1
|
Gold JM, Drewnowski A, Andersen MR, Rose C, Buszkiewicz J, Mou J, Ko LK. Investigating the effects of rurality on stress, subjective well-being, and weight-related outcomes. WELLBEING, SPACE AND SOCIETY 2023; 5:100171. [PMID: 38274306 PMCID: PMC10810484 DOI: 10.1016/j.wss.2023.100171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Purpose Rates of obesity are significantly higher for those living in a rural versus urban setting. High levels of stress and low levels of subjective well-being (SWB) have been linked to poor weight-related behaviors and outcomes, but it is unclear if these relationships differ as a function of rurality. This study investigated the extent to which living in a rural versus urban county ("rurality") moderated associations between stress / subjective wellbeing (predictors) and diet quality, dietary intake of added sugars, physical activity, and BMI (outcomes). Methods Participants were recruited from urban (n = 355) and rural (n = 347) counties in Washington State and self-reported psychological, demographic, and food frequency questionnaires while physical activity behavior was measured objectively. Findings After controlling for relevant covariates, levels of stress were positively associated with added sugar intake for those living in the urban county while this relationship was non-significant for those residing in the rural county. Similarly, SWB was negatively associated with added sugar intake, but only for urban residents. County of residence was also found to moderate the relationship between SWB and BMI. Higher SWB was inversely associated with BMI for those living in the urban county while no relationship was observed for rural county residents. Conclusions These findings support the hypothesis that the relationships between stress / SWB and weight function differentially based on the rurality of the residing county. This work adds to the growing body of literature highlighting the role stress and SWB play in the rural obesity disparity.
Collapse
Affiliation(s)
- Joshua M. Gold
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Adam Drewnowski
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
- Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, Washington, USA
| | - M. Robyn Andersen
- Department of Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Chelsea Rose
- Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, Washington, USA
| | - James Buszkiewicz
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Jin Mou
- MultiCare Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington, USA
| | - Linda K. Ko
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| |
Collapse
|
2
|
Clifford L, Tyler R, Knowles Z, Ashworth E, Boddy L, Foweather L, Fairclough SJ. Co-Creation of a School-Based Motor Competence and Mental Health Intervention: Move Well, Feel Good. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1403. [PMID: 37628403 PMCID: PMC10453743 DOI: 10.3390/children10081403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023]
Abstract
Low motor competence (MC) and inhibited psychosocial development are associated with mental health difficulties. Improving children's MC through school-based physical activity interventions emphasising psychosocial development may therefore be a mechanism for promoting positive mental health. This study describes and provides reflective insights into the co-creation of 'Move Well Feel Good', a primary school physical activity intervention to improve children's MC and mental health. Class teachers, school leaders, physical activity specialists, and children (aged 8-9 years) participated in a series of co-creation workshops. Stakeholders' knowledge and experiences were integrated with existing research evidence using creative methods (e.g., post-it note tasks, worksheets, and drawings) to facilitate discussion. The co-creation process culminated in stakeholder consensus voting for one of three proposed intervention ideas. Children cited physical and mental health benefits, enjoyment with friends, and high perceived competence as motives for being physically active. Opportunities to develop MC across the different segments of the school day were identified by adult stakeholders, who perceived children's lack of resilience, an overloaded curriculum, and poor parental support for physical activity as barriers to intervention implementation. The chosen intervention idea received six out of a possible twelve votes. Co-creation projects are specific to the contexts in which they are implemented. This study reinforces the complex nature of school-based intervention development and highlights the value of engaging with stakeholders in co-creation processes.
Collapse
Affiliation(s)
- Lauren Clifford
- Movement Behaviours, Health, Wellbeing, and Nutrition Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk L39 4QP, UK; (R.T.); (S.J.F.)
| | - Richard Tyler
- Movement Behaviours, Health, Wellbeing, and Nutrition Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk L39 4QP, UK; (R.T.); (S.J.F.)
| | - Zoe Knowles
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool L3 2EX, UK; (Z.K.); (L.B.); (L.F.)
| | - Emma Ashworth
- School of Psychology, Liverpool John Moores University, Liverpool L3 5UX, UK;
| | - Lynne Boddy
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool L3 2EX, UK; (Z.K.); (L.B.); (L.F.)
| | - Lawrence Foweather
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 5 Primrose Hill, Liverpool L3 2EX, UK; (Z.K.); (L.B.); (L.F.)
| | - Stuart J. Fairclough
- Movement Behaviours, Health, Wellbeing, and Nutrition Research Group, Department of Sport and Physical Activity, Edge Hill University, St. Helens Road, Ormskirk L39 4QP, UK; (R.T.); (S.J.F.)
| |
Collapse
|
3
|
Kong F, Chen H, Cheng Y. Social Interaction, Survival Stress and Smoking Behavior of Migrant Workers in China-An Empirical Analysis Using CHARLS Data from 2013-2018. Behav Sci (Basel) 2023; 13:680. [PMID: 37622820 PMCID: PMC10451940 DOI: 10.3390/bs13080680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023] Open
Abstract
Smoking is a major public health problem in most countries and usually occurs in marginalized groups. Analyzing the smoking behavior of migrant workers, a marginalized group in China, is of practical significance. Using panel data from the China Health and Retirement Longitudinal Study (CHARLS) database from 2013 to 2018, this study examined influence factors of smoking behavior (whether to smoke and smoking frequency) among migrant workers in China through the Heckman two-stage model. The results showed that the smoking rates of migrant workers were positively associated with social activity and a sense of loneliness, while smoking frequency was negatively associated with work stress and life satisfaction. Meanwhile, smoking behavior was associated with the demographic variables such as gender, age, and education level. Gender differences in smoking behavior were particularly notable among Chinese migrant workers. Furthermore, there was regional heterogeneity in smoking behavior among migrant workers. Smoking behavior in the eastern region was mainly influenced by psychological factors of wellbeing, such as social activity and life satisfaction, while it was affected by material conditions such as income in the central-western region. Effective strategies to control tobacco use among migrant workers are proposed in order to promote social integration between urban and rural residents, increase vocational education and training, and strengthen anti-smoking propaganda among migrant workers.
Collapse
Affiliation(s)
| | - Huiguang Chen
- College of Public Administration, Nanjing Agricultural University, Nanjing 210095, China; (F.K.); (Y.C.)
| | | |
Collapse
|
4
|
Keim-Klärner S, Adebahr P, Brandt S, Gamper M, Klärner A, Knabe A, Kupfer A, Müller B, Reis O, Vonneilich N, Ganser MA, de Bruyn C, von der Lippe H. Social inequality, social networks, and health: a scoping review of research on health inequalities from a social network perspective. Int J Equity Health 2023; 22:74. [PMID: 37098617 PMCID: PMC10131340 DOI: 10.1186/s12939-023-01876-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/28/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND This review summarises the present state of research on health inequalities using a social network perspective, and it explores the available studies examining the interrelations of social inequality, social networks, and health. METHODS Using the strategy of a scoping review, as outlined by Arksey and O'Malley (Int J Sci Res Methodol 8:19-32, 2005), our team performed two searches across eight scientific, bibliographic databases including papers published until October 2021. Studies meeting pre-defined eligibility criteria were selected. The data were charted in a table, and then collated, summarised, and reported in this paper. RESULTS Our search provided a total of 15,237 initial hits. After deduplication (n = 6,168 studies) and the removal of hits that did not meet our baseline criteria (n = 8,767 studies), the remaining 302 full text articles were examined. This resulted in 25 articles being included in the present review, many of which focused on moderating or mediating network effects. Such effects were found in the majority of these studies, but not in all. Social networks were found to buffer the harsher effects of poverty on health, while specific network characteristics were shown to intensify or attenuate the health effects of social inequalities. CONCLUSIONS Our review showed that the variables used for measuring health and social networks differed considerably across the selected studies. Thus, our attempt to establish a consensus of opinion across the included studies was not successful. Nevertheless, the usefulness of social network analysis in researching health inequalities and the employment of health-promoting interventions focusing on social relations was generally acknowledged in the studies. We close by suggesting ways to advance the research methodology, and argue for a greater orientation on theoretical models. We also call for the increased use of structural measures; the inclusion of measures on negative ties and interactions; and the use of more complex study designs, such as mixed-methods and longitudinal studies.
Collapse
Affiliation(s)
| | - Philip Adebahr
- Institute of Sociology, University of Technology Chemnitz, Chemnitz, Germany
| | - Stefan Brandt
- Landesfrauenrat Mecklenburg-Vorpommern e.V., Rostock, Germany
| | - Markus Gamper
- Institut für vergleichende Bildungsforschung und Sozialwissenschaften, University of Cologne, Cologne, Germany
| | - Andreas Klärner
- Thünen Institute of Rural Studies, Bundesallee 64, Brunswick, Germany
| | - André Knabe
- Rostocker Institut für Sozialforschung und gesellschaftliche Praxis e.V., Rostock, Germany
| | - Annett Kupfer
- Institute of Social Pedagogy, Social Work and Welfare Studies, Technische Universität Dresden, Dresden, Germany
| | - Britta Müller
- Institute of Medical Psychology and Medical Sociology, Rostock University Medical Center, Rostock, Germany
| | - Olaf Reis
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Rostock University Medical Center, Rostock, Germany
| | - Nico Vonneilich
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | |
Collapse
|
5
|
Haag DG, Santiago PR, Schuch HS, Brennan DS, Jamieson LM. Is the association between social support and oral health modified by household income? Findings from a national study of adults in Australia. Community Dent Oral Epidemiol 2022; 50:484-492. [PMID: 34989422 DOI: 10.1111/cdoe.12693] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/30/2021] [Accepted: 08/11/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To investigate whether the association between social support and oral health outcomes is modified by levels of household income. METHODS Data were from the National Study of Adults Oral Health (NSAOH 2004-06), a nationally representative study comprising n = 3619 adults in Australia. Effect measure modification (EMM) analysis was adopted to verify whether the association between social support and poor/fair self-rated oral health, lack of a functional dentition (<21 teeth) and low Oral Health Related Quality of Life (OHRQoL; measured using OHIP-14) varies according to levels of income. Poisson regressions adjusted for age, sex, education, country of birth, main language spoken at home and remoteness were used to estimate prevalence ratios (PR) for oral health outcomes for each stratum of social support (overall, family, friends and significant other) and income (effect modifier). We then computed the Relative Excess Risk due to Interaction (RERI), which represents the risk that is over what would be expected if the combination of low social support and low income was entirely additive. Sensitivity analyses for different cut-offs of household income were performed. RESULTS Adults with lower levels of social support had a 2.1, 1.2 and 1.9 times higher prevalence of fair/poor self-rated oral health, <21 teeth and poor OHRQoL respectively. The RERIs observed were 0.98 (95% CI -0.01; 1.96) for poor/fair self-rated oral health; 0.52 (95% CI -0.06; 1.10) for lack of a functional dentition and 0.50 (95% CI -0.16; 1.15) for poor OHRQoL. For all outcomes and all individual domains of social support, the positive RERIs indicated that the joint association of low social support and low household income surpassed the sum of their separate associations with objective and subjective oral health indicators. CONCLUSION Individuals with lower levels of social support had poorer oral health than those with high levels of social support, although this association was small for the outcome <21 teeth. The association between social support and poor oral health indicators is modified by levels of household income. Hence, the provision of social support had a stronger association with the oral health of low-income participants, suggesting that socioeconomically disadvantaged individuals would mostly benefit from a social support intervention.
Collapse
Affiliation(s)
- Dandara G Haag
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, SA, Australia
| | - Pedro R Santiago
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, SA, Australia
| | - Helena S Schuch
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - David S Brennan
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, SA, Australia
| | - Lisa M Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, SA, Australia
| |
Collapse
|
6
|
Newman-Norlund RD, Newman-Norlund SE, Sayers S, McLain AC, Riccardi N, Fridriksson J. Effects of social isolation on quality of life in elderly adults. PLoS One 2022; 17:e0276590. [PMID: 36327259 PMCID: PMC9632793 DOI: 10.1371/journal.pone.0276590] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Prolonged periods of social isolation are known to have significant negative health consequences and reduce quality of life, an effect that is particularly pronounced in older populations. Despite the known deleterious effects of social isolation, a key component of the response to the COVID-19 pandemic has been the issuance of stay at home and/or shelter in place orders. Relatively little is known about the potential effects these periods of social isolation could have on older adults, and less still is known about potential risk factors or protective factors that modulate these effects. Here, we describe results from a longitudinal study in which we measured quality of life both prior to and immediately following a one-month period of social isolation associated with the issuance and revocation of a shelter in place order (April 6, 2020 through May 4, 2020) in the state of South Carolina. Healthy adult participants (N = 62) between the ages of 60 and 80 who had already completed quality of life questionnaires prior to isolation again completed the questionnaires following a one-month order to shelter in place. Quality of life significantly decreased during the social isolation period, with older participants showing the greatest declines. Participants with higher levels of physical activity and better physical/mental health going into the isolation period tended to show greater decreases in quality of life over time. These results highlight the negative consequences of even short bouts of social isolation for the elderly and suggest that reductions in social contact related to COVID-19 may have significant effects on mental health and emotional well-being, at least among older individuals.
Collapse
Affiliation(s)
- Roger D. Newman-Norlund
- Department of Communication Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Sarah E. Newman-Norlund
- Department of Communication Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Sara Sayers
- Department of Communication Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Alexander C. McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Nicholas Riccardi
- Department of Psychology, College of Arts and Sciences, University of South Carolina, Columbia, South Carolina, United States of America
| | - Julius Fridriksson
- Department of Communication Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| |
Collapse
|
7
|
Association between Social Integration, Social Exclusion, and Vaccination Behavior among Internal Migrants in China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137915. [PMID: 35805576 PMCID: PMC9265632 DOI: 10.3390/ijerph19137915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022]
Abstract
Cross-sectional studies about the association between social integration, social exclusion, and vaccination behavior among internal migrants in China are lacking. In this study, we aimed to explore the association between the influenza vaccination behavior and social integration as well as social exclusion in China based on a cross-sectional study. We included 12,467 participants aged 15 years old or above from the 2017 Migrant Population Dynamic Monitoring Survey (MDMS). We used univariate analysis and logistic regression models to access the association between social integration, exclusion status, and influenza vaccination rates. Results suggested that the association between social integration and the vaccination rate was significantly positive. Moving between different districts impact on people’s mental health and their health performance. Significant association between influenza vaccination behavior and education attainment, income status, health record, and awareness of basic public health services program was reported. Therefore, in order to reduce the incidence of influenza disease and increase the vaccination rate, policymakers and the public should promote social integration for internal migrants. Meanwhile, our finding also implies possible strategies to promote COVID-19 vaccination.
Collapse
|
8
|
Assessing the Determinants of Quality of Life and the Impact on HIV Prevention Measures among HIV-Negative and Status-Unknown Young Men Who Have Sex with Men: A Study in Two U.S. Metropolitan Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020726. [PMID: 35055548 PMCID: PMC8776199 DOI: 10.3390/ijerph19020726] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 12/17/2022]
Abstract
Young men who have sex with men (YMSM) in the United States (U.S.) are disproportionally burdened by HIV and experience adverse social determinants of health. Minimal research has examined quality of life (QoL) and psychosocial/behavioral determinants among HIV-negative or status-unknown YMSM. We conducted a study with YMSM from two U.S. cities to assess their QoL scores, and whether specific QoL domains (e.g., physical, psychological, social, and environment) were associated with their demographics, psychosocial determinants, behavioral risk factors, and HIV prevention measures. Black YMSM, YMSM of low socioeconomic status (below high school education, income < $20,000, and lack of health insurance), and YMSM who did not disclose their sexual orientation had the lowest QoL scores across all domains. Substance use and unprotected anal intercourse were negatively associated with men’s physical/psychosocial health. Housing/food instability and perceived stress were among the strongest predictors of lower QoL in all domains. Higher physical/psychological and environment QoL scores were associated with a higher likelihood of HIV testing and PrEP use. The identification of YMSM within these demographic, behavioral, and psychosocial sub-groups is important for targeted intervention to enhance their well-being and engagement with HIV prevention.
Collapse
|
9
|
Bailey P, Vergis N, Allison M, Riddell A, Massey E. Psychosocial Evaluation of Candidates for Solid Organ Transplantation. Transplantation 2021; 105:e292-e302. [PMID: 33675318 DOI: 10.1097/tp.0000000000003732] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Transplant candidates should undergo an assessment of their mental health, social support, lifestyle, and behaviors. The primary aims of this "psychosocial evaluation" are to ensure that transplantation is of benefit to life expectancy and quality of life, and to allow optimization of the candidate and transplant outcomes. The content of psychosocial evaluations is informed by evidence regarding pretransplant psychosocial predictors of transplant outcomes. This review summarizes the current literature on pretransplant psychosocial predictors of transplant outcomes across differing solid organ transplants and discusses the limitations of existing research. Pretransplant depression, substance misuse, and nonadherence are associated with poorer posttransplant outcomes. Depression, smoking, and high levels of prescription opioid use are associated with reduced posttransplant survival. Pretransplant nonadherence is associated with posttransplant rejection, and nonadherence may mediate the effects of other psychosocial variables such as substance misuse. There is evidence to suggest that social support is associated with likelihood of substance misuse relapse after transplantation, but there is a lack of consistent evidence for an association between social support and posttransplant adherence, rejection, or survival across all organ transplant types. Psychosocial evaluations should be undertaken by a trained individual and should comprise multiple consultations with the transplant candidate, family members, and healthcare professionals. Tools exist that can be useful for guiding and standardizing assessment, but research is needed to determine how well scores predict posttransplant outcomes. Few studies have evaluated interventions designed to improve psychosocial functioning specifically pretransplant. We highlight the challenges of carrying out such research and make recommendations regarding future work.
Collapse
Affiliation(s)
- Pippa Bailey
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Renal and Transplant Service, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Nikhil Vergis
- Liver Services Department, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
- Department of Metabolism Digestion and Reproduction, Imperial College London, UK
| | - Michael Allison
- Cambridge Liver Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Amy Riddell
- Renal and Transplant Service, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- University of Exeter Medical School, Exeter, UK
| | - Emma Massey
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
10
|
Health-Related Quality of Life (HRQoL) Outcomes Following Injury in Childhood and Adolescence Using EuroQol (EQ-5D) Responses with Pooled Longitudinal Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910156. [PMID: 34639458 PMCID: PMC8507627 DOI: 10.3390/ijerph181910156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/11/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Injury is a leading contributor to the global disease burden in children, affecting their health-related quality of life (HRQoL)-yet valid estimates of burden are absent. METHODS This study pooled longitudinal data from five cohort studies of pediatric injury survivors (5-17 years) at baseline, 1-, 4-, 6-, 12-, and 24- months (n = 2334). HRQoL post-injury was measured using the 3-level EQ-5D utility score (EQ-5D) and five health states (mobility, self-care, activity, pain, anxiety and depression (anxiety)). RESULTS Mean EQ-5D post-injury did not return to baseline level (0.95) by 24 months (0.88) and was lower for females over time (-0.04, 95%CI -0.05, -0.02). A decreased adjusted risk ratio over time (ARR) was observed for intentional injuries (pain: 0.85, 95%CI 0.73,0.98; anxiety: 0.62, 95%CI 0.49,0.78); spinal cord injuries (mobility: 0.61, 95%CI 0.45,0.83), self-care: 0.76, 95%CI 0.63,0.91, activity: 0.64, 95%CI 0.47,0.88); moderate/severe traumatic brain injury (activity: 0.83, 95%CI 0.71,0.96). ARRs were also low for certain fractures, with various health states affected. CONCLUSIONS HRQoL outcomes over time for children and adolescents post-injury differed across key demographic and injury related attributes. HRQoL did not reach levels consistent with full health by 24 months with recovery plateauing from 6 to 24 months. Tailored interventions are required to respond to the varying post-injury recovery trajectories in this population.
Collapse
|
11
|
Malaeb D, Salameh P, Barbar S, Awad E, Haddad C, Hallit R, Sacre H, Akel M, Obeid S, Hallit S. Problematic social media use and mental health (depression, anxiety, and insomnia) among Lebanese adults: Any mediating effect of stress? Perspect Psychiatr Care 2021; 57:539-549. [PMID: 32633428 DOI: 10.1111/ppc.12576] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/25/2020] [Accepted: 06/28/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To examine the association between problematic social media use with depression, anxiety, insomnia, and stress in a sample of young Lebanese adults. METHODS This cross-sectional study was achieved between January and May 2019; 466 out of 600 adults completed the questionnaire. RESULTS Higher problematic social media use was significantly associated with higher depression, anxiety, and insomnia, but not stress. Stress mediated the relation between depression, anxiety, insomnia, and problematic social media use. PRACTICAL IMPLICATIONS This study showed that problematic social media use was associated with psychological disorders. Additional research is needed to identify and describe the potential causality between the use of social media and various mental health issues and the interplay between the social media network and other mental health factors.
Collapse
Affiliation(s)
- Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon.,Life Sciences and Health Department, Paris-Est University, Paris, France
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Sam Barbar
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Emmanuelle Awad
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, Université de Limoges, UMR 1094, Limoges, France
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon.,INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Sahar Obeid
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| |
Collapse
|
12
|
Le NK, Gabrick KS, Chouairi F, Mets EJ, Avraham T, Alperovich M. Impact of socioeconomic status on psychological functioning in survivorship following breast cancer and reconstruction. Breast J 2020; 26:1695-1701. [DOI: 10.1111/tbj.13849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/03/2020] [Accepted: 04/08/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Nicole K. Le
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
- Department of Plastic Surgery Morsani College of Medicine University of South Florida Tampa FL USA
| | - Kyle S. Gabrick
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
| | - Fouad Chouairi
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
| | - Elbert J. Mets
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
| | - Tomer Avraham
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
| | - Michael Alperovich
- Section of Plastic and Reconstructive Surgery Department of Surgery Yale University School of Medicine New Haven CT USA
| |
Collapse
|
13
|
Algren MH, Ekholm O, Nielsen L, Ersbøll AK, Bak CK, Andersen PT. Social isolation, loneliness, socioeconomic status, and health-risk behaviour in deprived neighbourhoods in Denmark: A cross-sectional study. SSM Popul Health 2020; 10:100546. [PMID: 32042889 PMCID: PMC6997896 DOI: 10.1016/j.ssmph.2020.100546] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/16/2020] [Accepted: 01/17/2020] [Indexed: 11/23/2022] Open
Abstract
The importance of social isolation and loneliness on our health is widely recognised in previous research. This study compares loneliness in deprived neighbourhood with that in the general population. It further examines whether social isolation and loneliness are associated with health-risk behaviours (including low intake of fruit or vegetables, daily smoking, high-risk alcohol intake, and physical inactivity and their co-occurrence) in deprived neighbourhoods, and whether social isolation and loneliness modify the associations between socioeconomic status and health-risk behaviours. Cross-sectional data from 5113 residents of 12 deprived neighbourhoods in Denmark were analysed using multiple logistic regression. Data on 14,686 individuals from the nationally representative Danish Health and Morbidity Survey 2010 were used as a comparison group with regard to loneliness. Cohabitation status, frequency of meeting with family and friends, participation in voluntary work were used as an indicator to measure social isolation. A question on feeling often unwillingly alone was used as an indicator to measure loneliness. Compared with the general population, residents of deprived neighbourhoods had higher odds of loneliness. Both social isolation and loneliness were significantly associated with higher odds of health-risk behaviour. When social isolation and loneliness were combined with low socioeconomic status, strong associations with health-risk behaviours were found. Social isolation and loneliness did not significantly modify the associations between socioeconomic status and health-risk behaviour. The findings in this study have important implications for the future planning of health promotion intervention programmes aimed to reduce health-risk behaviour in deprived neighbourhoods.
Collapse
Affiliation(s)
- Maria Holst Algren
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Ola Ekholm
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Line Nielsen
- National Institute of Public Health, University of Southern Denmark, Denmark
| | | | | | | |
Collapse
|
14
|
Mediators of Socioeconomic Inequity in Living-donor Kidney Transplantation: Results From a UK Multicenter Case-Control Study. Transplant Direct 2020; 6:e540. [PMID: 32309626 PMCID: PMC7145004 DOI: 10.1097/txd.0000000000000986] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/13/2019] [Accepted: 01/01/2020] [Indexed: 01/12/2023] Open
Abstract
Supplemental Digital Content is available in the text. There is evidence of socioeconomic inequity in access to living-donor kidney transplantation, but limited evidence as to why. We investigated possible mediators of the inequity.
Collapse
|
15
|
Wakata S, Takagi Y, Koizumi A. [Health-related QOL and Life Background of Outpatients Using Free/Low-Cost Medical Care Program]. Nihon Eiseigaku Zasshi 2020; 75. [PMID: 32132315 DOI: 10.1265/jjh.19015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES We investigated the quality of life (QOL) of patients using the Free/Low-Cost Medical Care Program, which is a system that enables people in financial difficulities to receive treatment free of charge or at a low cost. We also investigated the background charateristics and lifestyle of the patients. METHODS The subjects were 226 outpatients who used the Free/Low-Cost Medical Care Program (use group) and 226 outpatients who did not use the program (non-use group). The method was an anonymous cross-sectional servey by mail. The survey items included basic attributes, health-related QOL (HRQOL), feeling of being poor, lifestyle diseases, lifestyle, and connection with the community. RESULTS The number of respondants with valid responses was 97 in the use group and 85 in the non-use group. Among the basic attributes, there were a significant differense between the use group and the non-use group in the family structure, type of work, household income, and educational background. The HRQOL scores of the physical and social summary components were significantly lower in the use group than in the non-use group. The HRQOL scores of mental summary component were higher than the national standard HRQOL score in both the use and non-use groups. CONCLUSIONS In this study, it was considered that old age affected the HRQOL scores of the physical and social components. It was considered from the HRQOL scores of the mental aspect that the use of the Free/Low-Cost Medical Care Program might have contributed to mental stability a certain to extent.
Collapse
|
16
|
Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort-study. PLoS One 2019; 14:e0213700. [PMID: 30865713 PMCID: PMC6415852 DOI: 10.1371/journal.pone.0213700] [Citation(s) in RCA: 230] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 02/26/2019] [Indexed: 11/29/2022] Open
Abstract
Aim Children and adolescents with low socioeconomic status (SES) suffer from mental health problems more often than their peers with high SES. The aim of the current study was to investigate the direct and interactive association between commonly used indicators of SES and the exposure to stressful life situations in relation to children’s mental health problems. Methods The prospective BELLA cohort study is the mental health module of the representative, population-based German National Health Interview and Examination Survey for children and adolescents (KiGGS). Sample data include 2,111 participants (aged 7–17 years at baseline) from the first three measurement points (2003–2006, 2004–2007 and 2005–2008). Hierarchical multiple linear regression models were conducted to analyze associations among the SES indicators household income, parental education and parental unemployment (assessed at baseline), number of stressful life situations (e.g., parental accident, mental illness or severe financial crises; 1- and 2-year follow-ups) and parent-reported mental health problems (Strength and Difficulties Questionnaire; 2-year follow-up). Results All indicators of SES separately predicted mental health problems in children and adolescents at the 2-year follow-up. Stressful life situations (between baseline and 2-year follow-up) and the interaction of parental education and the number of stressful life situations remained significant in predicting children’s mental health problems after adjustment for control variables. Thereby, children with higher educated parents showed fewer mental health problems in a stressful life situation. No moderating effect was found for household income and parental employment. Overall, the detected effect sizes were small. Mental health problems at baseline were the best predictor for mental health problems two years later. Conclusions Children and adolescents with a low SES suffer from multiple stressful life situations and are exposed to a higher risk of developing mental health problems. The findings suggest that the reduction of socioeconomic inequalities and interventions for families with low parental education might help to reduce children’s mental health problems.
Collapse
|
17
|
Social networks and patterns of health risk behaviours over two decades: A multi-cohort study. J Psychosom Res 2017; 99:45-58. [PMID: 28712430 DOI: 10.1016/j.jpsychores.2017.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 06/05/2017] [Accepted: 06/05/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the associations between social network size and subsequent long-term health behaviour patterns, as indicated by alcohol use, smoking, and physical activity. METHODS Repeat data from up to six surveys over a 15- or 20-year follow-up were drawn from the Finnish Public Sector study (Raisio-Turku cohort, n=986; Hospital cohort, n=7307), and the Health and Social Support study (n=20,115). Social network size was determined at baseline, and health risk behaviours were assessed using repeated data from baseline and follow-up. We pooled cohort-specific results from repeated-measures log-binomial regression with the generalized estimating equations (GEE) method using fixed-effects meta-analysis. RESULTS Participants with up to 10 members in their social network at baseline had an unhealthy risk factor profile throughout the follow-up. The pooled relative risks adjusted for age, gender, survey year, chronic conditions and education were 1.15 for heavy alcohol use (95% CI: 1.06-1.24), 1.19 for smoking (95% CI: 1.12-1.27), and 1.25 for low physical activity (95% CI: 1.21-1.29), as compared with those with >20 members in their social network. These associations appeared to be similar in subgroups stratified according to gender, age and education. CONCLUSIONS Social network size predicted persistent behaviour-related health risk patterns up to at least two decades.
Collapse
|
18
|
Ji Y, Liu S, Zhao X, Jiang Y, Zeng Q, Chang C. Smoking and Its Determinants in Chinese Internal Migrants: Nationally Representative Cross-Sectional Data Analyses. Nicotine Tob Res 2016; 18:1719-26. [DOI: 10.1093/ntr/ntw101] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 04/03/2016] [Indexed: 11/14/2022]
|
19
|
Lacruz ME, Schmidt-Pokrzywniak A, Dragano N, Moebus S, Deutrich SE, Möhlenkamp S, Schmermund A, Kaelsch H, Erbel R, Stang A. Depressive symptoms, life satisfaction and prevalence of sleep disturbances in the general population of Germany: results from the Heinz Nixdorf Recall study. BMJ Open 2016; 6:e007919. [PMID: 26729376 PMCID: PMC4716226 DOI: 10.1136/bmjopen-2015-007919] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES It appears that not only depression, but also low life satisfaction (LS), is related to sleep disorder in the general population. We evaluate whether the prevalence of sleep disorder attributable to depressed mood is greater among participants with low LS. SETTING, PARTICIPANTS AND OUTCOME MEASURES Analysis of cross-sectional data from 3880 cohort members from the German Heinz Nixdorf Recall study (2006-2008) aged 51-81 years. Standard mood (Center for Epidemiological Studies Depression scale (CES-D) for Depressive symptoms and a single-item life satisfaction measure) and sleep quality (Pittsburgh Sleep Quality Index, PSQI) measures were conducted as part of the survey. Multiple imputation was used to deal with missing data in outcome, exposures or covariates. Relative excess risk for interaction (RERI) and its 95% CIs were estimated using adjusted prevalence ORs. Owing to the study size, the precision of the measures of additive interaction is relatively low. RESULTS We observed an association between depressed mood (5-units increase in CES-D score) (POR=1.7 (95% CI 1.6 to 1.8)) and sleep disorder, and between low LS (not very satisfied vs very satisfied) (POR=1.5 (1.1 to 2.2)) and sleep disorder. Also, we observed a synergistic effect between lower level of LS (not very satisfied) and depressed mood (score ≥ 16) on prevalence of sleep disorders (RERI=3.7 (-0.2 to 7.1)). Furthermore, these findings were corroborated in sensitivity analysis carried out with the complete case data set and in sex-specific analyses (RERI=5.5 (-0.4 to 11.3), and RERI=2.4 (-2.5 to 7.4) for men and women, respectively). CONCLUSIONS Both depressed mood and LS are notably associated with sleep quality, and these relationships are best captured by considering their joint effects. Depression and LS need to be taken into consideration when analysing sleep quality.
Collapse
Affiliation(s)
- Maria Elena Lacruz
- Medical Faculty, Martin-Luther-University, Institute of Medical Epidemiology, Biostatistics and Informatics, Halle, Germany
| | - Andrea Schmidt-Pokrzywniak
- Medical Faculty, Martin-Luther-University, Institute of Medical Epidemiology, Biostatistics and Informatics, Halle, Germany
| | - Nico Dragano
- Medical Faculty, Heinrich-Heine-University Düsseldorf, Institute for Medical Sociology, University Düsseldorf, Duesseldorf, Germany
| | - Susanne Moebus
- Institute of Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen, Essen, Germany
| | - Susanne Eva Deutrich
- Medical Faculty, Martin-Luther-University, Institute of Medical Epidemiology, Biostatistics and Informatics, Halle, Germany
| | | | - Axel Schmermund
- Cardioangiological Center Bethanien, Frankfurt/Main, Germany
| | - Hagen Kaelsch
- Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany
| | - Raimund Erbel
- Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany
| | - Andreas Stang
- Institute of Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen, Essen, Germany Department of Epidemiology, School of Public Health, Boston University, Boston, USA
| |
Collapse
|
20
|
Samuel LJ, Dennison Himmelfarb CR, Szklo M, Seeman TE, Echeverria SE, Diez Roux AV. Social engagement and chronic disease risk behaviors: the Multi-Ethnic Study of Atherosclerosis. Prev Med 2015; 71:61-6. [PMID: 25524614 PMCID: PMC4329061 DOI: 10.1016/j.ypmed.2014.12.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 12/01/2014] [Accepted: 12/08/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Although engagement in social networks is important to health, multiple different dimensions exist. This study identifies which dimensions are associated with chronic disease risk behaviors. METHODS Cross-sectional data on social support, loneliness, and neighborhood social cohesion from 5381 participants, aged 45-84 from the Multi-Ethnic Study of Atherosclerosis was used. RESULTS After adjusting for individual characteristics and all social engagement variables, social support was associated with lower smoking prevalence (PR=0.88, 95% CI: 0.82, 0.94), higher probability of having quit (PR=1.03, 95% CI: 1.01, 1.06) and a slightly higher probability of achieving physical activity recommendations (PR=1.03, 95% CI: 1.01, 1.06). Neighborhood social cohesion was associated with very slightly higher probability of achieving recommended (PR=1.03, 95% CI: 1.01, 1.05) or any regular (PR=1.0, 95% CI: 1.01, 1.04) physical activity, and a higher probability of consuming at least five daily fruit and vegetable servings (PR=1.05, 95% CI: 1.01, 1.09). CONCLUSIONS Both social support and neighborhood social cohesion, a less commonly considered aspect of social engagement, appear to be important for chronic disease prevention interventions and likely act via separate pathways.
Collapse
Affiliation(s)
- Laura J Samuel
- Johns Hopkins University, School of Nursing, 525 N Wolfe St., Baltimore, MD 21205, USA.
| | | | - Moyses Szklo
- Johns Hopkins University, Bloomberg School of Public Health, 615 North Wolfe Street, Room W6009, Baltimore, MD 21205, USA.
| | - Teresa E Seeman
- University of California, Los Angeles, David Geffen School of Medicine at UCLA, Department of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA; University of California, Los Angeles, School of Public Health, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Sandra E Echeverria
- Rutgers School of Public Health, RWJMS Research and School of Public Health Bldg., 683 Hoes Lane West, Room 205, Piscataway, NJ 08854, USA.
| | - Ana V Diez Roux
- University of Michigan, School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104, USA.
| |
Collapse
|
21
|
Poor nutrition and substance use in a Swiss cohort of adults with spinal cord injury. J Public Health (Oxf) 2015. [DOI: 10.1007/s10389-015-0653-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
22
|
Watt RG, Heilmann A, Sabbah W, Newton T, Chandola T, Aida J, Sheiham A, Marmot M, Kawachi I, Tsakos G. Social relationships and health related behaviors among older US adults. BMC Public Health 2014; 14:533. [PMID: 24885507 PMCID: PMC4046043 DOI: 10.1186/1471-2458-14-533] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 05/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health behaviors are a key determinant of health and well-being that are influenced by the nature of the social environment. This study examined associations between social relationships and health-related behaviors among a nationally representative sample of older people. METHODS We analyzed data from three waves (1999-2004) of the US National Health and Nutrition Examination Survey (NHANES). Participants were 4,014 older Americans aged 60 and over. Log-binomial regression models estimated prevalence ratios (PR) for the associations between social relationships and each of the following health behaviors: alcohol use, smoking, physical activity and dental attendance. RESULTS Health-compromising behaviors (smoking, heavy drinking and less frequent dental visits) were related to marital status, while physical activity, a health-promoting behavior, was associated with the size of friendship networks. Smoking was more common among divorced/separated (PR = 2.1; 95% CI: 1.6, 2.7) and widowed (PR = 1.7; 95% CI: 1.3, 2.3) respondents than among those married or cohabiting, after adjusting for socio-demographic background. Heavy drinking was 2.6 times more common among divorced/separated and 1.7 times more common among widowed men compared to married/cohabiting men, while there was no such association among women. For women, heavy drinking was associated with being single (PR = 1.7; 95% CI: 1.0, 2.9). Being widowed was related to a lower prevalence of having visited a dentist compared to being married or living with a partner (PR = 0.92; 95% CI 0.86, 0.99). Those with a larger circle of friends were more likely to be physically active (PR = 1.17; 95% CI:1.06, 1.28 for 5-8 versus less than 5 friends). CONCLUSIONS Social relationships of older Americans were independently associated with different health-related behaviors, even after adjusting for demographic and socioeconomic determinants. Availability of emotional support did not however mediate these associations. More research is needed to assess if strengthening social relationships would have a significant impact on older people's health behaviors and ultimately improve their health.
Collapse
Affiliation(s)
| | - Anja Heilmann
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Wynne C, Comiskey C, Hollywood E, Quirke MB, O'Sullivan K, McGilloway S. The relationship between body mass index and health-related quality of life in urban disadvantaged children. Qual Life Res 2014; 23:1895-905. [PMID: 24473990 DOI: 10.1007/s11136-014-0634-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2014] [Indexed: 01/13/2023]
Abstract
INTRODUCTION The study's aim was to establish, for children living in urban disadvantage, the nature and extent of the relationship between body mass index (BMI) and health-related quality of life (HRQoL), including the role of individual and family factors in influencing this relationship. METHODS Within the context of a longitudinal design, 255 children aged 7-12 years (50 % male) self-reported their HRQoL (Kidscreen-27) and had their height and weight measured at year one and two. One parent/guardian for each child was also assessed at year one with the OSLO Social Support Scale and Hospital Anxiety and Depression Scale. Regression analysis was also conducted. RESULTS BMI was weakly inversely associated with 'total HRQoL' (r = -.15, p < .05), 'physical well-being' and 'autonomy and parent relations'. Significant differences were found between normal weight and obese children on all but the latter dimension. Neither weight group, however, fell below the average European HRQoL range. BMI predicted physical well-being a year later and vice versa, whilst autonomy and parent relations also predicted BMI a year later. In terms of 'overweight' children (38 %), those approaching adolescence had poorer physical and school well-being than younger children, and those whose parents had moderate-to-severe levels of depression fared worse on school well-being than children whose parents were not depressed. CONCLUSION The findings suggest that obesity programmes could aim to prevent/reduce obesity and optimise HRQoL in urban disadvantaged preadolescent children whilst also targeting parental mental health difficulties. Future research should examine mediators of the effect of BMI on HRQoL.
Collapse
|
24
|
Icks A, Albers B, Haastert B, Pechlivanis S, Pundt N, Slomiany U, Erbel R, Jöckel KH, Kruse J, Kulzer B, Nowotny B, Herder C, Giani G, Moebus S. Risk for high depressive symptoms in diagnosed and previously undetected diabetes: 5-year follow-up results of the Heinz Nixdorf Recall study. PLoS One 2013; 8:e56300. [PMID: 23441174 PMCID: PMC3575467 DOI: 10.1371/journal.pone.0056300] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 01/08/2013] [Indexed: 12/02/2022] Open
Abstract
Objective The objective of this study was to determine the risk for the development of high depressive symptoms in study participants with diagnosed and previously undetected diabetes mellitus compared to those without diabetes in a prospective population-based cohort study in Germany. Methods We estimated the 5-year cumulative incidence of high depressive symptoms in participants without high depressive symptoms at baseline (n = 3,633, 51.4% men, mean age (SD) 59.1 (7.6) years, 7.0% diagnosed diabetes, 5.3% previously undetected diabetes) from the population-based Heinz Nixdorf Recall study. Diabetes was assessed by self-report, medication, and blood glucose. High depressive symptoms were assessed using CES-D. We calculated odds ratios and their corresponding 95% confidence interval, using multiple logistic regression analyses. Result Cumulative 5-year incidences (95% CI) of high depressive symptoms in participants with diagnosed, undetected, and without diabetes were 7.1 (4.2–10.9), 4.1 (1.8–8.0), and 6.5 (5.6–7.4), respectively. The age-sex-adjusted OR for developing high depressive symptoms was 1.22 (0.74–2.03) in participants with diagnosed compared to those without diabetes, and 1.00 (0.59–1.68) after adjustment for BMI, physical activity, education, stroke, and myocardial infarction. The age-sex adjusted OR for developing high depressive symptoms in participants with previously undetected diabetes compared to those without diabetes was 0.72; 0.35–1.48; and fully adjusted 0.62; 0.30–1.30. Conclusion We found no significant associations, maybe due to low power. However, our results are in line with a recent meta-analysis suggesting that risk of developing high depressive symptoms in patients with diagnosed diabetes may be moderately higher than in those without diabetes, and that comorbidity may explain in part this association. In participants with previously undetected diabetes, this first longitudinal study indicates that the risk is not increased or may even be decreased. These results support the hypothesis that high depressive symptoms develop due to diabetes-related burden and comorbidity and not due to hyperglycemia or hyperinsulinaemia.
Collapse
Affiliation(s)
- Andrea Icks
- Institute of Biometrics and Epidemiology, Leibniz Center for Diabetes Research at the Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Riedel N, Fuks K, Hoffmann B, Weyers S, Siegrist J, Erbel R, Viehmann A, Stang A, Scheiner J, Dragano N. Insomnia and urban neighbourhood contexts--are associations modified by individual social characteristics and change of residence? Results from a population-based study using residential histories. BMC Public Health 2012; 12:810. [PMID: 22994885 PMCID: PMC3503830 DOI: 10.1186/1471-2458-12-810] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 09/13/2012] [Indexed: 11/23/2022] Open
Abstract
Background Until now, insomnia has not been much of interest in epidemiological neighbourhood studies, although literature provides evidence enough for insomnia-related mechanisms being potentially dependent on neighbourhood contexts. Besides, studies have shown differences in sleep along individual social characteristics that might render residents more vulnerable to neighbourhood contextual exposures. Given the role of exposure duration and changes in the relationship between neighbourhoods and health, we studied associations of neighbourhood unemployment and months under residential turnover with insomnia by covering ten years of residential history of nearly 3,000 urban residents in the Ruhr Area, Germany. Methods Individual data were retrieved from the Heinz Nixdorf Recall Study, a population-based study of randomly chosen participants from adjacent cities, which contains self-rated insomnia symptoms and individual social characteristics. Participants’ residential addresses were retrospectively assessed using public registries. We built individually derived exposure measures informing about mean neighbourhood unemployment rates and months under high residential turnover. These measures were major predictors in multivariate logistic regressions modelling the association between social neighbourhood characteristics and insomnia in the whole sample and subgroups defined by low income, low education, social isolation, and change of residence. Traffic-related noise, age, gender, economic activity, and education were considered as covariates. Results Nearly 12 per cent of the participants complained about insomnia. Associations of neighbourhood unemployment with insomnia were more consistent than those of residential turnover in the whole sample (adjusted OR 1.42, 95% CI 1.00-2.03 for neighbourhood unemployment and OR 1.33, 95% CI 0.78-2.25 for residential turnover in the highest exposure categories). In low-income and socially isolated participants, neighbourhood unemployment odds of reporting insomnia were particularly elevated (adjusted OR 2.90, 95% CI 1.39-6.02 and OR 3.32, 95% CI 1.11-9.96, respectively). Less educated participants displayed relatively high odds of reporting insomnia throughout all upper neighbourhood unemployment exposure categories. Change of residence weakened associations, whereas undisrupted exposure sharpened them by trend. Conclusions Our findings hint at multiple stressors being effective in both the neighbourhood context and individual resident, possibly reflecting precarious life situations undermining residents’ sleep and health chances. Moreover, our results suggest a temporal dependency in the association between neighbourhood and insomnia.
Collapse
Affiliation(s)
- Natalie Riedel
- Faculty of Spatial Planning, Institute of Spatial Planning, TU Dortmund University, Dortmund, Germany.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Tobacco use and impact of tobacco-free policy on university employees in an environment of high tobacco use and production. Environ Health Prev Med 2012; 18:110-20. [PMID: 22893255 DOI: 10.1007/s12199-012-0297-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 07/18/2012] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To assess occupational tobacco use and the impact of a tobacco-free policy in the Central Appalachia, an environment characterized by high tobacco use and production. METHODS This study was an Internet-based survey conducted on 2,318 university employees. Descriptive, chi-square, and logistic regression statistics were performed. Unadjusted and adjusted odds ratios (AOR) with respective 95 % confidence intervals (CI) were reported. RESULTS The survey response rate was 50.8 %; of the respondents, 9.0 % were current smokers. Smoking prevalence among faculty, administrators/professionals, and clerical/support staff was 6.1, 8.1, and 13.1 %, respectively. While those respondents aged 30-39 years showed a significantly increased likelihood of being a current smoker (AOR 5.64, 95 % CI 1.31-9.26), knowledge that secondhand smoke is harmful (AOR 0.22, 95 % CI 0.07-0.70) and support for tobacco-free policy (AOR 0.11, 95 % CI 0.04-0.27) decreased the likelihood. CONCLUSION Low tobacco use among faculty and administrators confirmed the relationship between tobacco use and socio-economic status, even in a tobacco-producing environment. Disaggregation of tobacco use data assists the public health community in the efficient allocation of efforts and resources for cessation programs to reduce tobacco use in such environments.
Collapse
|
27
|
Baheiraei A, Mirghafourvand M, Mohammadi E, Charandabi SMA. The experiences of women of reproductive age regarding health-promoting behaviours: a qualitative study. BMC Public Health 2012; 12:573. [PMID: 22846587 PMCID: PMC3490730 DOI: 10.1186/1471-2458-12-573] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 07/13/2012] [Indexed: 01/30/2023] Open
Abstract
Background Health promotion is critical for community and family health. Health-promoting behaviours provide solutions for maintaining and promoting health. Although several studies have addressed the frequency and different types of health-promoting behaviours in women, little information is available about their experiences. This study aimed to explore the experiences of women of reproductive age regarding health-promoting behaviours. Methods In the present study, which was conducted in Tehran, Iran, 15 females, who were selected purposefully, participated in individual in-depth, semi-structured interviews. The interviews were recorded, transcribed verbatim, and analysed using conventional content analysis. Results Nine main categories were derived from the analysis, including establishing an appropriate eating pattern, establishing a balanced rest/activity pattern, spirituality, stress management, personal sensitivity and responsibility, establishing an appropriate pattern of social interactions, practicing safe and healthy recreations, feeling improvement in physical-functional health, and feeling improvement in emotional and psychological health. The first 7 categories represent the nature and types of real health-promoting behaviours in women of reproductive age, whereas the last 2 constitute feeling and understanding of the implementation of these behaviours. Conclusion The study findings show that the women experience improvement in physical-functional, emotional, and psychological health by implementing health-promoting behaviours. It is therefore necessary to introduce strategies in the context of the community culture for improving different aspects of health-promoting behaviours in women of reproductive age to maintain and improve their overall health.
Collapse
Affiliation(s)
- Azam Baheiraei
- Department of Reproductive Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | |
Collapse
|
28
|
Do social relations explain health inequalities? Evidence from a longitudinal survey in a changing eastern German region. Int J Public Health 2012; 57:619-27. [PMID: 22415373 DOI: 10.1007/s00038-012-0356-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 02/17/2012] [Accepted: 02/27/2012] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES This study explores the contribution of social relations to explain inequalities in self-rated health in a changing north-eastern German region. So far, there are only few studies that analysed the mediating effects of social relations in a longitudinal design. METHODS We used data from the Study of Health in Pomerania (SHIP) consisting of 3,300 randomly selected men and women at baseline (2001), and at the 5-year follow-up (2006). Indicators of social inequality were education, equivalent household income and occupational status. Social relations were estimated by the Social Integration Index (SII) and the perceived instrumental and emotional support. Self-rated general health was assessed at both waves of data collection. RESULTS Depending on the indicators used, social relations explain up to 35% of the inequalities in self-rated health. Changes in odds ratios are slightly more pronounced when education and income are used as inequality indicator and when adjusting for the SII. CONCLUSIONS Overall findings suggest that social relations are an important explanatory factor for health inequalities in a deprived German region.
Collapse
|
29
|
Does socioeconomic status affect the association of social relationships and health? A moderator analysis. Int J Equity Health 2011; 10:43. [PMID: 21995609 PMCID: PMC3216239 DOI: 10.1186/1475-9276-10-43] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 10/13/2011] [Indexed: 11/18/2022] Open
Abstract
Background Social relations have repeatedly been found to be an important determinant of health. However, it is unclear whether the association between social relations and health is consistent throughout different status groups. It is likely that health effects of social relations vary in different status groups, as stated in the hypothesis of differential vulnerability. In this analysis we explore whether socioeconomic status (SES) moderates the association between social relations and health. Methods In the baseline examination of the Heinz Nixdorf Recall study, conducted in a dense populated Western German region (N = 4,814, response rate 56%), SES was measured by income and education. Social relations were classified by using both structural as well as functional measures. The Social Integration Index was used as a structural measure, whilst functional aspects were assessed by emotional and instrumental support. Health was indicated by self-rated health (1 item) and a short version of the CES-D scale measuring the frequency of depressive symptoms. Based on logistic regression models we calculated the relative excess risk due to interaction (RERI) which indicates existing moderator effects. Results Our findings show highest odds ratios (ORs) for both poor self-rated health and more frequent depressive symptoms when respondents have a low SES as well as inappropriate social relations. For example, respondents with low income and a low level of social integration have an OR for a high depression score of 2.85 (95% CI 2.32-4.49), compared to an OR of 1.44 (95% CI 1.12-1.86) amongst those with a low income but a high level of social integration and an OR of 1.72 (95% CI 1.45-2.03) amongst respondents with high income but a low level of social integration. As reference group those reporting high income and a high level of social integration were used. Conclusions The analyses indicate that the association of social relations and subjective health differs across SES groups as we find moderating effects of SES. However, results are inconsistent as nearly all RERI scores are positive but do not reach a significant level. Also moderating effects vary between women and men and depending on the indicators of SES and social relations used. Thus, the hypothesis of differential vulnerability can only partially be supported. In terms of practical implications, psychosocial and health interventions aiming towards the enhancement of social relations should especially consider the situation of the socially deprived.
Collapse
|
30
|
Salonna F, Geckova AM, Zezula I, Sleskova M, Groothoff JW, Reijneveld SA, van Dijk JP. Does social support mediate or moderate socioeconomic differences in self-rated health among adolescents? Int J Public Health 2011; 57:609-17. [PMID: 21912942 PMCID: PMC3359452 DOI: 10.1007/s00038-011-0300-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Revised: 08/16/2011] [Accepted: 08/29/2011] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Social support is assumed to be a protective social determinant of health. The aim of this cross-sectional study was to explore whether social support from the father, mother and friends mediates or moderates the association between socioeconomic position and self-rated health among adolescents. METHODS The sample consisted of 1,863 secondary school students from the Kosice region in Slovakia (mean age 16.85; 53.3% females, response rate 98.9%). We assessed the mediation and moderation effects of social support from the mother, father and friends on the relation between socioeconomic position and self-rated health, performing binary logistic regression models. Socioeconomic position was measured by parents' education, the family affluence scale and financial strain. RESULTS Social support from the father mediated the association between family affluence and self-rated health among both males and females and the association between financial strain and self-rated health among males only. No moderating effect of social support on socioeconomic differences in self-rated health was found. CONCLUSION Father involvement seems to have the potential to mediate socioeconomic differences in health during adolescence.
Collapse
Affiliation(s)
- Ferdinand Salonna
- Graduate School Kosice Institute for Society and Health, P.J. Safarik University, Kosice, Slovakia.
| | | | | | | | | | | | | |
Collapse
|
31
|
Weyers S, Dragano N, Richter M, Bosma H. How does socio economic position link to health behaviour? Sociological pathways and perspectives for health promotion. Glob Health Promot 2010; 17:25-33. [PMID: 20587628 DOI: 10.1177/1757975910365232] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Socio economic inequalities in adult health behaviour are consistently observed. Despite a well-documented pattern, social determinants of variations in health behaviour have not been sufficiently clarified. This article therefore presents sociological pathways to explain the existing inequalities in health behaviour. At a micro level, control beliefs have been part of several behavioural theories. We suggest that these beliefs might bridge the gap between sociology and psychology by emphasising their roots in fundamental socio-economic environments. At a meso level, social networks and support have not been explicitly considered as behavioural determinants. This contribution states that these social factors influence health behaviour while being unequally distributed across society. At a macro level, characteristics of the neighbourhood environment influence health behaviour of its residents above and beyond their individual background. Providing further opportunity for policy makers, it is shown that peer and school context equalise inequalities in risky behaviour in adolescence. As a conclusion, factors such as control expectations, social networks, neighbourhood characteristics, and school context should be included as strategies to improve health behaviour in socially disadvantaged people.
Collapse
Affiliation(s)
- Simone Weyers
- Department of Medical Sociology, Heinrich-Heine-University, Universitätsstrasse 1 Duesseldorf 40225, Germany
| | - Nico Dragano
- Department of Medical Sociology, Heinrich-Heine-University, Universitätsstrasse 1 Duesseldorf 40225, Germany
| | - Matthias Richter
- Institute of Social and Preventive Medicine, University of Bern, Switzerland
| | - Hans Bosma
- Social Medicine, CAPHRI, Maastricht University, Netherlands
| |
Collapse
|