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Bauldry S, Thomas P, Sauerteig-Rolston M, Ferraro K. Racial-Ethnic Disparities in Dual-Function Life Expectancy. J Gerontol A Biol Sci Med Sci 2023; 78:1269-1275. [PMID: 36800307 PMCID: PMC10329220 DOI: 10.1093/gerona/glad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND This study develops a new concept, dual functionality, that integrates physical and cognitive function. We use the concept to define a measure of dual-function life expectancy (2FLE) and assess racial-ethnic inequalities in aging. METHODS Drawing on data from the National Health Interview Survey Linked Mortality Files and the Health and Retirement Study, we define dual functionality as having no limitations in activities of daily living and being free of dementia. We use this measure and Sullivan life tables to estimate age-50 total life expectancy and age-50 2FLE for women and men across 4 racial-ethnic and nativity groups. RESULTS At ages 50-54, between 79.0% (95% CI: 73.5, 84.5) and 87.6% (95% CI: 84.0, 91.2) of (non-Hispanic) Black, foreign-born Hispanic, and U.S.-born Hispanic women and men remain dual functional as compared with 90.4% (95% CI: 89.3, 91.4) and 91.4% (95% CI: 90.2, 92.5) of (non-Hispanic) White women and men, respectively. These and corresponding racial-ethnic disparities in dual functionality through ages 85 and older translate into substantial inequalities in 2FLE. For instance, the Black-White gap in age-50 2FLE is 6.9 years (95% CI: -7.5, -6.4) for women and 6.0 years (95% CI: -6.6, -5.4) for men. CONCLUSIONS Black, foreign-born Hispanic, and U.S.-born Hispanic older adults are estimated to live a smaller percentage of their remaining years with dual functionality than White older adults. These results reveal stark racial-ethnic inequalities in aging that have significant implications for quality of life, caregiving, and health needs.
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Affiliation(s)
- Shawn Bauldry
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, USA
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
| | - Patricia A Thomas
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, USA
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
| | - Madison R Sauerteig-Rolston
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, USA
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
| | - Kenneth F Ferraro
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, USA
- Department of Sociology, Purdue University, West Lafayette, Indiana, USA
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2
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Hummer RA. Race and Ethnicity, Racism, and Population Health in the United States: The Straightforward, the Complex, Innovations, and the Future. Demography 2023; 60:633-657. [PMID: 37158783 PMCID: PMC10731781 DOI: 10.1215/00703370-10747542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
For far too long, U.S. racialized groups have experienced human suffering and loss of life far too often and early. Thus, it is critical that the population sciences community does its part to improve the science, education, and policy in this area of study and help to eliminate ethnoracial disparities in population health. My 2022 PAA Presidential Address focuses on race and ethnicity, racism, and U.S. population health in the United States and is organized into five sections. First, I provide a descriptive overview of ethnoracial disparities in U.S. population health. Second, I emphasize the often overlooked scientific value of such descriptive work and demonstrate how such seemingly straightforward description is complicated by issues of population heterogeneity, time and space, and the complexity of human health. Third, I make the case that the population sciences have generally been far too slow in incorporating the role of racism into explanations for ethnoracial health disparities and lay out a conceptual framework for doing so. Fourth, I discuss how my research team is designing, collecting, and disseminating data for the scientific community that will have potential to, among many other purposes, create a better understanding of ethnoracial health disparities and the role of racism in producing such disparities. Finally, I close by suggesting some policy- and education-related efforts that are needed to address racism and population health within U.S. institutions.
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Affiliation(s)
- Robert A Hummer
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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3
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Tilstra AM, Gutin I, Dollar NT, Rogers RG, Hummer RA. "Outside the Skin": The Persistence of Black-White Disparities in U.S. Early-Life Mortality. Demography 2022; 59:2247-2269. [PMID: 36367341 PMCID: PMC10155466 DOI: 10.1215/00703370-10346963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Research on Black-White disparities in mortality emphasizes the cumulative pathways through which racism gets "under the skin" to affect health. Yet this framing is less applicable in early life, when death is primarily attributable to external causes rather than cumulative, biological processes. We use mortality data from the National Vital Statistics System Multiple Cause of Death files and population counts from the Surveillance, Epidemiology, and End Result Program to analyze 705,801 deaths among Black and White males and females, ages 15-24. We estimate age-standardized death rates and single-decrement life tables to show how all-cause and cause-specific mortality changed from 1990 to 2016 by race and sex. Despite overall declines in early-life mortality, Black-White disparities remain unchanged across several causes-especially homicide, for which mortality is nearly 20 times as high among Black as among White males. Suicide and drug-related deaths are higher among White youth during this period, yet their impact on life expectancy at birth is less than half that of homicide among Black youth. Critically, early-life disparities are driven by preventable causes of death whose impact occurs "outside the skin," reflecting racial differences in social exposures and experiences that prove harmful for both Black and White adolescents and young adults.
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4
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Rebok GW, Huang A, Smail E, Brichko R, Parisi JM, Marsiske M, Roth DL, Thorpe RJ, Felix C, Jones RN, Willis SL. Long-Term Effects of Cognitive Training on All-Cause Mortality in US Older Adults. J Aging Health 2022; 34:1135-1143. [PMID: 35510611 PMCID: PMC10069226 DOI: 10.1177/08982643221097681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Cognitive abilities have been implicated as predictors of mortality in older adults. This study examines the effects of cognitive training on mortality 20 years post-intervention. Methods: Data come from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized control trial (N = 2802). Participants were cognitively and physically healthy, community-dwelling adults aged 65 and older. Cox proportional hazard models were used to investigate (1) the association between baseline cognition and mortality risk and (2) the effect of ACTIVE cognitive training (memory, reasoning, and speed of processing) on mortality risk 20 years post-intervention. Results: Higher baseline cognition predicted lower mortality risk 20 years post-intervention. No significant effects of ACTIVE cognitive training in memory, reasoning, or speed of processing on mortality risk were observed. Discussion: More work is needed to identify cognitive training interventions that may lead to lower mortality risks in later adulthood.
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Affiliation(s)
- George W. Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer’s Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
| | - Alison Huang
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily Smail
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rostislav Brichko
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jeanine M. Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael Marsiske
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - David L. Roth
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Roland J. Thorpe
- Johns Hopkins Alzheimer’s Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cynthia Felix
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Richard N. Jones
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Sherry L. Willis
- Department of Psychiatry, University of Washington, Seattle, WA, USA
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5
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Newsom JT, Denning EC, Elman MR, Botoseneanu A, Allore HG, Nagel CL, Dorr DA, Quiñones AR. Physical Activity as a Mediator Between Race/Ethnicity and Changes in Multimorbidity. J Gerontol B Psychol Sci Soc Sci 2022; 77:1529-1538. [PMID: 34374757 PMCID: PMC9371457 DOI: 10.1093/geronb/gbab148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Studies report racial/ethnic disparities in multimorbidity (≥2 chronic conditions) and their rate of accumulation over time as well as differences in physical activity. Our study aimed to investigate whether racial/ethnic differences in the accumulation of multimorbidity were mediated by physical activity among middle-aged and older adults. METHOD We assessed racial/ethnic differences in the accumulation of multimorbidity (of 9 conditions) over 12 years (2004-2016) in the Health and Retirement Study (N = 18,264, mean age = 64.4 years). Structural equation modeling was used to estimate latent growth curve models of changes in multimorbidity and investigate whether the relationship of race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White participants) to changes in the number of chronic conditions was mediated by physical activity after controlling for age, sex, education, marital status, household wealth, insurance coverage, smoking, alcohol, and body weight. RESULTS There was a significant increase in multimorbidity over time. Initial levels and changes in multimorbidity over time varied significantly across individuals. Indirect effects of the relationship between race/ethnicity and changes in multimorbidity as mediated by physical activity were significant, consistent with the mediational hypothesis. Black respondents engaged in significantly lower levels of physical activity than White respondents after controlling for covariates, but there were no differences between Hispanic and White respondents once education was included. Discussion: These results provide important new information for understanding how modifiable lifestyle factors may help explain disparities in multimorbidity in mid-to-late life, suggesting greater need to intervene to reduce sedentary behavior and increase physical activity.
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Affiliation(s)
- Jason T Newsom
- Address correspondence to: Jason T. Newsom, PhD, Department of Psychology, Portland State University, P.O. Box 751, Portland, OR 97207, USA. E-mail:
| | - Emily C Denning
- Department of Psychology, Portland State University, Oregon, USA
| | - Miriam R Elman
- School of Public Health, Oregon Health & Science University/Portland State University, USA
| | - Anda Botoseneanu
- Department of Health and Human Services and Institute of Gerontology, University of Michigan, Ann Arbor, USA
- Department of Health and Human Services, University of Michigan, Dearborn, USA
| | - Heather G Allore
- Internal Medicine and Department of Biostatistics, Yale University, New Haven, Connecticut, USA
| | - Corey L Nagel
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, USA
| | - David A Dorr
- Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health and Science University, Portland, USA
| | - Ana R Quiñones
- Department of Family Medicine, Oregon Health and Science University, Portland, USA
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6
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Keyes KM, Rutherford C, Smith GS. Alcohol-Induced Death in the USA from 1999 to 2020: a Comparison of Age–Period–Cohort Methods. CURR EPIDEMIOL REP 2022. [DOI: 10.1007/s40471-022-00300-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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7
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Cuevas AG, Goler E, Guetta CJ, Krueger RF. Assessing the role of socioeconomic status and discrimination exposure for racial disparities in inflammation. Brain Behav Immun 2022; 102:333-337. [PMID: 35307502 PMCID: PMC9073909 DOI: 10.1016/j.bbi.2022.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/18/2022] [Accepted: 03/12/2022] [Indexed: 10/18/2022] Open
Abstract
Socioeconomic status (SES) and discrimination have been implicated as social determinants of health and health disparities. Yet, very little research has been done to assess their contributing role in Black-White disparities in inflammation. Using data from the Midlife in the United States (2004-2006), we conducted Oaxaca-Blinder decomposition analysis to quantify the extent to which three indicators of SES (i.e., education, household income, and employment status) and three forms of discrimination exposures (i.e., everyday, lifetime, and workplace discrimination) explained Black-White differences in inflammation. Education, particularly having a college degree or more, explained 16.88% of the differences between Blacks and Whites. There was no evidence that household income and employment status explained Black-White inflammation differences. Lifetime discrimination significantly explained 18.18% of Black-White difference in inflammation burden. There was no evidence that everyday and workplace discrimination explained Black-White difference in inflammation burden. Together, the predictors explained 44.16% of inflammation differences between Black and White participants. Education and lifetime exposure to discrimination may play a role in inflammation disparities. Further research is needed to examine other dimensions of SES (e.g., wealth) and discrimination (e.g., racial segregation) that are associated with health to better understand the contributions of these key social determinants of Black-White inflammation disparities.
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Affiliation(s)
- Adolfo G Cuevas
- Department of Community Health, Tufts University, United States.
| | - Evan Goler
- Department of Community Health, Tufts University, United States
| | | | - Robert F Krueger
- Department of Psychology, University of Minnesota, United States
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8
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Minagawa Y, Saito Y. Changes in Health Expectancy for Older Adults in Japan: Results from Two Longitudinal Surveys. Gerontology 2022; 68:1166-1173. [PMID: 35344955 DOI: 10.1159/000523790] [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: 09/29/2021] [Accepted: 02/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although there is evidence of improvements in health expectancy among the Japanese population, existing estimates are based on the prevalence of morbidity taken from cross-sectional survey data. OBJECTIVES This study employed a multistate life table approach to compute incidence-based health expectancy measures, namely active and inactive life expectancy (LE), for two longitudinal survey cohorts from 1990 to 2009. METHODS This study used data from two longitudinal surveys of older adults in Japan: the National Survey of the Japanese Elderly (1990-1999) and the Nihon University Japanese Longitudinal Study of Aging (1999-2009). We employed the Interpolation of Markov Chains technique to compute the number of years at age 65 years to be spent with and without difficulty in performing activities of daily living (ADLs) or instrumental ADLs. RESULTS We documented significant increases in active LE for men and women at age 65 years over the 10-year study period. There were significant changes in total LE for men and in the percentage of active life for women. Inactive LE did not significantly change across the two survey cohorts during the study period. CONCLUSIONS Our results show that the health status of older adults in Japan has largely improved over the 10-year study period, with increases in both the duration of life and time spent in an active state. This finding offers evidence of compression of morbidity among older men and women in Japan.
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Affiliation(s)
- Yuka Minagawa
- Faculty of Liberal Arts, Sophia University, Tokyo, Japan
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9
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Magee W, Elliott MR, Sinkewicz M, Finlay J, Clarke P. Who looks on the bright side? Optimistic and pessimistic perceptual-response reflexes over American adulthood. ADVANCES IN LIFE COURSE RESEARCH 2022; 51:100452. [PMID: 35250415 PMCID: PMC8890670 DOI: 10.1016/j.alcr.2021.100452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Research suggests that the way individuals are oriented towards the future is deeply embedded in their psychology, shaping how they perceive and react to opportunities and threats, even at unconscious levels. We argue that exposures to opportunities and threats over the life course can shape future orientation at a deep level, and that word-valence effects to survey questions indicate optimistic and pessimistic "perceptual-response reflexes" that are manifestations of unconscious dispositions. Using data collected over 25 years in the Americans' Changing Lives (ACL) study we analyze variation in word-valence effects by age, birth cohort, gender, and race. The broad adult age-range of the sample and the length of follow-up permits the examination of birth cohorts ranging from the "First Children of the 20th Century" (born before 1917) to "Baby Boomers" (born 1947-1962). We find notable differences in age-graded trends across two overarching birth cohort groups: those who reached high school age before the Supreme Court's landmark Brown vs Board of Education decision in 1954 (i.e., born before 1932) and after (i.e., born in 1932 and later). Age-related trends in optimistic perceptual response diverge notably for women versus men, and for Black versus White Americans. Trends in pessimistic perceptual response differ from trends in optimistic response. For example, in early adulthood Black Americans score higher on both optimistic and pessimistic response patterns than White Americans. Birth-cohort differences in both outcomes vary by gender and race. Those differences are interpreted in terms of changes in political, demographic, and sociocultural contexts.
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Affiliation(s)
- William Magee
- Department of Sociology, University of Toronto, Canada
| | - Michael R. Elliott
- Institute for Social Research, and Department of Biostatistics, School of Public Health, University of Michigan, USA
| | | | - Jessica Finlay
- Institute for Social Research, University of Michigan, USA
| | - Philippa Clarke
- Institute for Social Research, and Department of Epidemiology, School of Public Health, University of Michigan, USA
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10
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Kaur N, Hamilton AD, Chen Q, Hasin D, Cerda M, Martins SS, Keyes KM. Age, Period, and Cohort Effects of Internalizing Symptoms Among US Students and the Influence of Self-Reported Frequency of Attaining 7 or More Hours of Sleep: Results From the Monitoring the Future Survey 1991-2019. Am J Epidemiol 2022; 191:1081-1091. [PMID: 35048117 PMCID: PMC9393068 DOI: 10.1093/aje/kwac010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/15/2021] [Accepted: 01/12/2022] [Indexed: 01/22/2023] Open
Abstract
Adolescent internalizing symptoms have increased since 2010, whereas adequate sleep has declined for several decades. It remains unclear how self-reported sleep attainment has affected internalizing-symptoms trends. Using 1991-2019 data from the Monitoring the Future Study (n ~ 390,000), we estimated age-period-cohort effects in adolescent internalizing symptoms (e.g., loneliness, self-esteem, self-derogation, depressive affect) and the association with yearly prevalence of a survey-assessed, self-reported measure of attaining ≥7 hours of sleep most nights. We focused our main analysis on loneliness and used median odds ratios to measure variance in loneliness associated with period differences. We observed limited signals for cohort effects and modeled only period effects. The feeling of loneliness increased by 0.83% per year; adolescents in 2019 had 0.68 (95% CI: 0.49, 0.87) increased log odds of loneliness compared with the mean, which was consistent by race/ethnicity and parental education. Girls experienced steeper increases in loneliness than boys (P < 0.0001). The period-effect median odds ratio for loneliness was 1.16 (variance = 0.09; 95% CI: 0.06, 0.17) before adjustment for self-reported frequency of getting ≥7 hours sleep versus 1.07 (variance = 0.02; 95% CI: 0.01, 0.03) after adjustment. Adolescents across cohorts are experiencing worsening internalizing symptoms. Self-reported frequency of <7 hours sleep partially explains increases in loneliness, indicating the need for feasibility trials to study the effect of increasing sleep attainment on internalizing symptoms.
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Affiliation(s)
- Navdep Kaur
- Correspondence to Navdep Kaur, Department of Epidemiology, Columbia University Mailman School of Public Health, Room 723, 722 W 168th Street, New York, NY 10032 (e-mail: )
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11
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Kronk CA, Everhart AR, Ashley F, Thompson HM, Schall TE, Goetz TG, Hiatt L, Derrick Z, Queen R, Ram A, Guthman EM, Danforth OM, Lett E, Potter E, Sun SD, Marshall Z, Karnoski R. Transgender data collection in the electronic health record: Current concepts and issues. J Am Med Inform Assoc 2022; 29:271-284. [PMID: 34486655 PMCID: PMC8757312 DOI: 10.1093/jamia/ocab136] [Citation(s) in RCA: 72] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/13/2021] [Accepted: 06/18/2021] [Indexed: 11/13/2022] Open
Abstract
There are over 1 million transgender people living in the United States, and 33% report negative experiences with a healthcare provider, many of which are connected to data representation in electronic health records (EHRs). We present recommendations and common pitfalls involving sex- and gender-related data collection in EHRs. Our recommendations leverage the needs of patients, medical providers, and researchers to optimize both individual patient experiences and the efficacy and reproducibility of EHR population-based studies. We also briefly discuss adequate additions to the EHR considering name and pronoun usage. We add the disclaimer that these questions are more complex than commonly assumed. We conclude that collaborations between local transgender and gender-diverse persons and medical providers as well as open inclusion of transgender and gender-diverse individuals on terminology and standards boards is crucial to shifting the paradigm in transgender and gender-diverse health.
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Affiliation(s)
- Clair A Kronk
- Center for Medical Informatics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Avery R Everhart
- Population, Health, and Place Program, Spatial Sciences Institute, University of Southern California, Los Angeles, California, USA
- Center for Applied Transgender Studies, Chicago, Illinois, USA
| | - Florence Ashley
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- Faculty of Law and Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada
| | - Hale M Thompson
- Department of Psychiatry and Behavioral Science, Rush University Medical Center, Chicago, Illinois, USA
| | - Theodore E Schall
- Berman Institute of Bioethics, Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Teddy G Goetz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laurel Hiatt
- University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Zackary Derrick
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Roz Queen
- Health Information Science, School of Human and Social Development, University of Victoria, Victoria, British Columbia, Canada
| | - A Ram
- Program in Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
| | - E Mae Guthman
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey, USA
| | - Olivia M Danforth
- Department of Family Medicine, Samaritan Health Services Geary St. Clinic, Albany, Oregon, USA
| | - Elle Lett
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Emery Potter
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Simón(e) D Sun
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- Center for Neural Science, New York University, New York, New York, USA
- Department of Neuroscience and Physiology, Neuroscience Institute, NYU Grossman Medical Center, New York, New York, USA
| | - Zack Marshall
- School of Social Work, McGill University, Montreal, Quebec, Canada
| | - Ryan Karnoski
- Center for Applied Transgender Studies, Chicago, Illinois, USA
- School of Social Welfare, University of California, Berkeley, Berkeley, California, USA
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12
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Zhao L, Hessel P, Simon Thomas J, Beckfield J. Inequality in Place: Effects of Exposure to Neighborhood-Level Economic Inequality on Mortality. Demography 2021; 58:2041-2063. [PMID: 34477828 DOI: 10.1215/00703370-9463660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study contributes to the debate on whether income inequality is harmful for health by addressing several analytical weaknesses of previous studies. Using the Panel Study of Income Dynamics in combination with tract-level measures of income inequality in the United States, we estimate the effects of differential exposure to income inequality during three decades of the life course on mortality. Our study is among the first to consider the implications of income inequality within U.S. tracts for mortality using longitudinal and individual-level data. In addition, we improve upon prior work by accounting for the dynamic relationship between local areas and individuals' health, using marginal structural models to account for changes in exposure to local income inequality. In contrast to other studies that found no significant relation between income inequality and mortality, we find that recent exposure to higher local inequality predicts higher relative risk of mortality among individuals at ages 45 or older.
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Affiliation(s)
- Linda Zhao
- Cornell Population Center, Cornell University, Ithaca, NY, USA
| | - Philipp Hessel
- Alberto Lleras Camargo School of Government, University of the Andes, Bogotá, Colombia
| | | | - Jason Beckfield
- Department of Sociology, Harvard University, Cambridge, MA, USA
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13
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Mollborn S, Mercer KH, Edwards-Capen T. "Everything is Connected": Health Lifestyles and Teenagers' Social Distancing Behaviors in the COVID-19 Pandemic. SOCIOLOGICAL PERSPECTIVES : SP : OFFICIAL PUBLICATION OF THE PACIFIC SOCIOLOGICAL ASSOCIATION 2021; 64:920-938. [PMID: 35935597 PMCID: PMC9355366 DOI: 10.1177/07311214211005488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Social distancing during the COVID-19 pandemic requires people to engage in new health behaviors that are public, monitored, and often contested. Parents are typically considered responsible for controlling their children's behavior and instilling norms. We investigated how parents and teens managed teenagers' social distancing behaviors. Analyzing 100 longitudinal (2015-2020), dyadic qualitative interviews with teenagers and their parents in 20 families from two middle-class communities in which social distancing was normative, we found that preexisting health lifestyles were used to link social distancing behaviors to specific identities, norms, and understandings of health. The pandemic presented challenges resulting from contradictory threats to health, differing preferences, and conflicting social judgments. Parents responded to challenges by adhering to community norms and enforcing teens' social distancing behaviors. They drew on preexisting, individualized health lifestyles as cultural tools to justify social distancing messages, emphasizing group distinctions, morality, and worth in ways that perpetuated inequalities.
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Affiliation(s)
- Stefanie Mollborn
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder
| | - Katie Holstein Mercer
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder
| | - Theresa Edwards-Capen
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder
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14
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Tilstra AM, Simon DH, Masters RK. Trends in "Deaths of Despair" Among Working-Aged White and Black Americans, 1990-2017. Am J Epidemiol 2021; 190:1751-1759. [PMID: 33778856 DOI: 10.1093/aje/kwab088] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 01/09/2023] Open
Abstract
Life expectancy for US White men and women declined between 2013 and 2017. Initial explanations for the decline focused on increases in "deaths of despair" (i.e., deaths from suicide, drug use, and alcohol use), which have been interpreted as a cohort-based phenomenon afflicting middle-aged White Americans. There has been less attention on Black mortality trends from these same causes, and whether the trends are similar or different by cohort and period. We complement existing research and contend that recent mortality trends in both the US Black and White populations most likely reflect period-based exposures to 1) the US opioid epidemic and 2) the Great Recession. We analyzed cause-specific mortality trends in the United States for deaths from suicide, drug use, and alcohol use among non-Hispanic Black and non-Hispanic White Americans, aged 20-64 years, over 1990-2017. We employed sex-, race-, and cause-of-death-stratified Poisson rate models and age-period-cohort models to compare mortality trends. Results indicate that rising "deaths of despair" for both Black and White Americans are overwhelmingly driven by period-based increases in drug-related deaths since the late 1990s. Further, deaths related to alcohol use and suicide among both White and Black Americans changed during the Great Recession, despite some racial differences across cohorts.
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Gutin I, Hummer RA. Social Inequality and the Future of U.S. Life Expectancy. ANNUAL REVIEW OF SOCIOLOGY 2021; 47:501-520. [PMID: 34366549 PMCID: PMC8340572 DOI: 10.1146/annurev-soc-072320-100249] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Despite decades of progress, the future of life expectancy in the United States is uncertain due to widening socioeconomic disparities in mortality, continued disparities in mortality across racial/ethnic groups, and an increase in extrinsic causes of death. These trends prompt us to scrutinize life expectancy in a high-income but enormously unequal society like the United States, where social factors determine who is most able to maximize their biological lifespan. After reviewing evidence for biodemographic perspectives on life expectancy, the uneven diffusion of health-enhancing innovations throughout the population, and the changing nature of threats to population health, we argue that sociology is optimally positioned to lead discourse on the future of life expectancy. Given recent trends, sociologists should emphasize the importance of the social determinants of life expectancy, redirecting research focus away from extending extreme longevity and towards research on social inequality with the goal of improving population health for all.
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Affiliation(s)
- Iliya Gutin
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27516
- Corresponding author:
| | - Robert A. Hummer
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27516
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16
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George DR, Snyder B, Van Scoy LJ, Brignone E, Sinoway L, Sauder C, Murray A, Gladden R, Ramedani S, Ernharth A, Gupta N, Saran S, Kraschnewski J. Perceptions of Diseases of Despair by Members of Rural and Urban High-Prevalence Communities: A Qualitative Study. JAMA Netw Open 2021; 4:e2118134. [PMID: 34297071 PMCID: PMC8303097 DOI: 10.1001/jamanetworkopen.2021.18134] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Diseases of despair (ie, mortality or morbidity from suicidality, drug abuse, and alcoholism) were first characterized as increasing in rural White working-class populations in midlife with low educational attainment and associated with long-term economic decline. Excess mortality now appears to be associated with working-class citizens across demographic and geographic boundaries, but no known qualitative studies have engaged residents of rural and urban locales with high prevalence of diseases of despair to learn their perspectives. OBJECTIVE To explore perceptions about despair-related illness and potential intervention strategies among diverse community members residing in discrete rural and urban hotspots. DESIGN, SETTING, AND PARTICIPANTS In this qualitative study, high-prevalence hotspots for diseases of despair were identified from health insurance claims data in Central Pennsylvania. Four focus groups were conducted with 60 community members in organizations and coalitions from 3 census block group hotspot clusters in the health system between September 2019 and January 2020. Focus groups explored awareness and beliefs about causation and potential intervention strategies. MAIN OUTCOMES AND MEASURES A descriptive phenomenological approach was applied to thematic analysis, and a preliminary conceptual model was constructed to describe how various factors may be associated with perpetuating despair and with public health. RESULTS In total, 60 adult community members participated in 4 focus groups (44 women, 16 men; 40 White non-Hispanic, 17 Black, and 3 Hispanic/Latino members). Three focus groups with 43 members were held in rural areas with high prevalence of diseases of despair, and 1 focus group with 17 members in a high-prevalence urban area. Four themes emerged with respect to awareness and believed causation of despair-related illness, and participants identified common associated factors, including financial distress, lack of critical infrastructure and social services, deteriorating sense of community, and family fragmentation. Intervention strategies focused around 2 themes: (1) building resilience to despair through better community and organizational coordination and peer support at the local level and (2) encouraging broader state investments in social services and infrastructure to mitigate despair-related illness. CONCLUSIONS AND RELEVANCE In this qualitative study, rural and urban community members identified common factors associated with diseases of despair, highlighting the association between long-term political and economic decline and public health and a need for both community- and state-level solutions to address despair. Health care systems participating in addressing community health needs may improve processes to screen for despair (eg, social history taking) and codesign primary, secondary, and tertiary interventions aimed at addressing factors associated with distress. Such actions have taken on greater urgency with the COVID-19 pandemic.
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Affiliation(s)
- Daniel R. George
- Department of Humanities, Penn State College of Medicine, Hershey, Pennsylvania
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Bethany Snyder
- Qualitative and Mixed Methods Core, Penn State College of Medicine, Hershey, Pennsylvania
| | - Lauren J. Van Scoy
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
- Department of Medicine, Penn State College of Medicine, Hershey, Pennsylvania
| | | | - Lawrence Sinoway
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
- Clinical and Translational Science Institute, Penn State College of Medicine, Hershey, Pennsylvania
| | - Charity Sauder
- Clinical and Translational Science Institute, Penn State College of Medicine, Hershey, Pennsylvania
| | - Andrea Murray
- Clinical and Translational Science Institute, Penn State College of Medicine, Hershey, Pennsylvania
| | | | | | | | - Neha Gupta
- Penn State College of Medicine, Hershey, Pennsylvania
| | - Savreen Saran
- Penn State College of Medicine, Hershey, Pennsylvania
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Abstract
OBJECTIVES Sepsis is a life-threatening condition and is one of the leading causes of death in the United States. The burden of sepsis-related mortality in the United States in recent years is not well characterized. We sought to describe sepsis-related mortality rates and mortality trends in the United States from 2005 to 2018. DESIGN Retrospective population-based study. SETTING We used the Multiple Cause of Death Database available through the Centers for Disease Control and Prevention website. PATIENTS Decedents with sepsis-related deaths were identified using previously validated International Classification of Diseases codes. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS From 2005 to 2018, 6.7% of decedents had a diagnosis of sepsis. The overall sepsis-related mortality rates remained stable in both males (57 deaths per 100,000) and females (45.1 deaths per 100,000) during this period. Compared with Whites, the sepsis-related mortality rates were higher in Blacks (rate ratio = 1.78), Native Americans (rate ratio = 1.43), and Hispanics (rate ratio = 1.04) and were lower in Asians (rate ratio = 0.73). Sepsis-related mortality rates declined in Blacks, Hispanics, and Asians but increased in Whites and Native Americans. The majority of sepsis-related deaths occurred in the hospital. The percentage of deaths in the nursing home decreased, whereas deaths occurring at home and hospice increased. CONCLUSIONS From 2005 to 2018, the overall sepsis-related mortality rates were stable, but there were significant racial and gender disparities in mortality trends. Further research is needed to evaluate the genetic and environmental contributors to these differences.
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Masters R, Powers D. Clarifying assumptions in age-period-cohort analyses and validating results. PLoS One 2020; 15:e0238871. [PMID: 33021978 PMCID: PMC7537862 DOI: 10.1371/journal.pone.0238871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/25/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Age-period-cohort (APC) models are often used to decompose health trends into period- and cohort-based sources, but their use in epidemiology and population sciences remains contentious. Central to the contention are researchers' failures to 1) clearly state their analytic assumptions and/or 2) thoroughly evaluate model results. These failures often produce varying conclusions across APC studies and generate confusion about APC methods. Consequently, scholarly exchanges about APC methods usually result in strong disagreements that rarely offer practical advice to users or readers of APC methods. METHODS We use research guidelines to help practitioners of APC methods articulate their analytic assumptions and validate their results. To demonstrate the usefulness of the guidelines, we apply them to a 2015 American Journal of Epidemiology study about trends in black-white differences in U.S. heart disease mortality. RESULTS The application of the guidelines highlights two important findings. On the one hand, some APC methods produce inconsistent results that are highly sensitive to researcher manipulation. On the other hand, other APC methods estimate results that are robust to researcher manipulation and consistent across APC models. CONCLUSIONS The exercise shows the simplicity and effectiveness of the guidelines in resolving disagreements over APC results. The cautious use of APC models can generate results that are consistent across methods and robust to researcher manipulation. If followed, the guidelines can likely reduce the chance of publishing variable and conflicting results across APC studies.
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Affiliation(s)
- Ryan Masters
- University of Colorado Boulder, Boulder, CO, United States of America
| | - Daniel Powers
- University of Texas at Austin, Austin, Texas, United States of America
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19
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Fishman SH, Hummer RA, Sierra G, Hargrove T, Powers DA, Rogers RG. Race/ethnicity, maternal educational attainment, and infant mortality in the United States. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2020; 66:1-26. [PMID: 33682572 PMCID: PMC7951143 DOI: 10.1080/19485565.2020.1793659] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This study examines patterns of and explanations for racial/ethnic-education disparities in infant mortality in the United States. Using linked birth and death data (2007-2010), we find that while education-specific infant mortality rates are similar for Mexican Americans and Whites, infants of college-educated African American women experience 3.1 more deaths per 1,000 live births (Rate Ratio = 1.46) than infants of White women with a high school degree or less. The high mortality rates among infants born to African American women of all educational attainment levels are fully accounted for by shorter gestational lengths. Supplementary analyses of data from the National Longitudinal Study of Adolescent to Adult Health show that college-educated African American women exhibit similar socioeconomic, contextual, psychosocial, and health disadvantages as White women with a high school degree or less. Together, these results demonstrate African American-White infant mortality and socioeconomic, health, and contextual disparities within education levels, suggesting the role of life course socioeconomic disadvantage and stress processes in the poorer infant health outcomes of African Americans relative to Whites.
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Affiliation(s)
- Samuel H. Fishman
- Department of Sociology, Duke University, 276 Soc/Psych Building, 417 Chapel Dr., Durham, North Carolina 27708, USA
| | - Robert A. Hummer
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gracia Sierra
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Taylor Hargrove
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniel A. Powers
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Richard G. Rogers
- Department of Sociology and Population Program, IBS, University of Colorado Boulder, Boulder, Colorado, USA
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20
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Greenfield EA. Designing Retrospective Measures on Childhood for Older African American Adults. Int J Aging Hum Dev 2019; 92:158-169. [PMID: 31760756 DOI: 10.1177/0091415019887683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A growing body of research addresses the long-term implications of early-life circumstances for adult health and aging by drawing on retrospective reports on childhood. There has been little scholarly discourse on considerations for the design of such questions for members of racial/ethnic minority groups specifically. This article aims to encourage greater attention to this area by presenting insights from the process of designing a childhood history questionnaire within an ongoing study of cognition, health, and aging among older African American adults in greater Newark, New Jersey. The article presents on three overarching themes, including the importance of (a) adopting a resilience orientation with attention to protective factors, (b) being sensitive to concerns about questions on adverse childhood experiences, and (c) orienting to ethnoracially embedded cohort influences. The article concludes by describing the particular importance of cultural humility-with attention to intersectional social positions-among researchers who are engaged in studies on childhood with older adults from underrepresented racial/ethnic groups.
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Affiliation(s)
- Emily A Greenfield
- 242612 Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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21
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Muller CJ, Noonan CJ, MacLehose RF, Stoner JA, Lee ET, Best LG, Calhoun D, Jolly SE, Devereux RB, Howard BV. Trends in Cardiovascular Disease Morbidity and Mortality in American Indians Over 25 Years: The Strong Heart Study. J Am Heart Assoc 2019; 8:e012289. [PMID: 31648583 PMCID: PMC6898852 DOI: 10.1161/jaha.119.012289] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background American Indians experience high rates of cardiovascular disease. We evaluated whether cardiovascular disease incidence, mortality, and prevalence changed over 25 years among American Indians aged 30 to 85. Methods and Results The SHS (Strong Heart Study) and SHFS (Strong Heart Family Study) are prospective studies of cardiovascular disease in American Indians. Participants enrolled in 1989 to 1990 or 2000 to 2003 with birth years from 1915 to 1984 were followed for cardiovascular disease events through 2013. We used Poisson regression to analyze data for 5627 individuals aged 30 to 85 years during follow-up. Outcomes reflect change in age-specific cardiovascular disease incidence, mortality, and prevalence, stratified by sex. To illustrate generational change, 5-year relative risk compared most recent birth years for ages 45, 55, 65, and 75 to same-aged counterparts born 1 generation (23-25 years) earlier. At all ages, cardiovascular disease incidence was lower for people with more recent birth years. Cardiovascular disease mortality declined consistently among men, while prevalence declined among women. Generational comparisons were similar for women aged 45 to 75 (relative risk, 0.39-0.46), but among men magnitudes strengthened from age 45 to 75 (relative risk, 0.91-0.39). For cardiovascular disease mortality, risk was lower in the most recent versus the earliest birth years for women (relative risk, 0.56-0.83) and men (relative risk, 0.40-0.54), but results for women were inconclusive. Conclusions Cardiovascular disease incidence declined over a generation in an American Indian cohort. Mortality declined more for men, while prevalence declined more for women. These trends might reflect more improvement in case survival among men compared with women.
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Affiliation(s)
- Clemma J Muller
- Elson S. Floyd College of Medicine Washington State University Seattle WA
| | - Carolyn J Noonan
- Elson S. Floyd College of Medicine Washington State University Seattle WA
| | - Richard F MacLehose
- Department of Epidemiology and Community Health University of Minnesota Minneapolis MN
| | - Julie A Stoner
- Department of Biostatistics and Epidemiology University of Oklahoma Health Sciences Center Oklahoma City OK
| | - Elisa T Lee
- Department of Biostatistics and Epidemiology University of Oklahoma Health Sciences Center Oklahoma City OK
| | - Lyle G Best
- Missouri Breaks Industries Research Inc. Eagle Butte SD
| | - Darren Calhoun
- Phoenix Field Office MedStar Health Research Institute Phoenix AZ
| | - Stacey E Jolly
- Cleveland Clinic Lerner College of Medicine Cleveland OH.,Cleveland Clinic Department of General Internal Medicine Cleveland OH
| | | | - Barbara V Howard
- MedStar Health Research Institute Georgetown/Howard University Center for Clinical and Translational Sciences Hyattsville MD
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22
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Zang E, Zheng H, Yang YC, Land KC. Recent trends in US mortality in early and middle adulthood: racial/ethnic disparities in inter-cohort patterns. Int J Epidemiol 2019; 48:934-944. [PMID: 30508118 PMCID: PMC6934031 DOI: 10.1093/ije/dyy255] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A striking increase in the all-cause mortality of US middle-aged non-Hispanic Whites in the past two decades has been documented by previous studies. The inter-cohort patterns in US mortality, as well as their racial/ethnic disparities, are still unclear. METHODS Using official mortality data, we study US annual mortality rates for ages 25-54 from 1990 to 2016 by gender and race/ethnicity. We conduct an age-period-cohort analysis to disentangle the period and cohort forces driving the absolute changes in mortality across cohorts. Nine leading causes of death are also explored to explain the inter-cohort mortality patterns and their racial/ethnic disparities. RESULTS We find cohort-specific elevated mortality trends for gender- and race/ethnicity-specific populations. For non-Hispanic Blacks and Hispanics, Baby Boomers have increased mortality trends compared with other cohorts. For non-Hispanic White females, it is late-Gen Xers and early-Gen Yers for whom the mortality trends are higher than other cohorts. For non-Hispanic White males, the elevated mortality pattern is found for Baby Boomers, late-Gen Xers, and early-Gen Yers. The mortality pattern among Baby Boomers is at least partially driven by mortality related to drug poisoning, suicide, external causes, chronic obstructive pulmonary disease and HIV/AIDS for all race and gender groups affected. The elevated mortality patterns among late-Gen Xers and early-Gen Yers are at least partially driven by mortality related to drug poisonings and alcohol-related diseases for non-Hispanic Whites. Differential patterns of drug poisoning-related mortality play an important role in the racial/ethnic disparities in these mortality patterns. CONCLUSIONS We find substantial racial/ethnic disparities in inter-cohort mortality patterns. Our findings also point to the unique challenges faced by younger generations.
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Affiliation(s)
- Emma Zang
- Sanford School of Public Policy, Duke University, Durham, NC, USA
| | - Hui Zheng
- Department of Sociology, Ohio State University, Columbus, OH, USA
| | - Yang Claire Yang
- Department of Sociology, Lineberger Cancer Center, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kenneth C Land
- Department of Sociology and Social Science Research Institute, Duke University, Durham, NC, USA
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23
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Abstract
This review focuses on the widening disparities in death rates by socioeconomic class. In recent years, there has been a major increase in the availability of data linking mortality risk and measures of socioeconomic status. The result has been a virtual explosion of new empirical research showing not only the existence of large inequities in the risk of death between those at the top and those at the bottom of the socioeconomic distribution, but also that the gaps have been growing. This assessment of the empirical research finds a consistent pattern of growing disparities within the United States. However, this widening gap in death rates does appear to be a uniquely American phenomenon, as the disparities by socioeconomic class appear to be stable or even declining in Europe and Canada.
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Affiliation(s)
- Barry Bosworth
- Economics Studies Program, The Brookings Institution, Washington, DC 20036, USA;
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24
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Cebert M, Gonzalez-Guarda R, Stevenson E. Growing on (in)fertile ground: an evolutionary concept analysis of Black female fertility. HUM FERTIL 2019; 24:152-160. [DOI: 10.1080/14647273.2019.1601269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | | | - Eleanor Stevenson
- Duke University School of Nursing, Durham, NC, USA
- Division of Health of Women, Children and Families, Duke University School of Nursing, Durham, NC, USA
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25
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Prieto D, Soto-Ferrari M, Tija R, Peña L, Burke L, Miller L, Berndt K, Hill B, Haghsenas J, Maltz E, White E, Atwood M, Norman E. Literature review of data-based models for identification of factors associated with racial disparities in breast cancer mortality. Health Syst (Basingstoke) 2018; 8:75-98. [PMID: 31275571 DOI: 10.1080/20476965.2018.1440925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 01/29/2018] [Accepted: 02/08/2018] [Indexed: 01/03/2023] Open
Abstract
In the United States, early detection methods have contributed to the reduction of overall breast cancer mortality but this pattern has not been observed uniformly across all racial groups. A vast body of research literature shows a set of health care, socio-economic, biological, physical, and behavioural factors influencing the mortality disparity. In this paper, we review the modelling frameworks, statistical tests, and databases used in understanding influential factors, and we discuss the factors documented in the modelling literature. Our findings suggest that disparities research relies on conventional modelling and statistical tools for quantitative analysis, and there exist opportunities to implement data-based modelling frameworks for (1) exploring mechanisms triggering disparities, (2) increasing the collection of behavioural data, and (3) monitoring factors associated with the mortality disparity across time.
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Affiliation(s)
- Diana Prieto
- College of Engineering and Applied Sciences, Western Michigan University, Kalamazoo, MI, USA.,Johns Hopkins Carey Business School, Baltimore, MD, USA
| | - Milton Soto-Ferrari
- College of Engineering and Applied Sciences, Western Michigan University, Kalamazoo, MI, USA.,Department of Marketing and Operations, Scott College of Business, Terre Haute, IN, USA
| | - Rindy Tija
- College of Engineering and Applied Sciences, Western Michigan University, Kalamazoo, MI, USA
| | - Lorena Peña
- College of Engineering and Applied Sciences, Western Michigan University, Kalamazoo, MI, USA
| | - Leandra Burke
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Lisa Miller
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Kelsey Berndt
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Brian Hill
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Jafar Haghsenas
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Ethan Maltz
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Evan White
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Maggie Atwood
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Earl Norman
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
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26
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Masters RK, Tilstra AM, Simon DH. Explaining recent mortality trends among younger and middle-aged White Americans. Int J Epidemiol 2018; 47:81-88. [PMID: 29040539 PMCID: PMC6658718 DOI: 10.1093/ije/dyx127] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/15/2017] [Accepted: 06/30/2017] [Indexed: 11/14/2022] Open
Abstract
Background Recent research has suggested that increases in mortality among middle-aged US Whites are being driven by suicides and poisonings from alcohol and drug use. Increases in these 'despair' deaths have been argued to reflect a cohort-based epidemic of pain and distress among middle-aged US Whites. Methods We examine trends in all-cause and cause-specific mortality rates among younger and middle-aged US White men and women between 1980 and 2014, using official US mortality data. We estimate trends in cause-specific mortality from suicides, alcohol-related deaths, drug-related deaths, 'metabolic diseases' (i.e. deaths from heart diseases, diabetes, obesity and/or hypertension), and residual deaths from extrinsic causes (i.e. causes external to the body). We examine variation in mortality trends by gender, age and cause of death, and decompose trends into period- and cohort-based variation. Results Trends in middle-aged US White mortality vary considerably by cause and gender. The relative contribution to overall mortality rates from drug-related deaths has increased dramatically since the early 1990s, but the contributions from suicide and alcohol-related deaths have remained stable. Rising mortality from drug-related deaths exhibit strong period-based patterns. Declines in deaths from metabolic diseases have slowed for middle-aged White men and have stalled for middle-aged White women, and exhibit strong cohort-based patterns. Conclusions We find little empirical support for the pain- and distress-based explanations for rising mortality in the US White population. Instead, recent mortality increases among younger and middle-aged US White men and women have likely been shaped by the US opiate epidemic and an expanding obesogenic environment.
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Affiliation(s)
- Ryan K Masters
- Department of Sociology, University of Colorado Boulder
- Population Program, Institute of Behavioral Science, University of Colorado Boulder
| | - Andrea M Tilstra
- Department of Sociology, University of Colorado Boulder
- Population Program, Institute of Behavioral Science, University of Colorado Boulder
| | - Daniel H Simon
- Department of Sociology, University of Colorado Boulder
- Population Program, Institute of Behavioral Science, University of Colorado Boulder
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27
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Fitting Age-Period-Cohort Models Using the Intrinsic Estimator: Assumptions and Misapplications. Demography 2017; 53:1253-9. [PMID: 27306765 DOI: 10.1007/s13524-016-0481-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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28
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Haas SA, Oi K, Zhou Z. The Life Course, Cohort Dynamics, and International Differences in Aging Trajectories. Demography 2017; 54:2043-2071. [PMID: 29101683 PMCID: PMC5705395 DOI: 10.1007/s13524-017-0624-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In recent years, population health research has focused on understanding the determinants of later-life health. Two strands of that work have focused on (1) international comparisons of later-life health and (2) assessing the early-life origins of disease and disability and the importance of life course processes. However, the less frequently examined intersection of these approaches remains an important frontier. The present study contributes to the integration of these approaches. We use the Health and Retirement Study family of data sets and a cohort dynamic approach to compare functional health trajectories across 12 high-income countries and to examine the role of life course processes and cohort dynamics in contributing to variation in those trajectories. We find substantial international variation in functional health trajectories and an important role of cohort dynamics in generating that variation, with younger cohorts often less healthy at comparable ages than the older cohorts they are replacing. We further find evidence of heterogeneous effects of life course processes on health trajectories. The results have important implications for future trends in morbidity and mortality as well as public policy.
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Affiliation(s)
- Steven A Haas
- Department of Sociology and Criminology, Pennsylvania State University, 211 Oswald Tower, University Park, PA, 16802, USA.
- Population Research Institute, Pennsylvania State University, University Park, PA, USA.
| | - Katsuya Oi
- Social Science Research Institute, Duke University, Durham, NC, USA
| | - Zhangjun Zhou
- Department of Sociology and Criminology, Pennsylvania State University, 211 Oswald Tower, University Park, PA, 16802, USA
- Population Research Institute, Pennsylvania State University, University Park, PA, USA
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29
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Brown CS, Masters KS, Huebschmann AG. Identifying Motives of Midlife Black Triathlete Women Using Survey Transformation to Guide Qualitative Inquiry. J Cross Cult Gerontol 2017; 33:1-20. [PMID: 29164497 DOI: 10.1007/s10823-017-9339-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Demonstrating health disparities related to race, age, and gender, older Black women (BW) are the most sedentary demographic group in the United States. Increasing PA in mid-life is important, as it improves health as BW age into their later years. Advancing our understanding of the exercise motives of BW triathletes presents a "reverse engineering" opportunity to identify motives that could influence sedentary mid-life BW to increase their activity. The purposes of this study were to: (a) utilize an innovative survey transformation method to adapt a measure developed primarily in Caucasian males, i.e., the Motivations of Marathoners Scale for Triathletes (MOMS-T) into a qualitative interview guide for use with BW triathletes; (b) use this interview guide to identify culturally based motives for triathlon participation among BW not previously addressed by the MOMS-T and; (c) interpret the novel motivational domains of the MOMS-T discovered, in order to gain understanding and influence subsequent interventions. Purposive sampling was used to select 12 interview participants from 121 self-identified Black female US residents aged ≥36 years with recent experience completing or training for a triathlon. The interviews identified four culturally based themes, including improving body composition to become "more lean", physical attractiveness, triathlete family, and camaraderie. These novel themes were related to existing MOMS-T scales, but the current MOMS-T questions did not illuminate their culturally distinct aspects. The process of survey transformation provides a viable approach to identify important culturally based characteristics and to adapt surveys to cultural minority populations, particularly when study resources are limited.
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Affiliation(s)
- Candace S Brown
- Center for the Study of Aging and Human Development, Duke University , PO Box 3003, DUMC, Durham, NC, 27710, USA.
- Durham Veterans Administration Medical Center, 508 Fulton St., Mailstop GRECC 182, Durham, NC, 27705, USA.
| | - Kevin S Masters
- Department of Psychology, University of Colorado Denver, 1200 Larimer Street, Suite 5010C, Denver, CO, 80217-3364, USA
| | - Amy G Huebschmann
- Department of Medicine, Center for Women's Health Research and Division of General Internal Medicine, University of Colorado School of Medicine, 12631 E. 17th Ave., Mailstop B180, Aurora, CO, 80045, USA
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Stein EM, Gennuso KP, Ugboaja DC, Remington PL. The Epidemic of Despair Among White Americans: Trends in the Leading Causes of Premature Death, 1999-2015. Am J Public Health 2017; 107:1541-1547. [PMID: 28817333 DOI: 10.2105/ajph.2017.303941] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate trends in premature death rates by cause of death, age, race, and urbanization level in the United States. METHODS We calculated cause-specific death rates using the Compressed Mortality File, National Center for Health Statistics data for adults aged 25 to 64 years in 2 time periods: 1999 to 2001 and 2013 to 2015. We defined 48 subpopulations by 10-year age groups, race/ethnicity, and county urbanization level (large urban, suburban, small or medium metropolitan, and rural). RESULTS The age-adjusted premature death rates for all adults declined by 8% between 1999 to 2001 and 2013 to 2015, with decreases in 39 of the 48 subpopulations. Most decreases in death rates were attributable to HIV, cardiovascular disease, and cancer. All 9 subpopulations with increased death rates were non-Hispanic Whites, largely outside large urban areas. Most increases in death rates were attributable to suicide, poisoning, and liver disease. CONCLUSIONS The unfavorable recent trends in premature death rate among non-Hispanic Whites outside large urban areas were primarily caused by self-destructive health behaviors likely related to underlying social and economic factors in these communities.
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Affiliation(s)
- Elizabeth M Stein
- Elizabeth M. Stein is with the Preventive Medicine Residency Program, University of Wisconsin School of Medicine and Public Health, Madison. Keith P. Gennuso is with the Population Health Institute, County Health Rankings, University of Wisconsin Madison School of Medicine and Public Health. Donna C. Ugboaja is with the University of Wisconsin Madison School of Medicine and Public Health. Patrick L. Remington is with the Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health
| | - Keith P Gennuso
- Elizabeth M. Stein is with the Preventive Medicine Residency Program, University of Wisconsin School of Medicine and Public Health, Madison. Keith P. Gennuso is with the Population Health Institute, County Health Rankings, University of Wisconsin Madison School of Medicine and Public Health. Donna C. Ugboaja is with the University of Wisconsin Madison School of Medicine and Public Health. Patrick L. Remington is with the Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health
| | - Donna C Ugboaja
- Elizabeth M. Stein is with the Preventive Medicine Residency Program, University of Wisconsin School of Medicine and Public Health, Madison. Keith P. Gennuso is with the Population Health Institute, County Health Rankings, University of Wisconsin Madison School of Medicine and Public Health. Donna C. Ugboaja is with the University of Wisconsin Madison School of Medicine and Public Health. Patrick L. Remington is with the Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health
| | - Patrick L Remington
- Elizabeth M. Stein is with the Preventive Medicine Residency Program, University of Wisconsin School of Medicine and Public Health, Madison. Keith P. Gennuso is with the Population Health Institute, County Health Rankings, University of Wisconsin Madison School of Medicine and Public Health. Donna C. Ugboaja is with the University of Wisconsin Madison School of Medicine and Public Health. Patrick L. Remington is with the Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health
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Rogers RG, Lawrence EM, Hummer RA, Tilstra AM. Racial/Ethnic Differences in Early-Life Mortality in the United States. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2017; 63:189-205. [PMID: 29035105 PMCID: PMC5729754 DOI: 10.1080/19485565.2017.1281100] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
U.S. early-life (ages 1-24) deaths are tragic, far too common, and largely preventable. Yet demographers have focused scant attention on U.S. early-life mortality patterns, particularly as they vary across racial and ethnic groups. We employed the restricted-use 1999-2011 National Health Interview Survey-Linked Mortality Files and hazard models to examine racial/ethnic differences in early-life mortality. Our results reveal that these disparities are large, strongly related to differences in parental socioeconomic status, and expressed through different causes of death. Compared to non-Hispanic whites, non-Hispanic blacks experience 60 percent and Mexican Americans 32 percent higher risk of death over the follow-up period, with demographic controls. Our finding that Mexican Americans experience higher early-life mortality risk than non-Hispanic whites differs from much of the literature on adult mortality. We also show that these racial/ethnic differences attenuate with controls for family structure and especially with measures of socioeconomic status. For example, higher mortality risk among Mexican Americans than among non-Hispanic whites is no longer significant once we controlled for mother's education or family income. Our results strongly suggest that eliminating socioeconomic gaps across groups is the key to enhanced survival for children and adolescents in racial/ethnic minority groups.
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Affiliation(s)
- Richard G Rogers
- a Department of Sociology and Population Program , IBS, University of Colorado Boulder , Boulder , Colorado , USA
| | - Elizabeth M Lawrence
- b Carolina Population Center, University of North Carolina , Chapel Hill , North Carolina , USA
| | - Robert A Hummer
- c Department of Sociology and Carolina Population Center , University of Carolina , Chapel Hill , North Carolina , USA
| | - Andrea M Tilstra
- a Department of Sociology and Population Program , IBS, University of Colorado Boulder , Boulder , Colorado , USA
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Colen CG, Ramey DM, Browning CR. Declines in Crime and Teen Childbearing: Identifying Potential Explanations for Contemporaneous Trends. JOURNAL OF QUANTITATIVE CRIMINOLOGY 2016; 32:397-426. [PMID: 27695160 PMCID: PMC5040460 DOI: 10.1007/s10940-016-9284-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The previous 25 years have witnessed remarkable upheavals in the social landscape of the United States. Two of the most notable trends have been dramatic declines in levels of crime as well as teen childbearing. Much remains unknown about the underlying conditions that might be driving these changes. More importantly, we do not know if the same distal factors that are responsible for the drop in the crime rate are similarly implicated in falling rates of teen births. We examine four overarching potential explanations: fluctuations in economic opportunity, shifting population demographics, differences in state-level policies, and changes in expectations regarding health and mortality. METHODS We combine state-specific data from existing secondary sources and model trajectories of violent crime, homicides, robberies, and teen fertility over a 20-year period from 1990 to 2010 using simultaneous fixed-effects regression models. RESULTS We find that 4 of the 21 predictors examined - growth in the service sector of the labor market, increasing racial diversity especially among Hispanics, escalating levels of migration, and the expansion of family planning services to low-income women - offer the most convincing explanations for why rates of violent crime and teen births have been steadily decreasing over time. Moreover, we are able to account for almost a quarter of the joint declines in violent crime and teen births. CONCLUSIONS Our conclusions underscore the far reaching effects that aggregate level demographic conditions and policies are likely to have on important social trends that might, at first glance, seem unrelated. Furthermore, the effects of policy efforts designed to target outcomes in one area are likely to spill over into other domains.
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Affiliation(s)
- Cynthia G Colen
- The Ohio State University, Dept of Sociology, 217 Townshend Hall, 1885 Neil Ave Mall, Columbus, OH 43210,
| | - David M Ramey
- Penn State University, Dept of Sociology and Criminology, 414 Oswald Tower,
| | - Christopher R Browning
- The Ohio State University, Dept of Sociology, 214 Townshend Hall, 1885 Neil Ave Mall, Columbus, OH 43210,
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Te Grotenhuis M, Pelzer B, Luo L, Schmidt-Catran AW. The Intrinsic Estimator, Alternative Estimates, and Predictions of Mortality Trends: A Comment on Masters, Hummer, Powers, Beck, Lin, and Finch. Demography 2016; 53:1245-52. [PMID: 27173796 PMCID: PMC5016552 DOI: 10.1007/s13524-016-0476-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In this article, we discuss a study by Masters et al. (2014), published in Demography. Masters and associates estimated age, period, and cohort (APC) effects on U.S. mortality rates between 1959 and 2009 using the intrinsic estimator (IE). We first argue that before applying the IE, a grounded theoretical justification is needed for its fundamental constraint on minimum variance of the estimates. We next demonstrate IE's high sensitivity to the type of dummy parameterization used to obtain the estimates. Finally, we discuss challenges in the interpretation of APC models. Our comments are not restricted to the article in question but pertain generally to any research that uses the IE.
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Affiliation(s)
- Manfred Te Grotenhuis
- Department of Sociology and Social Sciences Research Methods, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands.
| | - Ben Pelzer
- Department of Sociology and Social Sciences Research Methods, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands
| | - Liying Luo
- Department of Sociology and Criminal Justice, University of Delaware, Newark, DE, USA
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Tehranifar P, Goyal A, Phelan JC, Link BG, Liao Y, Fan X, Desai M, Terry MB. Age at cancer diagnosis, amenability to medical interventions, and racial/ethnic disparities in cancer mortality. Cancer Causes Control 2016; 27:553-60. [PMID: 26970741 PMCID: PMC5401630 DOI: 10.1007/s10552-016-0729-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 02/10/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE Racial disparities in cancer mortality may be greater for cancers that are amenable to available early detection and treatment (amenability level). We investigated whether these patterns vary by age at cancer diagnosis. METHODS Using 5-year relative survival rates (5Y-RSR), we classified 51 cancer sites into least amenable, partly amenable, and mostly amenable cancers (<40%, 40-69%, ≥70% 5-YRS, respectively). We examined whether racial disparities in mortality rates (African-Americans, Asian/Pacific Islanders, Hispanics, whites), as estimated through Cox regression models, were modified by age at diagnosis and amenability level in 516,939 cancer cases diagnosed in 1995-1999. RESULTS As compared with whites, all racial minority groups experienced higher cancer mortality rates in the youngest age group of 20-34 years. African-Americans and Hispanics diagnosed with partly and mostly amenable cancers had higher mortality rates relative to whites with cancers of the same amenability levels; further, these differences decreased in magnitude or reversed in direction with increasing age. In contrast, the racial differences in mortality were smaller and remained fairly constant across age groups for least amenable cancers. For example, in the youngest (20-34) and oldest (80-99) age groups, the adjusted hazard ratios (HRs) for African-Americans versus whites with least amenable cancers were, respectively, 1.26 (95% CI 1.02, 1.55) and 0.90 (95% CI 0.85, 0.96), while the HRs for African-Americans versus whites with mostly amenable cancers were 2.77 (95% CI 2.38, 3.22) and 1.07 (95% CI 0.98, 1.17). CONCLUSIONS Cancer survival disadvantage for racial minorities is larger in younger age groups for cancers that are more amenable to medical interventions.
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Affiliation(s)
- Parisa Tehranifar
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.
| | - Abhishek Goyal
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA
| | - Jo C Phelan
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Bruce G Link
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Public Policy, University of California Riverside, Riverside, CA, USA
| | - Yuyan Liao
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA
| | - Xiaozhou Fan
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA
| | - Manisha Desai
- Department of Medicine, Division of General Medical Disciplines, Stanford University, Palo Alto, CA, USA
| | - Mary Beth Terry
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA
- The Imprints Center for Genetic and Environmental Lifecourse Studies, Columbia UniversityMailman School of Public Health, New York, NY, USA
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Domingue BW, Wedow R, Conley D, McQueen M, Hoffmann TJ, Boardman JD. Genome-Wide Estimates of Heritability for Social Demographic Outcomes. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2016; 62:1-18. [PMID: 27050030 PMCID: PMC4918078 DOI: 10.1080/19485565.2015.1068106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
An increasing number of studies that are widely used in the demographic research community have collected genome-wide data from their respondents. It is therefore important that demographers have a proper understanding of some of the methodological tools needed to analyze such data. This article details the underlying methodology behind one of the most common techniques for analyzing genome-wide data, genome-wide complex trait analysis (GCTA). GCTA models provide heritability estimates for health, health behaviors, or indicators of attainment using data from unrelated persons. Our goal was to describe this model, highlight the utility of the model for biodemographic research, and demonstrate the performance of this approach under modifications to the underlying assumptions. The first set of modifications involved changing the nature of the genetic data used to compute genetic similarities between individuals (the genetic relationship matrix). We then explored the sensitivity of the model to heteroscedastic errors. In general, GCTA estimates are found to be robust to the modifications proposed here, but we also highlight potential limitations of GCTA estimates.
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Affiliation(s)
| | - Robbee Wedow
- Institute of Behavioral Science, University of Colorado Boulder
| | - Dalton Conley
- Department of Sociology & Center for Genomics and Systems Biology, New York University
| | - Matt McQueen
- Institute of Behavioral Science, University of Colorado Boulder
| | - Thomas J. Hoffmann
- Department of Epidemiology & Biostatistics, and Institute for Human Genetics, University of California San Francisco
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Short SE, Mollborn S. Social Determinants and Health Behaviors: Conceptual Frames and Empirical Advances. Curr Opin Psychol 2015; 5:78-84. [PMID: 26213711 PMCID: PMC4511598 DOI: 10.1016/j.copsyc.2015.05.002] [Citation(s) in RCA: 195] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Health behaviors shape health and well-being in individuals and populations. Drawing on recent research, we review applications of the widely applied "social determinants" approach to health behaviors. This approach shifts the lens from individual attribution and responsibility to societal organization and the myriad institutions, structures, inequalities, and ideologies undergirding health behaviors. Recent scholarship integrates a social determinants perspective with biosocial approaches to health behavior dynamics. Empirical advances model feedback among social, psychological and biological factors. Health behaviors are increasingly recognized as multidimensional and embedded in health lifestyles, varying over the life course and across place and reflecting dialectic between structure and agency that necessitates situating individuals in context. Advances in measuring and modeling health behaviors promise to enhance representations of this complexity.
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Affiliation(s)
- Susan E. Short
- Department of Sociology, Brown University, Box 1916, Providence, RI 02912, USA
| | - Stefanie Mollborn
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, Boulder, CO 80309-0483, USA
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Abstract
Investigations of age, period, and cohort effects are difficult because the 3 factors are linearly dependent. In a novel application, Kramer et al. (Am J Epidemiol. 2015;182(4):302-312) have used graphical analysis and statistical models to estimate the impact that age, period, and cohort effects have had on trends in black-white inequalities in heart disease mortality. Using a constrained regression approach (with the first 2 periods' effects constrained to zero), Kramer et al. find evidence that age and cohort effects figure more prominently than do period effects in contributing to relative black-white mortality differences, and they argue that early-life exposures should be given greater consideration for mitigation of racial differences in heart disease. In this invited commentary, I argue that the utility of age-period-cohort models for understanding health inequalities depends on the plausibility of the assumptions used to break the link between the 3 factors. Based on the existing age-period-cohort literature, alternative assumptions seem likely to produce substantially different results. I also argue that interpretations of the impacts of age, period, and cohort effects on racial inequalities in heart disease mortality may depend on whether inequalities are assessed on the absolute scale or the relative scale.
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Navaneethan SD, Schold JD, Arrigain S, Jolly SE, Nally JV. Cause-Specific Deaths in Non-Dialysis-Dependent CKD. J Am Soc Nephrol 2015; 26:2512-20. [PMID: 26045089 DOI: 10.1681/asn.2014101034] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/31/2015] [Indexed: 11/03/2022] Open
Abstract
CKD is associated with higher risk of death, but details regarding differences in cause-specific death in CKD are unclear. We examined the leading causes of death among a non-dialysis-dependent CKD population using an electronic medical record-based CKD registry in a large healthcare system and the Ohio Department of Health mortality files. We included 33,478 white and 5042 black patients with CKD who resided in Ohio between January 2005 and September 2009 and had two measurements of eGFR<60 ml/min per 1.73 m(2) obtained 90 days apart. Causes of death (before ESRD) were classified into cardiovascular, malignancy, and non-cardiovascular/non-malignancy diseases and non-disease-related causes. During a median follow-up of 2.3 years, 6661 of 38,520 patients (17%) with CKD died. Cardiovascular diseases (34.7%) and malignant neoplasms (31.8%) were the leading causes of death, with malignancy-related deaths more common among those with earlier stages of kidney disease. After adjusting for covariates, each 5 ml/min per 1.73 m(2) decline in eGFR was associated with higher risk of death due to cardiovascular disease (hazard ratio [HR], 1.10; 95% confidence interval [95% CI], 1.08 to 1.12) and non-cardiovascular/non-malignancy diseases (HR, 1.12; 95% CI, 1.09 to 1.14) but not to malignancy. In the adjusted models, blacks had overall-mortality hazard ratios similar to those of whites but higher hazard ratios for cardiovascular deaths. Further studies to confirm these findings and explain the mechanisms for differences are warranted. In addition to lowering cardiovascular burden in CKD, efforts to target known risk factors for cancer at the population level are needed.
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Affiliation(s)
- Sankar D Navaneethan
- Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of CWRU, Cleveland, Ohio; and
| | - Jesse D Schold
- Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio; Departments of Quantitative Health Sciences, and
| | | | - Stacey E Jolly
- Cleveland Clinic Lerner College of Medicine of CWRU, Cleveland, Ohio; and General Internal Medicine, Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Joseph V Nally
- Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of CWRU, Cleveland, Ohio; and
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Yang YC, Land KC. Misunderstandings, mischaracterizations, and the problematic choice of a specific instance in which the IE should never be applied. Demography 2014; 50:1969-71; discussion 1985-8. [PMID: 24132743 DOI: 10.1007/s13524-013-0254-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Yang Claire Yang
- Department of Sociology, Lineberger Cancer Center, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-3210, USA,
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