based on panel data from the China Health and Retirement Longitudinal Study (CHARLS) for the years 2011, 2013, and 2015, this study employs the difference-in-differences (DID) method to investigate whether the smart city pilot policy can improve the social adaptive health and mental health of middle-aged and elderly people and to explore in depth the mechanism of its influence. The study finds that compared with non-pilot cities, the social adaptive health and mental health of middle-aged and elderly people in smart cities improve by 0.6% and 2.2%, respectively. The mechanism effect study shows that the smart city pilot policy can improve the mental health of the middle-aged and the elderly through the use of Information and Communication Technology (ICT) and the enhancement of human capital. Furthermore, for the social adaptive health of middle-aged and elderly individuals, the smart city pilot policy can only make improvements through the enhancement of human capital. Heterogeneity analysis shows that the effect of smart city pilot policies on social adaptive health is more pronounced in the middle-aged group than in the elderly group.

As a result of Black–White inequities in life expectancy, recent research has indicated that Black individuals are disproportionately exposed to the deaths of multiple family members compared to White individuals. Black individuals are also more likely to live in coresident households—that is, households that extend beyond the nuclear family. However, it is unclear the degree to which this population may be disproportionately exposed to the loss of deaths marked by the geographic closeness of the household. In this study, I use data from the Panel Study of Income Dynamics to provide the first nationally representative estimates of Black-White disparities in exposure to household member deaths. I find that Black people are significantly more likely than White individuals to have experienced the death of a household member. Based on these findings, I argue the dual inequities of racial disparities in life expectancy and racial disparities in coresidence are an overlooked, salient source of racial disparities in exposure to death. By illuminating a broader range of network sources that contribute to racial inequities in exposure to death, this study sets forth a new conceptual unit of analysis—that of the household—to investigate the intergenerational reproduction of inequality in health and socioeconomic status due to exposure to death.

In the context of the “Chinese Differential Mode of Association” in traditional Chinese culture, this paper examines the heterogeneous effects of interpersonal interactions in different relationships on older adults’ depressive emotions from a cultural-psychological perspective. Results using data from Chinese General Social Survey demonstrate that: interactions with children are the most helpful in reducing perceived depression for the elderly, followed by communications with siblings and relatives. However, interactions with friends and other fellows do not significantly reduce older people’s perceived depression. This reflects the “Chinese Differential Mode of Association” in interpersonal relationships. When using different perceived depression measures, and Double Debiased Machine Learning (DDML) approaches for robustness and endogeneity tests, above findings are very robust. The impact mechanism is that interactions with children and siblings reduce depressive emotions by decreasing older adults’ sense of loneliness, while communications with others do not have such a significant effect. This paper further discusses the roles of different types of interactions with adult children. It is found that receiving and providing emotional support can prominently decrease depressive emotions for older people, whereas the effects of monetary support and non-material assistance are less pronounced. In addition, interpersonal interactions’ impacts are more significant for those who are female, older than 75 and with poorer health, as well as older people who exercise less frequently, have higher social status, and hold more traditional beliefs. In the current context of active promotion of healthy aging, findings of this paper have important implications for a deeper understanding and scientific management of depressive emotions among the elderly.

Parental incarceration is an adverse childhood experience that inequitably burdens families of color and affects millions of U.S. children and adolescents. Although racialized disparities in exposure to parental incarceration are often acknowledged, researchers have yet to examine whether manifestations of racism may affect the link between parental incarceration and youth outcomes. This study provides a first look at how parental incarceration relates to health vulnerabilities in the Adolescent Brain Cognitive Development (ABCD) study, an ongoing, population-based study of U.S. children born between 2006 and 2008. We start by describing exposure to parental incarceration and then examine how parental incarceration, state-level racial prejudice, and discrimination relate to health risks among 9191 White (66%), Black (19%), or Hispanic (15%) youth. Consistent with what we know about pervasive racialized disparities in the U.S. criminal legal system, we find that 19.3% of Black children in our sample have experienced parental incarceration, followed by 7.8% of Hispanic children, and 4.8% of White children. Results of multilevel mixed models further indicate that parental incarceration was associated with increased health risks among White children whereas family economic hardship and discrimination experiences were more robustly associated with health vulnerabilities among Black and Hispanic children. Additional analyses explored whether parental incarceration was associated with other outcomes among Black and Hispanic children, revealing increased risk for behavior problems contingent upon parental incarceration and discrimination for Black children and Hispanic boys. Among Hispanic girls, parental incarceration was associated with increased risk of behavior problems in states with higher levels of racism. Results suggest that parental incarceration contributes to risk among early adolescents across racialized groups, but that the specific toll it takes depends on outcomes assessed and the context in which it occurs.