Pub Date : 2024-08-12DOI: 10.1016/j.annepidem.2024.08.003
Purpose
Long COVID-19 syndrome occurs in 10–20 % of people after a confirmed/probable SARS-COV-2 infection; new symptoms begin within three months of COVID-19 diagnosis and last > 8 weeks. Little is known about risk factors for long COVID, particularly in older people who are at greater risk of COVID complications.
Methods
Data are from Women’s Health Initiative (WHI) postmenopausal women who completed COVID surveys that included questions on whether they had ever been diagnosed with COVID and length and nature of symptoms. Long COVID was classified using standard consensus criteria. Using WHI demographic and health data collected at study enrollment (1993–98) through the present day, machine learning identified the top 20 risk factors for long COVID. These variables were tested in logistic regression models.
Results
Of n = 37,280 survey respondents, 1237 (mean age = 83 years) reported a positive COVID-19 test and 425 (30 %) reported long COVID. Symptoms included an array of neurological, cardio-pulmonary, musculoskeletal, and general fatigue, and malaise symptoms. Long COVID risk factors included weight loss, physical and mobility limitations, and specific heath conditions (e.g., history of heart valve procedure, rheumatoid arthritis).
Conclusions
Knowledge of risk factors for long COVID may be the first step in understanding the etiology of this complex disease.
{"title":"Risk factors for long COVID syndrome in postmenopausal women with previously reported diagnosis of COVID-19","authors":"","doi":"10.1016/j.annepidem.2024.08.003","DOIUrl":"10.1016/j.annepidem.2024.08.003","url":null,"abstract":"<div><h3>Purpose</h3><p>Long COVID-19 syndrome occurs in 10–20 % of people after a confirmed/probable SARS-COV-2 infection; new symptoms begin within three months of COVID-19 diagnosis and last > 8 weeks. Little is known about risk factors for long COVID, particularly in older people who are at greater risk of COVID complications.</p></div><div><h3>Methods</h3><p>Data are from Women’s Health Initiative (WHI) postmenopausal women who completed COVID surveys that included questions on whether they had ever been diagnosed with COVID and length and nature of symptoms. Long COVID was classified using standard consensus criteria. Using WHI demographic and health data collected at study enrollment (1993–98) through the present day, machine learning identified the top 20 risk factors for long COVID. These variables were tested in logistic regression models.</p></div><div><h3>Results</h3><p>Of n = 37,280 survey respondents, 1237 (mean age = 83 years) reported a positive COVID-19 test and 425 (30 %) reported long COVID. Symptoms included an array of neurological, cardio-pulmonary, musculoskeletal, and general fatigue, and malaise symptoms. Long COVID risk factors included weight loss, physical and mobility limitations, and specific heath conditions (e.g., history of heart valve procedure, rheumatoid arthritis).</p></div><div><h3>Conclusions</h3><p>Knowledge of risk factors for long COVID may be the first step in understanding the etiology of this complex disease.</p></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-10DOI: 10.1016/j.annepidem.2024.08.001
{"title":"Response to commentary","authors":"","doi":"10.1016/j.annepidem.2024.08.001","DOIUrl":"10.1016/j.annepidem.2024.08.001","url":null,"abstract":"","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-08DOI: 10.1016/j.annepidem.2024.08.002
{"title":"Re: Adjustment for duration of employment in occupational epidemiology","authors":"","doi":"10.1016/j.annepidem.2024.08.002","DOIUrl":"10.1016/j.annepidem.2024.08.002","url":null,"abstract":"","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.annepidem.2023.12.003
Objective
To determine the association between non-adherence to long term chronic obstructive pulmonary disease (COPD) medications and COPD related emergency department (ED) visits and hospitalizations in patients with incident COPD, utilizing time varying measures of adherence as well as accounting for time-varying confounding impacted by prior adherence.
Study design and setting
We conducted a population-based retrospective cohort study between 2007–2017 among individuals aged 66 years and older with incident COPD using multiple linked administrative health databases from the province of Ontario, Canada. Adherence to COPD medications was measured using time varying proportion of days covered based on insurance claims for medications dispensed at community pharmacies. The parametric g-formula was used to assess the association between time-varying adherence (in the last 90-days) to COPD medications and risk of COPD related hospitalizations and ED visits while accounting for time varying confounding by COPD severity.
Results
Overall, 60,251 individuals with incident COPD were included; mean age was 76 (SD 7) and 59% were male. Mean adherence over the entire follow-up was 23% (SD 0.3). There were 7248 (12%) COPD related ED visits (2.8 events per 100 person years [PY]) and 9188 (15%) COPD related hospitalizations (3.5 events per 100 PY). Compared to those with 0% 90-day adherence, those with adherence between 1–33% had a 19% decreased risk of COPD related ED visits (adjusted risk ratio[aRR]:0.81, 95% confidence interval [CI]:0.78–0.83), those with adherence between 34%−67% had a 18% decreased risk (aRR: 0.82, 95% CI: 0.77–0.85) while those with 68%−100% 90-day adherence had a 63% increased risk of COPD related ED visits (aRR: 1.63, 95% CI: 1.47–1.78). Nearly identical results were obtained for COPD specific hospitalizations.
Conclusion
After accounting for time varying confounding by COPD severity, the highest time varying 90-days adherence was associated with an increased risk of both COPD related ED visits and hospitalizations compared to the lowest adherence categories. Differences in COPD severity between adherence categories, perception of need for medication management in the higher adherence categories, and potential residual confounding makes it difficult to disentangle the independent effects of adherence from the severity of the condition itself.
{"title":"Non-adherence to COPD medications and its association with adverse events: A longitudinal population based cohort study of older adults","authors":"","doi":"10.1016/j.annepidem.2023.12.003","DOIUrl":"10.1016/j.annepidem.2023.12.003","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the association between non-adherence to long term chronic obstructive pulmonary disease (COPD) medications and COPD related emergency department (ED) visits and hospitalizations in patients with incident COPD, utilizing time varying measures of adherence as well as accounting for time-varying confounding impacted by prior adherence.</p></div><div><h3>Study design and setting</h3><p>We conducted a population-based retrospective cohort study between 2007–2017 among individuals aged 66 years and older with incident COPD using multiple linked administrative health databases from the province of Ontario, Canada. Adherence to COPD medications was measured using time varying proportion of days covered based on insurance claims for medications dispensed at community pharmacies. The parametric g-formula was used to assess the association between time-varying adherence (in the last 90-days) to COPD medications and risk of COPD related hospitalizations and ED visits while accounting for time varying confounding by COPD severity.</p></div><div><h3>Results</h3><p>Overall, 60,251 individuals with incident COPD were included; mean age was 76 (SD 7) and 59% were male. Mean adherence over the entire follow-up was 23% (SD 0.3). There were 7248 (12%) COPD related ED visits (2.8 events per 100 person years [PY]) and 9188 (15%) COPD related hospitalizations (3.5 events per 100 PY). Compared to those with 0% 90-day adherence, those with adherence between 1–33% had a 19% decreased risk of COPD related ED visits (adjusted risk ratio[aRR]:0.81, 95% confidence interval [CI]:0.78–0.83), those with adherence between 34%−67% had a 18% decreased risk (aRR: 0.82, 95% CI: 0.77–0.85) while those with 68%−100% 90-day adherence had a 63% increased risk of COPD related ED visits (aRR: 1.63, 95% CI: 1.47–1.78). Nearly identical results were obtained for COPD specific hospitalizations.</p></div><div><h3>Conclusion</h3><p>After accounting for time varying confounding by COPD severity, the highest time varying 90-days adherence was associated with an increased risk of both COPD related ED visits and hospitalizations compared to the lowest adherence categories. Differences in COPD severity between adherence categories, perception of need for medication management in the higher adherence categories, and potential residual confounding makes it difficult to disentangle the independent effects of adherence from the severity of the condition itself.</p></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1047279723002284/pdfft?md5=015f275a86b26411aeaeafd531cca3b7&pid=1-s2.0-S1047279723002284-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139021557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.annepidem.2023.12.004
Purpose
To examine nativity differences of co-occurring liver disease (LD) and heart failure (HF) on 13-year mortality among Mexican American older adults.
Methods
Prospective cohort study of 1601 Mexican Americans aged ≥ 75 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/05–2016). Participants were grouped into four groups: no LD and no HF (n = 1138), LD only (n = 53), HF only (n = 382), and both LD and HF (n = 28). We used Cox proportional hazards regression model to estimate the hazard ratio (HR) and 95% confidence interval (CI) of death over time.
Results
The HR of death, as a function of HF only, was 1.32 (95% CI=1.07–1.62) among US-born and 1.36 (95% CI=1.04–1.78) among foreign-born participants, vs. those with no LD and no HF. Among foreign-born participants, the HR of death as a function of LD and HF was 3.39 (95% CI=1.65–6.93) vs. those without either. LD alone was not associated with mortality in either group. Among US-born, co-occurring LD and HF was not associated with mortality.
Conclusions
Foreign-born participants with both LD and HF were at higher risk of mortality over 13 years of follow up.
{"title":"Liver disease, heart failure, and 13-year mortality among Mexican American older adults: Nativity differences","authors":"","doi":"10.1016/j.annepidem.2023.12.004","DOIUrl":"10.1016/j.annepidem.2023.12.004","url":null,"abstract":"<div><h3>Purpose</h3><p>To examine nativity differences of co-occurring liver disease (LD) and heart failure (HF) on 13-year mortality among Mexican American older adults.</p></div><div><h3>Methods</h3><p>Prospective cohort study of 1601 Mexican Americans aged ≥ 75 years from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/05–2016). Participants were grouped into four groups: no LD and no HF (n = 1138), LD only (n = 53), HF only (n = 382), and both LD and HF (n = 28). We used Cox proportional hazards regression model to estimate the hazard ratio (HR) and 95% confidence interval (CI) of death over time.</p></div><div><h3>Results</h3><p>The HR of death, as a function of HF only, was 1.32 (95% CI=1.07–1.62) among US-born and 1.36 (95% CI=1.04–1.78) among foreign-born participants, vs. those with no LD and no HF. Among foreign-born participants, the HR of death as a function of LD and HF was 3.39 (95% CI=1.65–6.93) vs. those without either. LD alone was not associated with mortality in either group. Among US-born, co-occurring LD and HF was not associated with mortality.</p></div><div><h3>Conclusions</h3><p>Foreign-born participants with both LD and HF were at higher risk of mortality over 13 years of follow up.</p></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139027776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-31DOI: 10.1016/j.annepidem.2024.07.091
Purpose
To assess the incidence of congenital hypothyroidism (CH) and acquired hypothyroidism (AH) between 2014 and 2019 in continental France.
Methods
New cases of CH and AH were identified using the French National Health Data System (Système Nationale des Données de Santé, SNDS). Temporal trends were studied using linear regression models. Spatial distributions were studied using Moran's global index (I) and the statistical method and local indicators of spatial association.
Results
The incidence of permanent CH in females increased by 8.9 % per year (2014: 36.9 [31.1–43.7] per 100,000 birth-years vs. 2019: 51 [43.9–59.3] per 100,000 birth-years, p < 0.01). The incidence of AH decreased between 2014 and 2019 for both females (2014: 535.7 [533.2–538.2] per 100,000 person-years vs 2019: 335.5 [333.6–337.4] per 100,000 person-years, p < 0.01) and males (2014: 197.5 [195.9–199] per 100,000 person-years vs 2019: 141.7 [140.4–142.9] per 100,000 person-years, p < 0.01). The incidence of hypothyroidism was high in the Nord-Pas-De-Calais and Lorraine regions (CH and AH).
Conclusions
The incidence of permanent CH in females has increased over time. AH incidence decreased. It seems necessary to investigate environmental factors in the disparity of incidence distribution.
{"title":"Congenital and acquired hypothyroidism: Temporal and spatial trends in France from 2014 to 2019","authors":"","doi":"10.1016/j.annepidem.2024.07.091","DOIUrl":"10.1016/j.annepidem.2024.07.091","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the incidence of congenital hypothyroidism (CH) and acquired hypothyroidism (AH) between 2014 and 2019 in continental France.</p></div><div><h3>Methods</h3><p>New cases of CH and AH were identified using the French National Health Data System (<em>Système Nationale des Données de Santé,</em> SNDS). Temporal trends were studied using linear regression models. Spatial distributions were studied using Moran's global index (I) and the statistical method and local indicators of spatial association.</p></div><div><h3>Results</h3><p>The incidence of permanent CH in females increased by 8.9 % per year (2014: 36.9 [31.1–43.7] per 100,000 birth-years vs. 2019: 51 [43.9–59.3] per 100,000 birth-years, p < 0.01). The incidence of AH decreased between 2014 and 2019 for both females (2014: 535.7 [533.2–538.2] per 100,000 person-years vs 2019: 335.5 [333.6–337.4] per 100,000 person-years, p < 0.01) and males (2014: 197.5 [195.9–199] per 100,000 person-years vs 2019: 141.7 [140.4–142.9] per 100,000 person-years, p < 0.01). The incidence of hypothyroidism was high in the Nord-Pas-De-Calais and Lorraine regions (CH and AH).</p></div><div><h3>Conclusions</h3><p>The incidence of permanent CH in females has increased over time. AH incidence decreased. It seems necessary to investigate environmental factors in the disparity of incidence distribution.</p></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1047279724002102/pdfft?md5=6d28c722d08b86dbc02f1b477f8a19e3&pid=1-s2.0-S1047279724002102-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1016/j.annepidem.2024.07.047
Background
Multimorbidity, the concurrent presence of multiple chronic health conditions in an individual, represents a mounting public health challenge. Chronic illnesses are prevalent in the Indigenous populations, which contributes to multimorbidity. However, the epidemiology of multimorbidity in this population is not well studied. This review aimed to elucidate the extent, determinants, consequences, and prevention of multimorbidity within Indigenous populations globally, contrasting findings with non-Indigenous populations.
Methods
Adhering to the PRISMA guidelines, this systematic review assimilated peer-reviewed articles and grey literature, focusing on the prevalence, determinants, implications, and preventive strategies of multimorbidity in global Indigenous populations. Emphasis was given to original, English-language, full-text articles, excluding editorials, and conference abstracts.
Findings
Of the 444 articles identified, 13 met the inclusion criteria. Five studies are from Australia, and the rest are from the USA, Canada, New Zealand, and India. The study indicated a higher multimorbidity prevalence among Indigenous populations, with consistent disparities observed across various age groups. Particularly, Indigenous individuals exhibited a 2-times higher likelihood of multimorbidity compared to non-Indigenous populations. Noteworthy findings underscored the elevated severity of certain comorbid conditions, especially strokes, within Indigenous groups, with further revelations highlighting their significant pairing with conditions such as heart diseases and diabetes.
Interpretation
The findings affirm the elevated burden of multimorbidity among Indigenous populations. Prevalence and risk of developing multimorbidity are significantly higher in this population compared to their non-Indigenous counterparts. Future research should prioritize harmonized research methodologies, fostering insights into the multimorbidity landscape, and promoting strategies to address health disparities in Indigenous populations.
{"title":"Multimorbidity among the Indigenous population: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.annepidem.2024.07.047","DOIUrl":"10.1016/j.annepidem.2024.07.047","url":null,"abstract":"<div><h3>Background</h3><p>Multimorbidity, the concurrent presence of multiple chronic health conditions in an individual, represents a mounting public health challenge. Chronic illnesses are prevalent in the Indigenous populations, which contributes to multimorbidity. However, the epidemiology of multimorbidity in this population is not well studied. This review aimed to elucidate the extent, determinants, consequences, and prevention of multimorbidity within Indigenous populations globally, contrasting findings with non-Indigenous populations.</p></div><div><h3>Methods</h3><p>Adhering to the PRISMA guidelines, this systematic review assimilated peer-reviewed articles and grey literature, focusing on the prevalence, determinants, implications, and preventive strategies of multimorbidity in global Indigenous populations. Emphasis was given to original, English-language, full-text articles, excluding editorials, and conference abstracts.</p></div><div><h3>Findings</h3><p>Of the 444 articles identified, 13 met the inclusion criteria. Five studies are from Australia, and the rest are from the USA, Canada, New Zealand, and India. The study indicated a higher multimorbidity prevalence among Indigenous populations, with consistent disparities observed across various age groups. Particularly, Indigenous individuals exhibited a 2-times higher likelihood of multimorbidity compared to non-Indigenous populations. Noteworthy findings underscored the elevated severity of certain comorbid conditions, especially strokes, within Indigenous groups, with further revelations highlighting their significant pairing with conditions such as heart diseases and diabetes.</p></div><div><h3>Interpretation</h3><p>The findings affirm the elevated burden of multimorbidity among Indigenous populations. Prevalence and risk of developing multimorbidity are significantly higher in this population compared to their non-Indigenous counterparts. Future research should prioritize harmonized research methodologies, fostering insights into the multimorbidity landscape, and promoting strategies to address health disparities in Indigenous populations.</p></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1047279724001662/pdfft?md5=c30e033732d282aec9fb5a3ac14e4e38&pid=1-s2.0-S1047279724001662-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.1016/j.annepidem.2024.07.049
Background
Smoking is associated with an increased risk of HPV infection. However, the use of e-cigarettes and marijuana, number of cigarettes, and serum cotinine concentrations in relation with HPV (6, 11, 16, 18) and high-risk HPV (16 or 18) infections in underserved and understudied populations remain poorly understood.
Methods
Data included 687 males and 664 females among whom 489 were White, 375 were Black and 342 were Hispanics from the NHANES 2013–2016 with HPV and high-risk HPV infections. Smoking history included current and past smokers, number of cigarettes, use of e-cigarettes, marijuana, and serum cotinine levels. Weighted multivariable-adjusted logistic regression models were conducted.
Results
High-risk HPV infection was associated with current smoking history plus ≥ 20 cigarettes/day (OR=1.92, 95 % CI=1.09, 3.37) in the overall population. E-cigarettes use (5 days) was positively associated with high-risk HPV infection (OR=2.43, 95 % CI=1.13, 5.22) in the overall population, with similar findings with e-cigarette (past 30 days) among women and Whites.
Conclusion
High number of cigarettes, e-cigarette usage and marijuana were associated with HPV and high-risk HPV infections in the overall population. Most of these associations remained significant when stratified by gender and race/ethnicity. Increasing use of e-cigarettes and marijuana in these population warrants further investigation for the prevention of HPV infection and related cancers.
{"title":"Association of electronic-cigarette, number of cigarettes, and marijuana use with high-risk Human Papillomavirus (HPV) among men and women: A cross-sectional analysis of a nationally representative sample","authors":"","doi":"10.1016/j.annepidem.2024.07.049","DOIUrl":"10.1016/j.annepidem.2024.07.049","url":null,"abstract":"<div><h3>Background</h3><p>Smoking is associated with an increased risk of HPV infection. However, the use of e-cigarettes and marijuana, number of cigarettes, and serum cotinine concentrations in relation with HPV (6, 11, 16, 18) and high-risk HPV (16 or 18) infections in underserved and understudied populations remain poorly understood.</p></div><div><h3>Methods</h3><p>Data included 687 males and 664 females among whom 489 were White, 375 were Black and 342 were Hispanics from the NHANES 2013–2016 with HPV and high-risk HPV infections. Smoking history included current and past smokers, number of cigarettes, use of e-cigarettes, marijuana, and serum cotinine levels. Weighted multivariable-adjusted logistic regression models were conducted.</p></div><div><h3>Results</h3><p>High-risk HPV infection was associated with current smoking history plus ≥ 20 cigarettes/day (OR=1.92, 95 % CI=1.09, 3.37) in the overall population. E-cigarettes use (5 days) was positively associated with high-risk HPV infection (OR=2.43, 95 % CI=1.13, 5.22) in the overall population, with similar findings with e-cigarette (past 30 days) among women and Whites.</p></div><div><h3>Conclusion</h3><p>High number of cigarettes, e-cigarette usage and marijuana were associated with HPV and high-risk HPV infections in the overall population. Most of these associations remained significant when stratified by gender and race/ethnicity. Increasing use of e-cigarettes and marijuana in these population warrants further investigation for the prevention of HPV infection and related cancers.</p></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-21DOI: 10.1016/j.annepidem.2024.07.048
Introduction
Prior studies have examined the cross-sectional relationship between adolescent sleep and substance use; however, fewer have explored the long-term connections between childhood sleep and adolescent substance use.
Methods
This study investigated both cross-sectional associations during adolescence and prospective associations between childhood weeknight sleep and later alcohol and marijuana use in the Future of Families and Child Wellbeing Study, a diverse national birth cohort of urban children from 20 cities with populations greater than 200,000. Parents reported their child’s bedtime at ages 3, 5, and 9 and their child’s sleep duration at ages 5 and 9.
Results
At age 15, adolescents self-reported their bedtime, sleep duration, and alcohol and marijuana use (n = 1514). Logistic regression analyses for each substance use outcome at age 15 were adjusted for sex, age at time of assessment, race/ethnicity, income-relative-to-poverty threshold, family structure, and caregiver education level. At age 15, later bedtime (AOR=1.39; 95 % CI=1.22, 1.57) and shorter sleep duration (AOR=1.28; 95 % CI=1.14, 1.43) were associated with greater odds of consuming a full drink of alcohol more than once, and later bedtime was associated with greater odds of trying marijuana (AOR=1.35; 95 % CI=1.20, 1.51). Unexpectedly, later bedtimes at age 3 were associated with lower odds of drinking alcohol by age 15 (AOR=0.74; 95 % CI=0.59, 0.92). In contrast, later bedtimes at age 9 were associated with greater odds of drinking alcohol (AOR=1.45; 95 % CI=1.11, 1.90). Additionally, later bedtime at age 5 (AOR=1.26; 95 % CI=1.01, 1.58) and shorter sleep duration at age 9 (AOR=1.19; 95 % CI=1.04, 1.36) were associated with greater odds of trying marijuana. Conclusion: Taken together, these associations support the importance of protecting childhood sleep habits to reduce the likelihood of substance use starting as early as mid-adolescence.
Implications and contribution
In this longitudinal cohort study, adolescents were more likely to have consumed alcohol or tried marijuana by age 15 if they had later bedtimes and shorter sleep duration during childhood and adolescence. Protecting sleep health throughout childhood may reduce the likelihood of substance use during early adolescence.
{"title":"Childhood sleep is prospectively associated with adolescent alcohol and marijuana use","authors":"","doi":"10.1016/j.annepidem.2024.07.048","DOIUrl":"10.1016/j.annepidem.2024.07.048","url":null,"abstract":"<div><h3>Introduction</h3><p>Prior studies have examined the cross-sectional relationship between adolescent sleep and substance use; however, fewer have explored the long-term connections between childhood sleep and adolescent substance use.</p></div><div><h3>Methods</h3><p>This study investigated both cross-sectional associations during adolescence and prospective associations between childhood weeknight sleep and later alcohol and marijuana use in the Future of Families and Child Wellbeing Study, a diverse national birth cohort of urban children from 20 cities with populations greater than 200,000. Parents reported their child’s bedtime at ages 3, 5, and 9 and their child’s sleep duration at ages 5 and 9.</p></div><div><h3>Results</h3><p>At age 15, adolescents self-reported their bedtime, sleep duration, and alcohol and marijuana use (n = 1514). Logistic regression analyses for each substance use outcome at age 15 were adjusted for sex, age at time of assessment, race/ethnicity, income-relative-to-poverty threshold, family structure, and caregiver education level. At age 15, later bedtime (AOR=1.39; 95 % CI=1.22, 1.57) and shorter sleep duration (AOR=1.28; 95 % CI=1.14, 1.43) were associated with greater odds of consuming a full drink of alcohol more than once, and later bedtime was associated with greater odds of trying marijuana (AOR=1.35; 95 % CI=1.20, 1.51). Unexpectedly, later bedtimes at age 3 were associated with lower odds of drinking alcohol by age 15 (AOR=0.74; 95 % CI=0.59, 0.92). In contrast, later bedtimes at age 9 were associated with greater odds of drinking alcohol (AOR=1.45; 95 % CI=1.11, 1.90). Additionally, later bedtime at age 5 (AOR=1.26; 95 % CI=1.01, 1.58) and shorter sleep duration at age 9 (AOR=1.19; 95 % CI=1.04, 1.36) were associated with greater odds of trying marijuana. Conclusion: Taken together, these associations support the importance of protecting childhood sleep habits to reduce the likelihood of substance use starting as early as mid-adolescence.</p></div><div><h3>Implications and contribution</h3><p>In this longitudinal cohort study, adolescents were more likely to have consumed alcohol or tried marijuana by age 15 if they had later bedtimes and shorter sleep duration during childhood and adolescence. Protecting sleep health throughout childhood may reduce the likelihood of substance use during early adolescence.</p></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-20DOI: 10.1016/j.annepidem.2024.07.046
Purpose
To compare the physical and mental health of sexual and gender minority (SGM) parents to SGM non-parents.
Methods
A cross-sectional analysis using 2018–2020 data from The PRIDE Study, a national longitudinal cohort of SGM adults. We used Poisson regression adjusted for age, gender, relationship status, race/ethnicity, household income, and education to assess the association between parental status and each outcome.
Results
Among 9625 SGM participants, 1460 (15 %) were parents. Older participants were more likely to be parents: 2% of participants aged 18–30, 18% aged 30–39, and 38% aged 40+ were parents. In adjusted analyses, parenthood was associated with greater depression, anxiety, and post-traumatic stress symptoms as well as ever cigarette smoking. Among individuals assigned female sex at birth, parents were twice as likely to have been diagnosed with pelvic inflammatory disease compared to non-parents. There was no association between parenthood status and alcohol use, substance use, diabetes, HIV, hypertension, or autism.
Conclusions
In this national cohort of SGM adults, parenthood was associated with differences in physical and mental health measures. Understanding how parenthood influences the health and well-being of the estimated 3 million SGM parents in the US will help our health systems support diverse families.
{"title":"Parenthood and the physical and mental health of sexual and gender minority parents: A cross-sectional, observational analysis from The PRIDE Study","authors":"","doi":"10.1016/j.annepidem.2024.07.046","DOIUrl":"10.1016/j.annepidem.2024.07.046","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare the physical and mental health of sexual and gender minority (SGM) parents to SGM non-parents.</p></div><div><h3>Methods</h3><p>A cross-sectional analysis using 2018–2020 data from The PRIDE Study, a national longitudinal cohort of SGM adults. We used Poisson regression adjusted for age, gender, relationship status, race/ethnicity, household income, and education to assess the association between parental status and each outcome.</p></div><div><h3>Results</h3><p>Among 9625 SGM participants, 1460 (15 %) were parents. Older participants were more likely to be parents: 2% of participants aged 18–30, 18% aged 30–39, and 38% aged 40+ were parents. In adjusted analyses, parenthood was associated with greater depression, anxiety, and post-traumatic stress symptoms as well as ever cigarette smoking. Among individuals assigned female sex at birth, parents were twice as likely to have been diagnosed with pelvic inflammatory disease compared to non-parents. There was no association between parenthood status and alcohol use, substance use, diabetes, HIV, hypertension, or autism.</p></div><div><h3>Conclusions</h3><p>In this national cohort of SGM adults, parenthood was associated with differences in physical and mental health measures. Understanding how parenthood influences the health and well-being of the estimated 3 million SGM parents in the US will help our health systems support diverse families.</p></div>","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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