Pub Date : 2024-12-31DOI: 10.1136/jech-2024-223050
Isabella Marinetti, Dmitri A Jdanov, Domantas Jasilionis, Marília Nepomuceno, Nazrul Islam, Fanny Janssen
Background: Seasonal fluctuations in mortality affect annual life expectancy at birth (e0). Nevertheless, evidence on the impact of seasonal mortality on longevity is very limited and mainly restricted to assessing season-specific mortality levels due to shocks (e.g., heatwaves and influenza epidemics). We investigated the influence of seasonality in mortality on life expectancy levels and temporal trends across 20 European countries during 2000-2019.
Data and methods: We used harmonised weekly population-level mortality data from the Human Mortality Database. Seasonal contributions to life expectancy at birth and age 65, by sex, were estimated using the excess mortality approach and decomposition analysis. Time-series analysis was used to evaluate the impact on long-term mortality trends.
Results: Seasonal mortality had a substantial but stable impact on e0 between 2000 and 2019. On average, we found an annual reduction in life expectancy due to seasonal excess mortality of 1.14 years for males and 0.80 years for females. Deaths in the elderly population (65+) were the main driver of this impact: around 70% and 90% of these reductions in life expectancy were attributable to older ages. Excess mortality in winter had the strongest impact on annual life expectancy, especially in Portugal and Bulgaria (around 0.8-year loss on e0).
Conclusions: The study revealed significant cross-country variations in contributions of seasonal mortality. The most pronounced effects were observed in winter months and at older ages. These findings underscore the need for timely and targeted public health interventions to mitigate excess seasonal mortality.
{"title":"Seasonality in mortality and its impact on life expectancy levels and trends across Europe.","authors":"Isabella Marinetti, Dmitri A Jdanov, Domantas Jasilionis, Marília Nepomuceno, Nazrul Islam, Fanny Janssen","doi":"10.1136/jech-2024-223050","DOIUrl":"https://doi.org/10.1136/jech-2024-223050","url":null,"abstract":"<p><strong>Background: </strong>Seasonal fluctuations in mortality affect annual life expectancy at birth (e<sub>0</sub>). Nevertheless, evidence on the impact of seasonal mortality on longevity is very limited and mainly restricted to assessing season-specific mortality levels due to shocks (e.g., heatwaves and influenza epidemics). We investigated the influence of seasonality in mortality on life expectancy levels and temporal trends across 20 European countries during 2000-2019.</p><p><strong>Data and methods: </strong>We used harmonised weekly population-level mortality data from the Human Mortality Database. Seasonal contributions to life expectancy at birth and age 65, by sex, were estimated using the excess mortality approach and decomposition analysis. Time-series analysis was used to evaluate the impact on long-term mortality trends.</p><p><strong>Results: </strong>Seasonal mortality had a substantial but stable impact on e<sub>0</sub> between 2000 and 2019. On average, we found an annual reduction in life expectancy due to seasonal excess mortality of 1.14 years for males and 0.80 years for females. Deaths in the elderly population (65+) were the main driver of this impact: around 70% and 90% of these reductions in life expectancy were attributable to older ages. Excess mortality in winter had the strongest impact on annual life expectancy, especially in Portugal and Bulgaria (around 0.8-year loss on e<sub>0</sub>).</p><p><strong>Conclusions: </strong>The study revealed significant cross-country variations in contributions of seasonal mortality. The most pronounced effects were observed in winter months and at older ages. These findings underscore the need for timely and targeted public health interventions to mitigate excess seasonal mortality.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-25DOI: 10.1136/jech-2024-222476
Brendan T Smith, Claire Benny, Alessandra T Andreacchi, Naomi Schwartz, Christine M Warren, Samantha Forbes, Erin Hobin
Background: Differential vulnerability to alcohol contributes to socioeconomic inequities in alcohol-attributable harm. This study aimed to estimate the sex-/gender-specific joint effects of socioeconomic position (SEP) and heavy episodic drinking or volume of alcohol use on 100% alcohol-attributable emergency department (ED) visits.
Methods: We conducted a cohort study among 36 900 men and 39 700 women current and former alcohol consumers aged 15-64 from population-representative Canadian Community Health Surveys (2003-2008) linked to administrative ED visit data through 2017 in Ontario and Alberta. We estimated sex-/gender-specific associations between SEP (both education and income) and heavy episodic drinking (≥5 standard drinks on one occasion, at least monthly) or volume of alcohol use (standard drinks per week) on incident alcohol-attributable ED visits and assessed additive interactions using the Synergy Index (S).
Results: Lower levels of education (eg, less than high school vs Bachelor's degree or above: men: adjusted HR (aHR)=3.71, 95% CI 2.47 to 5.58; women: aHR=1.75, 95% CI 1.15 to 2.68) and income (eg, quintile (Q)1 vs Q5, men: aHR=2.07, 95% CI 1.35 to 3.17; women: aHR=1.84, 95% CI 0.91 to 3.71) were associated with increased rates of alcohol-attributable ED visits. Among men and women, superadditive joint effects (ie, greater than the sum of both exposures experienced independently) were observed between low SEP (education and income) and heavy episodic drinking and higher volume of alcohol use on alcohol-attributable ED visits.
Interpretation: Our results indicate that individuals with lower SEP experience increased vulnerability to alcohol use and related harms. These findings highlight the urgent need for population-level interventions that reduce both the high burden and socioeconomic inequities in alcohol-attributable harm.
背景:酒精易感性的差异导致了酒精致害的社会经济不平等。本研究旨在评估社会经济地位(SEP)和重度间歇性饮酒或酒精使用量对100%酒精归因于急诊科(ED)就诊的联合影响。方法:我们对年龄在15-64岁的36900名男性和39700名女性进行了队列研究,这些人来自具有人口代表性的加拿大社区健康调查(2003-2008),与安大略省和阿尔伯塔省截至2017年的行政ED就诊数据相关。我们估计了SEP(教育程度和收入)与酒精引起的突发ED就诊中重度间歇性饮酒(一次≥5标准饮酒,至少每月一次)或饮酒量(每周标准饮酒)之间的性别/性别特异性关联,并使用协同指数(S)评估了累加性相互作用。结果:教育水平较低(例如,低于高中与学士学位或以上学历:男性:调整HR (aHR)=3.71, 95% CI 2.47至5.58;女性:aHR=1.75, 95% CI 1.15 - 2.68)和收入(例如,五分位数(Q)1 vs Q5,男性:aHR=2.07, 95% CI 1.35 - 3.17;女性:aHR=1.84, 95% CI 0.91 - 3.71)与酒精导致的ED就诊率增加相关。在男性和女性中,观察到低SEP(教育和收入)与酒精引起的ED就诊中大量间歇性饮酒和较高酒精使用量之间的超加性联合效应(即大于独立经历的两种暴露的总和)。解释:我们的研究结果表明,SEP较低的个体对酒精使用和相关危害的易感性增加。这些发现突出表明,迫切需要采取人口层面的干预措施,以减少酒精所致危害的高负担和社会经济不平等。
{"title":"Socioeconomic position, alcohol use and alcohol-attributable emergency department visits.","authors":"Brendan T Smith, Claire Benny, Alessandra T Andreacchi, Naomi Schwartz, Christine M Warren, Samantha Forbes, Erin Hobin","doi":"10.1136/jech-2024-222476","DOIUrl":"10.1136/jech-2024-222476","url":null,"abstract":"<p><strong>Background: </strong>Differential vulnerability to alcohol contributes to socioeconomic inequities in alcohol-attributable harm. This study aimed to estimate the sex-/gender-specific joint effects of socioeconomic position (SEP) and heavy episodic drinking or volume of alcohol use on 100% alcohol-attributable emergency department (ED) visits.</p><p><strong>Methods: </strong>We conducted a cohort study among 36 900 men and 39 700 women current and former alcohol consumers aged 15-64 from population-representative Canadian Community Health Surveys (2003-2008) linked to administrative ED visit data through 2017 in Ontario and Alberta. We estimated sex-/gender-specific associations between SEP (both education and income) and heavy episodic drinking (≥5 standard drinks on one occasion, at least monthly) or volume of alcohol use (standard drinks per week) on incident alcohol-attributable ED visits and assessed additive interactions using the Synergy Index (S).</p><p><strong>Results: </strong>Lower levels of education (eg, less than high school vs Bachelor's degree or above: men: adjusted HR (aHR)=3.71, 95% CI 2.47 to 5.58; women: aHR=1.75, 95% CI 1.15 to 2.68) and income (eg, quintile (Q)1 vs Q5, men: aHR=2.07, 95% CI 1.35 to 3.17; women: aHR=1.84, 95% CI 0.91 to 3.71) were associated with increased rates of alcohol-attributable ED visits. Among men and women, superadditive joint effects (ie, greater than the sum of both exposures experienced independently) were observed between low SEP (education and income) and heavy episodic drinking and higher volume of alcohol use on alcohol-attributable ED visits.</p><p><strong>Interpretation: </strong>Our results indicate that individuals with lower SEP experience increased vulnerability to alcohol use and related harms. These findings highlight the urgent need for population-level interventions that reduce both the high burden and socioeconomic inequities in alcohol-attributable harm.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-25DOI: 10.1136/jech-2024-223202
Alexander Testa, Luis Mijares, Karyn Fu, Dylan Jackson, Carmen Gutierrez, Reed DeAngelis, Kyle Ganson, Jason Nagata, Rahma Mungia
Background: This study examines the longitudinal patterns of dental care use from adolescence to middle adulthood (ages 11-43) and investigates racial and ethnic disparities in these patterns.
Methods: Data from Waves I through V of the National Longitudinal Study of Adolescent to Adult Health (1993-2018; ages 11-43). Semiparametric group-based trajectory model identified distinct dental care use trajectories. Multinomial logistic regression was used to estimate membership in these trajectory groups by race/ethnicity while accounting for covariates, including socioeconomic status, biological sex, nativity and unmet healthcare needs.
Results: The analysis identified four distinct dental care use trajectories (1): Intermittent decreasing dental care use (37.9%), (2) intermittent increasing dental care use (22.5%), (3) high dental care use (22.5%) and (4) low dental care use (17.0%). Non-Hispanic black and Hispanic respondents were more likely than non-Hispanic white respondents to belong to low dental care use and intermittent decreasing dental care use groups relative to high dental care use. Additionally, non-Hispanic black respondents were more likely than non-Hispanic white respondents to belong to the Intermittent Increasing Dental Use group. Higher socioeconomic status was inversely associated with low and intermittent use group membership. Males and those with unmet healthcare needs at Wave I were also more likely to belong to trajectories with low and intermittent dental care use.
Conclusions: Findings reveal persistent racial disparities in dental care use from adolescence into adulthood. Further research is needed to understand the individual and structural factors perpetuating racial disparities in dental care use over the life course.
{"title":"Race disparities in dental care use from adolescence to middle adulthood in the USA.","authors":"Alexander Testa, Luis Mijares, Karyn Fu, Dylan Jackson, Carmen Gutierrez, Reed DeAngelis, Kyle Ganson, Jason Nagata, Rahma Mungia","doi":"10.1136/jech-2024-223202","DOIUrl":"10.1136/jech-2024-223202","url":null,"abstract":"<p><strong>Background: </strong>This study examines the longitudinal patterns of dental care use from adolescence to middle adulthood (ages 11-43) and investigates racial and ethnic disparities in these patterns.</p><p><strong>Methods: </strong>Data from Waves I through V of the National Longitudinal Study of Adolescent to Adult Health (1993-2018; ages 11-43). Semiparametric group-based trajectory model identified distinct dental care use trajectories. Multinomial logistic regression was used to estimate membership in these trajectory groups by race/ethnicity while accounting for covariates, including socioeconomic status, biological sex, nativity and unmet healthcare needs.</p><p><strong>Results: </strong>The analysis identified four distinct dental care use trajectories (1): Intermittent decreasing dental care use (37.9%), (2) intermittent increasing dental care use (22.5%), (3) high dental care use (22.5%) and (4) low dental care use (17.0%). Non-Hispanic black and Hispanic respondents were more likely than non-Hispanic white respondents to belong to low dental care use and intermittent decreasing dental care use groups relative to high dental care use. Additionally, non-Hispanic black respondents were more likely than non-Hispanic white respondents to belong to the Intermittent Increasing Dental Use group. Higher socioeconomic status was inversely associated with low and intermittent use group membership. Males and those with unmet healthcare needs at Wave I were also more likely to belong to trajectories with low and intermittent dental care use.</p><p><strong>Conclusions: </strong>Findings reveal persistent racial disparities in dental care use from adolescence into adulthood. Further research is needed to understand the individual and structural factors perpetuating racial disparities in dental care use over the life course.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-22DOI: 10.1136/jech-2024-222488
Emily Dema, Roeann Osman, Kate Soldan, Nigel Field, Pam Sonnenberg
Background: Uptake of human papillomavirus (HPV) vaccination is generally high in high-income countries with school-based vaccination programmes; however, lower uptake in certain population subgroups could continue pre-immunisation inequalities in cervical cancer.
Methods: Six electronic databases were searched for quantitative articles published between 1 September 2006 and 20 February 2023, which were representative of the general population, with individual-level data on routine school-based vaccination (with >50% coverage) and sociodemographic measures. Titles, abstracts and full-text articles were screened for eligibility criteria and assessed for bias. A second independent reviewer randomly screened 20% of articles at each stage. A narrative synthesis summarised findings.
Results: 24 studies based in eight countries (Australia, Belgium, Canada, New Zealand, Norway, Sweden, Switzerland, UK) were included. Studies reported vaccination uptake by individual-level and area-level socioeconomic status (SES), parental education, religion, ethnicity and/or country of birth. 19 studies reported that more than 70% were vaccinated (range: 50.7%-93.0%). Minority ethnic groups and migrants were more likely to have lower vaccination uptake than White groups and non-migrants (11/11 studies). Lower SES was also associated with lower uptake of vaccination (11/17 studies). Associations with other sociodemographic characteristics, such as parental education and religion, were less clear.
Conclusions: Even in high-income countries with high coverage school-based vaccination programmes, inequalities are seen. The totality of available evidence suggests girls from lower SES and minority ethnic groups tend to be less likely to be vaccinated. Findings could inform targeted approaches to mop-up vaccination and cervical cancer screening amidst changing HPV epidemiology in a vaccine era.
{"title":"Are there any sociodemographic factors associated with non-uptake of HPV vaccination of girls in high-income countries with school-based vaccination programmes? A systematic review.","authors":"Emily Dema, Roeann Osman, Kate Soldan, Nigel Field, Pam Sonnenberg","doi":"10.1136/jech-2024-222488","DOIUrl":"10.1136/jech-2024-222488","url":null,"abstract":"<p><strong>Background: </strong>Uptake of human papillomavirus (HPV) vaccination is generally high in high-income countries with school-based vaccination programmes; however, lower uptake in certain population subgroups could continue pre-immunisation inequalities in cervical cancer.</p><p><strong>Methods: </strong>Six electronic databases were searched for quantitative articles published between 1 September 2006 and 20 February 2023, which were representative of the general population, with individual-level data on routine school-based vaccination (with >50% coverage) and sociodemographic measures. Titles, abstracts and full-text articles were screened for eligibility criteria and assessed for bias. A second independent reviewer randomly screened 20% of articles at each stage. A narrative synthesis summarised findings.</p><p><strong>Results: </strong>24 studies based in eight countries (Australia, Belgium, Canada, New Zealand, Norway, Sweden, Switzerland, UK) were included. Studies reported vaccination uptake by individual-level and area-level socioeconomic status (SES), parental education, religion, ethnicity and/or country of birth. 19 studies reported that more than 70% were vaccinated (range: 50.7%-93.0%). Minority ethnic groups and migrants were more likely to have lower vaccination uptake than White groups and non-migrants (11/11 studies). Lower SES was also associated with lower uptake of vaccination (11/17 studies). Associations with other sociodemographic characteristics, such as parental education and religion, were less clear.</p><p><strong>Conclusions: </strong>Even in high-income countries with high coverage school-based vaccination programmes, inequalities are seen. The totality of available evidence suggests girls from lower SES and minority ethnic groups tend to be less likely to be vaccinated. Findings could inform targeted approaches to mop-up vaccination and cervical cancer screening amidst changing HPV epidemiology in a vaccine era.</p><p><strong>Trial registration number: </strong>CRD42023399648.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-18DOI: 10.1136/jech-2024-222748
Kenneth Petscavage, Martin Kavao Mutua, Abram Luther Wagner, Emily Treleaven
Background: Extreme weather events, or natural disasters, present a large and increasing threat to human health, infrastructure and food security, including in sub-Saharan Africa (SSA), where the burden of undernutrition is high. However, research about associations between natural disasters and undernutrition in early childhood is limited.
Methods: We combined anthropometric data of children aged 0-59 months from 51 Demographic and Health Surveys datasets collected from 2010 to 2019 in 30 countries in SSA with information on natural disaster events (flood, drought, other) from the Emergency Events Database database to determine disaster exposure. The analytic sample included 320 479 children. We used generalised estimating equations to predict stunting, wasting and anaemia by disaster exposure and selected covariates.
Results: Almost 20% (19.7%) of children under five were exposed to a natural disaster in the preceding year. In adjusted analysis, children exposed to at least one disaster in the preceding year had a relative risk (RR) of wasting 1.17 times higher than unexposed children (95% CI 1.12, 1.22). Adjusted models examining exposure to drought or flood consistently estimated higher risks of wasting post-disaster (drought RR 1.36, 95% CI 1.26, 1.47; flood RR 1.07, 95% CI 1.02, 1.12). RRs increased when using a 3-month exposure period. However, exposure to natural disaster was not consistently associated with significant differences in RR of stunting or anaemia.
Conclusion: Natural disasters are prevalent in SSA. Given the high risk of wasting associated with disaster exposure, policymakers should prioritise interventions to address wasting in post-disaster settings.
背景:极端天气事件或自然灾害对人类健康、基础设施和粮食安全构成巨大且日益严重的威胁,包括在营养不良负担严重的撒哈拉以南非洲地区。然而,关于自然灾害与儿童早期营养不良之间关系的研究是有限的。方法:我们将2010年至2019年在SSA 30个国家收集的51个人口与健康调查数据集中的0-59个月儿童的人体测量数据与紧急事件数据库数据库中的自然灾害事件(洪水、干旱等)信息相结合,以确定灾害暴露程度。分析样本包括320 479名儿童。我们使用广义估计方程通过灾害暴露和选定的协变量来预测发育迟缓、消瘦和贫血。结果:近20%(19.7%)的5岁以下儿童在前一年遭受过自然灾害。在调整分析中,在前一年暴露于至少一次灾害的儿童的相对危险度(RR)比未暴露的儿童高1.17倍(95% CI 1.12, 1.22)。检查干旱或洪水暴露的调整模型一致地估计了更高的灾后浪费风险(干旱风险比1.36,95%可信区间1.26,1.47;洪水风险比1.07,95%可信区间1.02,1.12)。当使用3个月的暴露期时,rrr增加。然而,暴露于自然灾害与发育迟缓或贫血的RR差异并不一致。结论:SSA地区自然灾害多发。鉴于与灾害暴露相关的浪费风险很高,决策者应优先采取干预措施,解决灾后环境中的浪费问题。
{"title":"Associations between extreme weather events and child undernutrition: evidence from sub-Saharan Africa, 2010-2019.","authors":"Kenneth Petscavage, Martin Kavao Mutua, Abram Luther Wagner, Emily Treleaven","doi":"10.1136/jech-2024-222748","DOIUrl":"https://doi.org/10.1136/jech-2024-222748","url":null,"abstract":"<p><strong>Background: </strong>Extreme weather events, or natural disasters, present a large and increasing threat to human health, infrastructure and food security, including in sub-Saharan Africa (SSA), where the burden of undernutrition is high. However, research about associations between natural disasters and undernutrition in early childhood is limited.</p><p><strong>Methods: </strong>We combined anthropometric data of children aged 0-59 months from 51 Demographic and Health Surveys datasets collected from 2010 to 2019 in 30 countries in SSA with information on natural disaster events (flood, drought, other) from the Emergency Events Database database to determine disaster exposure. The analytic sample included 320 479 children. We used generalised estimating equations to predict stunting, wasting and anaemia by disaster exposure and selected covariates.</p><p><strong>Results: </strong>Almost 20% (19.7%) of children under five were exposed to a natural disaster in the preceding year. In adjusted analysis, children exposed to at least one disaster in the preceding year had a relative risk (RR) of wasting 1.17 times higher than unexposed children (95% CI 1.12, 1.22). Adjusted models examining exposure to drought or flood consistently estimated higher risks of wasting post-disaster (drought RR 1.36, 95% CI 1.26, 1.47; flood RR 1.07, 95% CI 1.02, 1.12). RRs increased when using a 3-month exposure period. However, exposure to natural disaster was not consistently associated with significant differences in RR of stunting or anaemia.</p><p><strong>Conclusion: </strong>Natural disasters are prevalent in SSA. Given the high risk of wasting associated with disaster exposure, policymakers should prioritise interventions to address wasting in post-disaster settings.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-12DOI: 10.1136/jech-2024-222915
Aapo Hiilamo, Maria Reinholdt Jensen, Åsmund Hermansen
Background: Psychiatric disorder diagnoses are linked to long-term socioeconomic 'shadows' into adulthood, but little is known about how these diagnoses are associated with adulthood payment problems in Norway and whether these associations are moderated by parental and area characteristics.
Methods: We combine Norwegian registry data with payment problem records from the public debt enforcement agency for the 1995-1997 birth cohorts (n=173 750). We ascertain behavioural, neurotic, mood and substance use disorder diagnoses from specialised care at ages 13-17. Payment problems are defined as any records of mandatory deductions in wages or benefits up to age 23. Causal forests are used to explore the potential moderating role of sociodemographic variables.
Results: Some 6% of the sample have payment problems, but the share is higher among men and among people with low childhood socioeconomic status. After adjusting for background characteristics, behavioural problem diagnoses are linked to a 4.6 percentage point higher risk of payment problems (95% CI 4.1 to 5), mood disorder diagnoses to a 2.2 percentage point higher risk (95% CI 1.5 to 2.9), neurotic disorder diagnoses to a 2.5 percentage point higher risk (95% CI 2 to 3.1) and substance use disorder diagnoses to a 9.3 percentage point higher risk (95% CI 7.6 to 10.9). The associations between substance use and behavioural diagnoses and payment problems are stronger for people with low childhood socioeconomic status.
Conclusion: The associations between adolescent substance and behavioural diagnoses and adulthood payment problems are particularly strong among people with low childhood socioeconomic status. Reducing these associations is critical for preventing the accumulation of disadvantages.
背景:精神疾病的诊断与成年期的长期社会经济“阴影”有关,但对于挪威这些诊断与成年期支付问题的关系以及这些关系是否受到父母和地区特征的调节,人们知之甚少。方法:我们将挪威登记数据与公共债务执行机构1995-1997年出生队列(n= 173,750)的支付问题记录相结合。我们确定了13-17岁儿童的行为、神经症、情绪和物质使用障碍的诊断。支付问题被定义为在23岁之前强制性扣除工资或福利的任何记录。因果森林用于探索社会人口变量的潜在调节作用。结果:约6%的样本有支付问题,但这一比例在男性和童年社会经济地位较低的人群中更高。在调整背景特征后,行为问题诊断与支付问题风险增加4.6个百分点(95% CI 4.1至5)有关,情绪障碍诊断与2.2个百分点的风险增加有关(95% CI 1.5至2.9),神经性障碍诊断与2.5个百分点的风险增加有关(95% CI 2至3.1),物质使用障碍诊断与9.3个百分点的风险增加有关(95% CI 7.6至10.9)。对于儿童时期社会经济地位较低的人来说,药物使用与行为诊断和支付问题之间的联系更强。结论:青少年物质和行为诊断与成年支付问题之间的关联在童年社会经济地位较低的人群中尤为明显。减少这些联系对于防止不利因素的积累至关重要。
{"title":"Associations between adolescent psychiatric disorders and adulthood payment problems: a Norwegian register study of complete birth cohorts of 1995-1997.","authors":"Aapo Hiilamo, Maria Reinholdt Jensen, Åsmund Hermansen","doi":"10.1136/jech-2024-222915","DOIUrl":"10.1136/jech-2024-222915","url":null,"abstract":"<p><strong>Background: </strong>Psychiatric disorder diagnoses are linked to long-term socioeconomic 'shadows' into adulthood, but little is known about how these diagnoses are associated with adulthood payment problems in Norway and whether these associations are moderated by parental and area characteristics.</p><p><strong>Methods: </strong>We combine Norwegian registry data with payment problem records from the public debt enforcement agency for the 1995-1997 birth cohorts (n=173 750). We ascertain behavioural, neurotic, mood and substance use disorder diagnoses from specialised care at ages 13-17. Payment problems are defined as any records of mandatory deductions in wages or benefits up to age 23. Causal forests are used to explore the potential moderating role of sociodemographic variables.</p><p><strong>Results: </strong>Some 6% of the sample have payment problems, but the share is higher among men and among people with low childhood socioeconomic status. After adjusting for background characteristics, behavioural problem diagnoses are linked to a 4.6 percentage point higher risk of payment problems (95% CI 4.1 to 5), mood disorder diagnoses to a 2.2 percentage point higher risk (95% CI 1.5 to 2.9), neurotic disorder diagnoses to a 2.5 percentage point higher risk (95% CI 2 to 3.1) and substance use disorder diagnoses to a 9.3 percentage point higher risk (95% CI 7.6 to 10.9). The associations between substance use and behavioural diagnoses and payment problems are stronger for people with low childhood socioeconomic status.</p><p><strong>Conclusion: </strong>The associations between adolescent substance and behavioural diagnoses and adulthood payment problems are particularly strong among people with low childhood socioeconomic status. Reducing these associations is critical for preventing the accumulation of disadvantages.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1136/jech-2024-221989
Kirstin Kielhold, Kate Shannon, Andrea Krüsi, Esteban Valencia, Jennie Pearson, Shira M Goldenberg
Background: Women sex workers face substantial health inequities due to structural barriers including criminalisation and stigma. Stigma has been associated with HIV-related inequities among marginalised populations, however, we know less about the impacts of sex work-specific occupational stigma on HIV/sexually transmitted infection (STI) risk among women sex workers. Given these research gaps and the disproportionate burden of stigma faced by sex workers, we evaluated the association between sex work occupational stigma and recent inconsistent condom use with clients, over an 8-year period (2014-2022).
Methods: Baseline and semiannual questionnaire data from a prospective, community-based cohort of sex workers in Vancouver, Canada from September 2014 to February 2022 were used. We employed complete-case bivariate and multivariate logistic regression analysis using generalised estimating equations to analyse the relationship between sex work occupational stigma and inconsistent condom use for vaginal/anal sex with clients in the past 6 months.
Results: Among 574 participants, the cumulative prevalence of inconsistent condom use by clients and sex work occupational stigma in the last 6 months was 32.1% (n=184) and 59.9% (n=344), respectively, over the 8-year period. In adjusted multivariable analysis, exposure to sex work occupational stigma was associated with almost twofold increased odds of recent inconsistent condom use with clients (adjusted OR 1.93, 95% CI 1.23 to 3.03) over the 8-year period.
Conclusion: Multilevel interventions addressing the role of occupational stigma are needed for HIV and STI prevention efforts, including scale-up of sex worker-led/delivered sexual health services and structural changes to decriminalise and destigmatise sex work.
{"title":"Association between sex work occupational stigma and inconsistent condom use: findings from a community-based cohort of women sex workers in Vancouver, Canada (2014-2022).","authors":"Kirstin Kielhold, Kate Shannon, Andrea Krüsi, Esteban Valencia, Jennie Pearson, Shira M Goldenberg","doi":"10.1136/jech-2024-221989","DOIUrl":"10.1136/jech-2024-221989","url":null,"abstract":"<p><strong>Background: </strong>Women sex workers face substantial health inequities due to structural barriers including criminalisation and stigma. Stigma has been associated with HIV-related inequities among marginalised populations, however, we know less about the impacts of sex work-specific occupational stigma on HIV/sexually transmitted infection (STI) risk among women sex workers. Given these research gaps and the disproportionate burden of stigma faced by sex workers, we evaluated the association between sex work occupational stigma and recent inconsistent condom use with clients, over an 8-year period (2014-2022).</p><p><strong>Methods: </strong>Baseline and semiannual questionnaire data from a prospective, community-based cohort of sex workers in Vancouver, Canada from September 2014 to February 2022 were used. We employed complete-case bivariate and multivariate logistic regression analysis using generalised estimating equations to analyse the relationship between sex work occupational stigma and inconsistent condom use for vaginal/anal sex with clients in the past 6 months.</p><p><strong>Results: </strong>Among 574 participants, the cumulative prevalence of inconsistent condom use by clients and sex work occupational stigma in the last 6 months was 32.1% (n=184) and 59.9% (n=344), respectively, over the 8-year period. In adjusted multivariable analysis, exposure to sex work occupational stigma was associated with almost twofold increased odds of recent inconsistent condom use with clients (adjusted OR 1.93, 95% CI 1.23 to 3.03) over the 8-year period.</p><p><strong>Conclusion: </strong>Multilevel interventions addressing the role of occupational stigma are needed for HIV and STI prevention efforts, including scale-up of sex worker-led/delivered sexual health services and structural changes to decriminalise and destigmatise sex work.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"36-41"},"PeriodicalIF":4.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1136/jech-2024-222134
Teresa Herrera, Eunsil Seok, Whitney Cowell, Eric Brown, Sheryl Magzamen, Ako Adams Ako, Rosalind J Wright, Leonardo Trasande, Robin Ortiz, Annemarie Stroustrup, Akhgar Ghassabian
Background: Evidence suggests historical redlining shaped the built environment and health outcomes in urban areas. Only a handful of studies have examined redlining's association with air pollution and adverse birth outcomes in New York City (NYC). Additionally, no NYC-specific studies have examined the impact of redlining on birth weight.
Methods: This longitudinal cohort study analysed data from the National Institute of Health Environmental Influences on Child Health Outcomes Programme to investigate the extent to which maternal residence in a historically redlined neighbourhood is associated with fine particulate matter (PM2.5) exposure during pregnancy using multivariable regression models. Additionally, we examined how maternal residence in a historically redlined neighbourhood during pregnancy influenced birth weight z-score, preterm birth and low birth weight.
Results: Our air pollution model showed that living in a historically redlined census tract or an ungraded census tract was associated with increased PM2.5 exposure during pregnancy. We also found living in a historically redlined census tract or an ungraded census tract was associated with a lower birth weight z-score. This finding remained significant when controlling for individual and census tract-level race, ethnicity and income. When we controlled PM2.5 in our models assessing the relationship between redlining grade and birth outcome, our results did not change.
Discussion: Our study supports the literature linking redlining to contemporary outcomes. However, our research in ungraded tracts suggests redlining alone is insufficient to fully explain inequality in birth outcomes and PM2.5 levels today.
背景:有证据表明,历史上的 "红线 "影响了城市地区的建筑环境和健康结果。只有少数研究探讨了纽约市(NYC)的红线区划与空气污染和不良出生结果之间的关系。此外,还没有针对纽约市的研究探讨了红线区对出生体重的影响:这项纵向队列研究分析了美国国立卫生研究院(National Institute of Health)"环境对儿童健康结果的影响 "项目(Environmental Influences on Child Health Outcomes Programme)的数据,利用多变量回归模型研究了母亲居住在历史上被划为红线的社区与孕期细颗粒物(PM2.5)暴露的相关程度。此外,我们还研究了孕产妇在怀孕期间居住在历史上被划为红线的社区对出生体重 Z 值、早产和低出生体重的影响:我们的空气污染模型显示,居住在历史红线人口普查区或未分级人口普查区与孕期 PM2.5 暴露增加有关。我们还发现,居住在历史上曾被划为红线的人口普查区或未被划为红线的人口普查区与较低的出生体重 Z 值有关。在控制了个人和人口普查区层面的种族、民族和收入后,这一发现仍然很重要。当我们在评估红线等级与出生结果之间关系的模型中控制 PM2.5 时,结果没有变化:我们的研究支持将红线与当代结果联系起来的文献。然而,我们对未分级地区的研究表明,仅靠划定红线不足以完全解释当今出生结果和 PM2.5 水平的不平等。
{"title":"Redlining in New York City: impacts on particulate matter exposure during pregnancy and birth outcomes.","authors":"Teresa Herrera, Eunsil Seok, Whitney Cowell, Eric Brown, Sheryl Magzamen, Ako Adams Ako, Rosalind J Wright, Leonardo Trasande, Robin Ortiz, Annemarie Stroustrup, Akhgar Ghassabian","doi":"10.1136/jech-2024-222134","DOIUrl":"10.1136/jech-2024-222134","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests historical redlining shaped the built environment and health outcomes in urban areas. Only a handful of studies have examined redlining's association with air pollution and adverse birth outcomes in New York City (NYC). Additionally, no NYC-specific studies have examined the impact of redlining on birth weight.</p><p><strong>Methods: </strong>This longitudinal cohort study analysed data from the National Institute of Health Environmental Influences on Child Health Outcomes Programme to investigate the extent to which maternal residence in a historically redlined neighbourhood is associated with fine particulate matter (PM<sub>2.5</sub>) exposure during pregnancy using multivariable regression models. Additionally, we examined how maternal residence in a historically redlined neighbourhood during pregnancy influenced birth weight z-score, preterm birth and low birth weight.</p><p><strong>Results: </strong>Our air pollution model showed that living in a historically redlined census tract or an ungraded census tract was associated with increased PM<sub>2.5</sub> exposure during pregnancy. We also found living in a historically redlined census tract or an ungraded census tract was associated with a lower birth weight z-score. This finding remained significant when controlling for individual and census tract-level race, ethnicity and income. When we controlled PM<sub>2.5</sub> in our models assessing the relationship between redlining grade and birth outcome, our results did not change.</p><p><strong>Discussion: </strong>Our study supports the literature linking redlining to contemporary outcomes. However, our research in ungraded tracts suggests redlining alone is insufficient to fully explain inequality in birth outcomes and PM<sub>2.5</sub> levels today.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"12-18"},"PeriodicalIF":4.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1136/jech-2023-220726
Junwen Yang-Huang, Jennifer J McGrath, Lise Gauvin, Beatrice Nikiéma, Nicholas James Spencer, Yara Abu Awad, Susan Clifford, Wolfgang Markham, Fiona Mensah, Pär Andersson White, Johnny Ludvigsson, Tomas Faresjö, Liesbeth Duijts, Amy van Grieken, Hein Raat
Objective: To examine the associations between maternal education and household income during early childhood with asthma-related outcomes in children aged 9-12 years in the UK, the Netherlands, Sweden, Australia, the USA and Canada.
Methods: Data on 31 210 children were obtained from 7 prospective birth cohort studies across six countries. Asthma-related outcomes included ever asthma, wheezing/asthma attacks and medication control for asthma. Relative social inequalities were estimated using pooled risk ratios (RRs) adjusted for potential confounders (child age, sex, mother ethnic background and maternal age) for maternal education and household income. The Slope Index of Inequality (SII) was calculated for each cohort to evaluate absolute social inequalities.
Results: Ever asthma prevalence ranged from 8.3% (Netherlands) to 29.1% (Australia). Wheezing/asthma attacks prevalence ranged from 3.9% (Quebec) to 16.8% (USA). Pooled RRs for low (vs high) maternal education and low (vs high) household income were: ever asthma (education 1.24, 95% CI 1.13 to 1.37; income 1.28, 95% CI 1.15 to 1.43), wheezing/asthma attacks (education 1.14, 95% CI 0.97 to 1.35; income 1.22, 95% CI 1.03 to 1.44) and asthma with medication control (education 1.16, 95% CI 0.97 to 1.40; income 1.25, 95% CI 1.01 to 1.55). SIIs supported the lower risk for children with more highly educated mothers and those from higher-income households in most cohorts, with few exceptions.
Conclusions: Social inequalities by household income on the risk of ever asthma, wheezing/asthma attacks, and medication control for asthma were evident; the associations were attenuated for maternal education. These findings support the need for prevention policies to address the relatively high risks of respiratory morbidity in children in families with low socioeconomic status.
目的研究英国、荷兰、瑞典、澳大利亚、美国和加拿大 9-12 岁儿童早期母亲教育程度和家庭收入与哮喘相关结果之间的关系:方法:从 6 个国家的 7 项前瞻性出生队列研究中获得了 31 210 名儿童的数据。哮喘相关结果包括曾经患过哮喘、喘息/哮喘发作和哮喘药物控制。在对潜在的混杂因素(儿童年龄、性别、母亲种族背景和母亲年龄)、母亲教育程度和家庭收入进行调整后,使用集合风险比(RRs)对相对社会不平等进行了估计。对每个队列计算不平等斜率指数(SII),以评估绝对的社会不平等:哮喘患病率从 8.3%(荷兰)到 29.1%(澳大利亚)不等。喘息/哮喘发作率从 3.9%(魁北克)到 16.8%(美国)不等。母亲受教育程度低(与母亲受教育程度高)和家庭收入低(与家庭收入高)的合并死亡率分别为:曾经患过哮喘(受教育程度为 1.24,95% CI 为 1.13 至 1.37;收入为 1.28,95% CI 为 1.15 至 1.43)、喘息/哮喘发作(受教育程度为 1.24,95% CI 为 1.13 至 1.37;收入为 1.28,95% CI 为 1.15 至 1.43)。43)、喘息/哮喘发作(教育程度 1.14,95% CI 0.97 至 1.35;收入 1.22,95% CI 1.03 至 1.44)和药物控制的哮喘(教育程度 1.16,95% CI 0.97 至 1.40;收入 1.25,95% CI 1.01 至 1.55)。在大多数组群中,母亲教育程度较高和来自高收入家庭的儿童风险较低,但也有少数例外:结论:在哮喘、喘息/哮喘发作和哮喘药物控制的风险方面,家庭收入的社会不平等是显而易见的;母亲受教育程度越高,相关性越小。这些研究结果表明,有必要制定预防政策,以应对社会经济地位较低家庭中儿童呼吸系统发病率相对较高的风险。
{"title":"Early family socioeconomic status and asthma-related outcomes in school-aged children: Results from seven birth cohort studies.","authors":"Junwen Yang-Huang, Jennifer J McGrath, Lise Gauvin, Beatrice Nikiéma, Nicholas James Spencer, Yara Abu Awad, Susan Clifford, Wolfgang Markham, Fiona Mensah, Pär Andersson White, Johnny Ludvigsson, Tomas Faresjö, Liesbeth Duijts, Amy van Grieken, Hein Raat","doi":"10.1136/jech-2023-220726","DOIUrl":"10.1136/jech-2023-220726","url":null,"abstract":"<p><strong>Objective: </strong>To examine the associations between maternal education and household income during early childhood with asthma-related outcomes in children aged 9-12 years in the UK, the Netherlands, Sweden, Australia, the USA and Canada.</p><p><strong>Methods: </strong>Data on 31 210 children were obtained from 7 prospective birth cohort studies across six countries. Asthma-related outcomes included ever asthma, wheezing/asthma attacks and medication control for asthma. Relative social inequalities were estimated using pooled risk ratios (RRs) adjusted for potential confounders (child age, sex, mother ethnic background and maternal age) for maternal education and household income. The Slope Index of Inequality (SII) was calculated for each cohort to evaluate absolute social inequalities.</p><p><strong>Results: </strong>Ever asthma prevalence ranged from 8.3% (Netherlands) to 29.1% (Australia). Wheezing/asthma attacks prevalence ranged from 3.9% (Quebec) to 16.8% (USA). Pooled RRs for low (vs high) maternal education and low (vs high) household income were: ever asthma (education 1.24, 95% CI 1.13 to 1.37; income 1.28, 95% CI 1.15 to 1.43), wheezing/asthma attacks (education 1.14, 95% CI 0.97 to 1.35; income 1.22, 95% CI 1.03 to 1.44) and asthma with medication control (education 1.16, 95% CI 0.97 to 1.40; income 1.25, 95% CI 1.01 to 1.55). SIIs supported the lower risk for children with more highly educated mothers and those from higher-income households in most cohorts, with few exceptions.</p><p><strong>Conclusions: </strong>Social inequalities by household income on the risk of ever asthma, wheezing/asthma attacks, and medication control for asthma were evident; the associations were attenuated for maternal education. These findings support the need for prevention policies to address the relatively high risks of respiratory morbidity in children in families with low socioeconomic status.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"1-11"},"PeriodicalIF":4.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1136/jech-2024-222428
Esther S Yao, Denise Neumann, Seini Taufa, Renee Liang, Te Kani Kingi, Fiona Langridge, Sarah-Jane Paine
Background: Longitudinal studies can generate valuable scientific knowledge, but can be compromised by systematic attrition. Previous research shows that sociodemographic characteristics (eg, ethnicity, age, educational level, socioeconomic circumstances) are associated with attrition rates. However, little is known about whether these characteristics differ by ethnicity, and how this impacts cohort retention strategies.
Methods: Using antenatal to 12-year data from the Growing Up in New Zealand birth cohort study (N=6743), we examined transversal response rates by ethnicity (Māori, Pacific, Asian, European), used sequence analysis and cluster analysis to identify unique longitudinal response patterns, and binary logistic regression to examine ethnic-specific sociodemographic characteristics associated with these response patterns.
Results: The overall response rate at 12 years was 71.0%, with ethnic differences in response rates widening over the six data collection waves. Three longitudinal response patterns were identified: frequent responders (65.2%), intermittent non-responders (29.6%) and frequent non-responders (5.2%). Sociodemographic characteristics such as younger maternal age and lower maternal education were associated with a higher likelihood of membership in the non-response clusters across all ethnic groups. However, there were also important nuances by ethnicity. Individual level factors (eg, household material deprivation and maternal general health) tended to be associated with non-response for Europeans, whereas structural level factors (eg, area-level deprivation and racial discrimination) tended to be associated with non-response for Māori, Pacific and Asian peoples.
Conclusion: Ethnic differences in longitudinal response patterns are due to multiple factors of disadvantage, and therefore require targeted retention strategies. Stratifying analyses by ethnicity is important for revealing nuanced insights.
背景:纵向研究可以产生有价值的科学知识,但也可能因系统性减员而受到影响。以往的研究表明,社会人口特征(如种族、年龄、教育水平、社会经济状况)与流失率有关。然而,人们对这些特征是否因种族而异,以及这对群体保留策略有何影响知之甚少:方法:我们利用新西兰出生队列研究(Growing Up in New Zealand birth cohort study,N=6743)中从产前到 12 年的数据,按种族(毛利人、太平洋岛屿族裔、亚裔、欧裔)研究了横向响应率,使用序列分析和聚类分析确定了独特的纵向响应模式,并使用二元逻辑回归研究了与这些响应模式相关的特定种族社会人口特征:12年的总体应答率为71.0%,在六次数据收集过程中,不同种族的应答率差异有所扩大。发现了三种纵向应答模式:经常应答者(65.2%)、间歇性不应答者(29.6%)和经常不应答者(5.2%)。在所有种族群体中,产妇年龄较小、受教育程度较低等社会人口学特征与较高的未回复群组成员可能性相关。然而,不同种族之间也存在重要的细微差别。对于欧洲人来说,个人层面的因素(如家庭物质匮乏和孕产妇一般健康状况)往往与不回应有关,而对于毛利人、太平洋岛屿族裔和亚洲人来说,结构层面的因素(如地区层面的匮乏和种族歧视)往往与不回应有关:纵向响应模式中的种族差异是由多种不利因素造成的,因此需要有针对性的保留策略。按种族进行分层分析对于揭示细微差别非常重要。
{"title":"Ethnic-specific characteristics associated with longitudinal response patterns from prebirth to 12 years: evidence from <i>Growing Up in New Zealand</i>.","authors":"Esther S Yao, Denise Neumann, Seini Taufa, Renee Liang, Te Kani Kingi, Fiona Langridge, Sarah-Jane Paine","doi":"10.1136/jech-2024-222428","DOIUrl":"10.1136/jech-2024-222428","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal studies can generate valuable scientific knowledge, but can be compromised by systematic attrition. Previous research shows that sociodemographic characteristics (eg, ethnicity, age, educational level, socioeconomic circumstances) are associated with attrition rates. However, little is known about whether these characteristics differ by ethnicity, and how this impacts cohort retention strategies.</p><p><strong>Methods: </strong>Using antenatal to 12-year data from the <i>Growing Up in New Zealand</i> birth cohort study (N=6743), we examined transversal response rates by ethnicity (Māori, Pacific, Asian, European), used sequence analysis and cluster analysis to identify unique longitudinal response patterns, and binary logistic regression to examine ethnic-specific sociodemographic characteristics associated with these response patterns.</p><p><strong>Results: </strong>The overall response rate at 12 years was 71.0%, with ethnic differences in response rates widening over the six data collection waves. Three longitudinal response patterns were identified: frequent responders (65.2%), intermittent non-responders (29.6%) and frequent non-responders (5.2%). Sociodemographic characteristics such as younger maternal age and lower maternal education were associated with a higher likelihood of membership in the non-response clusters across all ethnic groups. However, there were also important nuances by ethnicity. Individual level factors (eg, household material deprivation and maternal general health) tended to be associated with non-response for Europeans, whereas structural level factors (eg, area-level deprivation and racial discrimination) tended to be associated with non-response for Māori, Pacific and Asian peoples.</p><p><strong>Conclusion: </strong>Ethnic differences in longitudinal response patterns are due to multiple factors of disadvantage, and therefore require targeted retention strategies. Stratifying analyses by ethnicity is important for revealing nuanced insights.</p>","PeriodicalId":54839,"journal":{"name":"Journal of Epidemiology and Community Health","volume":" ","pages":"19-26"},"PeriodicalIF":4.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}