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Baeker Bispo JA, Goo I, Ashad-Bishop K, Kobetz E, Bailey Z. Does Neighborhood Social Cohesion Influence Participation in Routine Cancer Screening? Findings From a Representative Sample of Adults in South Florida. FAMILY & COMMUNITY HEALTH 2024; 47:130-140. [PMID: 38372330 DOI: 10.1097/fch.0000000000000400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Neighborhood social cohesion (NSC) has been associated with a variety of health outcomes, but limited research has examined its impact on behaviors that support cancer control. The purpose of this study was to examine associations between NSC and guideline-concordant breast, cervical and colorectal cancer screening. METHODS Data are from a cross-sectional survey administered to 716 adults in South Florida from 2019 to 2020. The analytic samples included adults eligible for breast (n = 134), cervical (n = 195), and colorectal cancer (n = 265) screening. NSC was measured using a validated 5-item instrument. Associations between NSC and guideline-concordant screening were examined using multivariable logistic regression. RESULTS In fully adjusted analyses, the odds of guideline-concordant breast cancer screening increased by 86% for every unit increase in NSC (aOR = 1.86; 95% CI, 1.03-3.36). NSC was not statistically significantly associated with guideline-concordant cervical cancer screening (aOR = 0.86; 95% CI, 0.54-1.38) or colorectal cancer screening (aOR = 1.29; 95% CI, 0.81-2.04). CONCLUSIONS These findings suggest that NSC supports some screening behaviors, namely, mammography use. To better understand heterogeneous relationships between NSC and utilization of preventive care services such as cancer screening, more research is needed that disaggregates effects by sex, age, race/ethnicity, and socioeconomic status.
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Affiliation(s)
- Jordan A Baeker Bispo
- American Cancer Society, Surveillance and Health Equity Science, Atlanta, Georgia (Drs Baeker Bispo and Ashad-Bishop); Miller School of Medicine, University of Miami, Miami, Florida (Drs Goo and Kobetz); Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida (Dr Kobetz); Keck School of Medicine, University of Southern California, Los Angeles, California (Dr Goo); and University of Minnesota School of Public Health, Minneapolis, Minnesota (Dr Bailey)
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Elmohr MM, Javed Z, Dubey P, Jordan JE, Shah L, Nasir K, Rohren EM, Lincoln CM. Social Determinants of Health Framework to Identify and Reduce Barriers to Imaging in Marginalized Communities. Radiology 2024; 310:e223097. [PMID: 38376404 PMCID: PMC10902599 DOI: 10.1148/radiol.223097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 02/21/2024]
Abstract
Social determinants of health (SDOH) are conditions influencing individuals' health based on their environment of birth, living, working, and aging. Addressing SDOH is crucial for promoting health equity and reducing health outcome disparities. For conditions such as stroke and cancer screening where imaging is central to diagnosis and management, access to high-quality medical imaging is necessary. This article applies a previously described structural framework characterizing the impact of SDOH on patients who require imaging for their clinical indications. SDOH factors can be broadly categorized into five sectors: economic stability, education access and quality, neighborhood and built environment, social and community context, and health care access and quality. As patients navigate the health care system, they experience barriers at each step, which are significantly influenced by SDOH factors. Marginalized communities are prone to disparities due to the inability to complete the required diagnostic or screening imaging work-up. This article highlights SDOH that disproportionately affect marginalized communities, using stroke and cancer as examples of disease processes where imaging is needed for care. Potential strategies to mitigate these disparities include dedicating resources for clinical care coordinators, transportation, language assistance, and financial hardship subsidies. Last, various national and international health initiatives are tackling SDOH and fostering health equity.
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Affiliation(s)
- Mohab M. Elmohr
- From the Department of Radiology, Baylor College of Medicine, Houston, 1 Baylor Plaza, BCM 360, Houston, TX 77030 (M.M.E., E.M.R.); Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist Hospital, Houston, Tex (Z.J., K.N.); Houston Radiology Associates, Houston Methodist Hospital, Houston, Tex (P.D.); ACR Commission on Neuroradiology, American College of Radiology, Reston, Va (J.E.J.); Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, Calif (J.E.J.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (L.S.); Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex (K.N.); Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex (K.N.); and Department of Neuroradiology, Division of Diagnostic Imaging, MD Anderson Cancer Center, Houston, Tex (C.M.L.)
| | - Zulqarnain Javed
- From the Department of Radiology, Baylor College of Medicine, Houston, 1 Baylor Plaza, BCM 360, Houston, TX 77030 (M.M.E., E.M.R.); Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist Hospital, Houston, Tex (Z.J., K.N.); Houston Radiology Associates, Houston Methodist Hospital, Houston, Tex (P.D.); ACR Commission on Neuroradiology, American College of Radiology, Reston, Va (J.E.J.); Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, Calif (J.E.J.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (L.S.); Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex (K.N.); Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex (K.N.); and Department of Neuroradiology, Division of Diagnostic Imaging, MD Anderson Cancer Center, Houston, Tex (C.M.L.)
| | - Prachi Dubey
- From the Department of Radiology, Baylor College of Medicine, Houston, 1 Baylor Plaza, BCM 360, Houston, TX 77030 (M.M.E., E.M.R.); Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist Hospital, Houston, Tex (Z.J., K.N.); Houston Radiology Associates, Houston Methodist Hospital, Houston, Tex (P.D.); ACR Commission on Neuroradiology, American College of Radiology, Reston, Va (J.E.J.); Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, Calif (J.E.J.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (L.S.); Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex (K.N.); Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex (K.N.); and Department of Neuroradiology, Division of Diagnostic Imaging, MD Anderson Cancer Center, Houston, Tex (C.M.L.)
| | - John E. Jordan
- From the Department of Radiology, Baylor College of Medicine, Houston, 1 Baylor Plaza, BCM 360, Houston, TX 77030 (M.M.E., E.M.R.); Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist Hospital, Houston, Tex (Z.J., K.N.); Houston Radiology Associates, Houston Methodist Hospital, Houston, Tex (P.D.); ACR Commission on Neuroradiology, American College of Radiology, Reston, Va (J.E.J.); Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, Calif (J.E.J.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (L.S.); Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex (K.N.); Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex (K.N.); and Department of Neuroradiology, Division of Diagnostic Imaging, MD Anderson Cancer Center, Houston, Tex (C.M.L.)
| | - Lubdha Shah
- From the Department of Radiology, Baylor College of Medicine, Houston, 1 Baylor Plaza, BCM 360, Houston, TX 77030 (M.M.E., E.M.R.); Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist Hospital, Houston, Tex (Z.J., K.N.); Houston Radiology Associates, Houston Methodist Hospital, Houston, Tex (P.D.); ACR Commission on Neuroradiology, American College of Radiology, Reston, Va (J.E.J.); Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, Calif (J.E.J.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (L.S.); Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex (K.N.); Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex (K.N.); and Department of Neuroradiology, Division of Diagnostic Imaging, MD Anderson Cancer Center, Houston, Tex (C.M.L.)
| | - Khurram Nasir
- From the Department of Radiology, Baylor College of Medicine, Houston, 1 Baylor Plaza, BCM 360, Houston, TX 77030 (M.M.E., E.M.R.); Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist Hospital, Houston, Tex (Z.J., K.N.); Houston Radiology Associates, Houston Methodist Hospital, Houston, Tex (P.D.); ACR Commission on Neuroradiology, American College of Radiology, Reston, Va (J.E.J.); Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, Calif (J.E.J.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (L.S.); Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex (K.N.); Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex (K.N.); and Department of Neuroradiology, Division of Diagnostic Imaging, MD Anderson Cancer Center, Houston, Tex (C.M.L.)
| | - Eric M. Rohren
- From the Department of Radiology, Baylor College of Medicine, Houston, 1 Baylor Plaza, BCM 360, Houston, TX 77030 (M.M.E., E.M.R.); Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist Hospital, Houston, Tex (Z.J., K.N.); Houston Radiology Associates, Houston Methodist Hospital, Houston, Tex (P.D.); ACR Commission on Neuroradiology, American College of Radiology, Reston, Va (J.E.J.); Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, Calif (J.E.J.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (L.S.); Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex (K.N.); Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex (K.N.); and Department of Neuroradiology, Division of Diagnostic Imaging, MD Anderson Cancer Center, Houston, Tex (C.M.L.)
| | - Christie M. Lincoln
- From the Department of Radiology, Baylor College of Medicine, Houston, 1 Baylor Plaza, BCM 360, Houston, TX 77030 (M.M.E., E.M.R.); Division of Health Equity and Disparities Research, Center for Outcomes Research, Houston Methodist Hospital, Houston, Tex (Z.J., K.N.); Houston Radiology Associates, Houston Methodist Hospital, Houston, Tex (P.D.); ACR Commission on Neuroradiology, American College of Radiology, Reston, Va (J.E.J.); Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University School of Medicine, Stanford, Calif (J.E.J.); Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (L.S.); Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tex (K.N.); Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist Hospital, Houston, Tex (K.N.); and Department of Neuroradiology, Division of Diagnostic Imaging, MD Anderson Cancer Center, Houston, Tex (C.M.L.)
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Baeker Bispo J, Lee H, Pal Choudhury P, Bailey Z, Jemal A, Islami F. Government Housing Assistance and Cancer Screening Among Adults With Low Income. Am J Prev Med 2024; 66:205-215. [PMID: 37943202 DOI: 10.1016/j.amepre.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Access to affordable housing may support cancer control for adults with low income by alleviating financial barriers to preventive care. This study examines relationships between cancer screening and receipt of government housing assistance among adults with low income. METHODS Data are from the 2019 and 2021 National Health Interview Survey. Eligible respondents were classified as up-to-date or not with breast cancer (BC), cervical cancer (CVC) and colorectal cancer (CRC) screening guidelines. Multivariable logistic regression was used to model guideline-concordant screening by receipt of government housing assistance, overall and stratified by urban-rural status, race/ethnicity, and age. Analyses were performed in 2023. RESULTS Analyses for BC, CVC and CRC screening included 2,258, 3,132, and 3,233 respondents, respectively. There was no difference in CVC screening by housing assistance status, but screening for BC and CRC was higher among those who received assistance compared to those who did not (59.7% vs. 50.8%, p<0.01 for BC; 57.1% vs. 44.1%, p<0.01 for CRC). In models adjusted for sociodemographic characteristics, health status and insurance, these differences were not statistically significant for either BC or CRC screening. In stratified adjusted models, housing assistance was statistically significantly associated with increased BC screening in urban areas (aOR=1.35, 95% CI=1.00-1.82) and among Hispanic women (aOR=2.20, 95% CI=1.01-4.78) and women 45-54 years of age (aOR=2.10, 95% CI=1.17-3.75). CONCLUSIONS Policies that address housing affordability may enhance access to BC screening for some subgroups, including women in urban areas, Hispanic women, and younger women. More research on the mechanisms that link housing assistance to BC screening is needed.
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Affiliation(s)
- Jordan Baeker Bispo
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia.
| | - Hyunjung Lee
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Parichoy Pal Choudhury
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Zinzi Bailey
- University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Ahmedin Jemal
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Farhad Islami
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
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Arriola KJ, Merken TM, Bigger L, Haardörfer R, Hermstad A, Owolabi S, Daniel J, Kegler M. Understanding the relationship between social capital, health, and well-being in a southern rural population. J Rural Health 2024; 40:162-172. [PMID: 37438857 DOI: 10.1111/jrh.12782] [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: 12/21/2022] [Revised: 05/31/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE Social capital is thought to contribute to health and well-being, but its application to a rural context is poorly understood. This study seeks to examine how different forms of social capital relate to health and well-being among rural residents and the extent to which race and degree of rurality moderates these relationships. METHODS Data from a population-based survey of 6 counties in rural Georgia (n = 1,385) are used. We examined 3 forms of social capital (diversity of interaction, civic engagement, and voting behavior) in relation to 3 health and well-being measures (overall life satisfaction, general health status, and 30-day physical health). FINDINGS Interacting with more diverse social networks was associated with higher overall life satisfaction for White but not Black participants (P ≤ .001). For those living in more rural communities, interacting with a more diverse social network was more strongly associated with greater general health as compared to those who lived "in town" (P ≤ .01). Greater civic engagement and voting behavior were associated with greater general health for White but not Black participants (Ps < .05). Likewise, voting in all 3 elections was associated with greater overall life satisfaction and fewer days of poor physical health for White but not Black participants (Ps ≤ .05). CONCLUSION Social capital may be associated with positive health and well-being among those living in rural areas, but it may vary by race and degree of community rurality, suggesting the need to further understand how social capital operates in a rural context.
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Affiliation(s)
- Kimberly Jacob Arriola
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Tatenda Mangurenje Merken
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Lauren Bigger
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Regine Haardörfer
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - April Hermstad
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Shade Owolabi
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jerry Daniel
- Master of Social Work Program, Albany State University, Albany, Georgia, USA
| | - Michelle Kegler
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Baum S. Exploring Disparities in Breast Cancer Screening: An Ecological Analysis of Australian Data. Asian Pac J Cancer Prev 2023; 24:4139-4145. [PMID: 38156849 PMCID: PMC10909116 DOI: 10.31557/apjcp.2023.24.12.4139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE The objective of this study is to analyse the socio-spatial patterns of breast cancer screening across Australian regions. METHODS The research is an ecological study. Data for breast screening participation and associated social and demographic factors are obtained from the Australian Institute of Health and Welfare and the Australian Bureau of Statistics. The unit of measurement for the analysis is spatially aggregated regions (Statistical Area 3). Geographically weighted regression is used to analyse the relationship between a dependent variable and one or more independent variables while considering the spatial or geographic relationships among the data points. RESULTS Globally, there was a significant (p<0.05) association between screening participation and income, English ability, education level, Indigenous background, and transport availability. The geographically weighted regression model represented an improved fit with a higher R2 (R2=0.89) and the Akaike information criterion (AIC) has improved, (AIC= 391.92). The Monte-Carlo tests for spatial variability were significant for all independent variables (p<0.05). Visually, there was marked spatial variation in the association between breast cancer screening rates and the significant independent variables from the global model. CONCLUSION The identification of significant spatial variability in the association between breast cancer screening participation and important social and demographic factors provides important input into the design of programs aimed at increasing participation in screening regimes.
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Affiliation(s)
- Scott Baum
- School of Engineering and Built Environment, Griffith University, Australia.
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Gilbert KL, Shaw M, Siddiqi A, Goodman MS. Achieving the Health Equity Agenda Through Transformative Community-Engaged Strategies. Prev Chronic Dis 2023; 20:E99. [PMID: 37943729 PMCID: PMC10684278 DOI: 10.5888/pcd20.230077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Affiliation(s)
- Keon L Gilbert
- Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave, St. Louis, MO 63104
- Brookings Institution, Washington, DC
| | - Mary Shaw
- Jackson State University, Department of Behavioral & Environmental Health, College of Health Sciences, Jackson, Mississippi
| | - Arjumand Siddiqi
- University of Toronto, Dalla Lana School of Public Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Melody S Goodman
- New York University, School of Global Public Health, New York, New York
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Zhou L, Ju P, Li Y, Liu B, Wang Y, Zhang X, Yin H. Preventive health behaviors among the middle-aged and elderly in China: Does social capital matter? Prev Med Rep 2023; 35:102329. [PMID: 37554353 PMCID: PMC10404801 DOI: 10.1016/j.pmedr.2023.102329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 08/10/2023] Open
Abstract
This study explores the status quo of preventive care use and social capital among middle-aged and elderly people (≥45 years old) in China, and employs a multi-level model to analyze whether social capital at different levels is associated with preventive care use. The data are derived from the 2018 China Health and Retirement Longitudinal Study (CHARLS), which includes 11,503 respondents and 450 communities. Preventive care use covers the utilization of routine physical examination services. Individual social capital is measured by the level of social network and social activities participation. Social network includes contacting with children or other people, for example, by phone, text message. Social activities participation is measured by the involvement in social activities, for example, playing mahjong, going to community club. Community social capital is evaluated by the richness of community facilities. Results reveals that the utilization of preventive care is 48.94% among middle-aged and elderly in China. The most used preventive service is routine blood test. The intra-class correlation (ICC) coefficient indicates that preventive health behaviors of the respondents are clustered at communities where they live. Multi-level regression shows that influence of social network is not significant to preventive care use (p > 0.05). Community facilities and individual social activities participation are significantly associated with preventive care use (p < 0.05). The association between social capital and preventive care use could be considered as an important factor when making policies to promote preventive care use.
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Affiliation(s)
- Liangru Zhou
- School of Health Management, Harbin Medical University, Harbin, China
| | - Peiyan Ju
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yi Li
- School of Health Management, Harbin Medical University, Harbin, China
| | - Bingjie Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yan Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Xin Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Hui Yin
- School of Health Management, Harbin Medical University, Harbin, China
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Villalonga-Olives E, Majercak KR, Wang W, Dean LT, Ransome Y. Different Responses to Social Capital Among Black People and White People: What Racial Differential Item Functioning Reveals for Racial Health Equity. Am J Epidemiol 2023; 192:1264-1273. [PMID: 36928913 DOI: 10.1093/aje/kwad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 12/02/2022] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Social capital has been conceptualized as features of social organization, such as networks, and norms that facilitate coordination and cooperation for mutual benefit. Because of long-standing anti-Black structural oppression in the United States, social capital may be associated with health differently for Black people than for other racial/ethnic groups. Our aim was to examine the psychometric properties of social capital indicators, comparing responses from Black and White people to identify whether there is differential item functioning (DIF) in social capital according to race. DIF examines how items are related to a latent construct and whether this relationship differs across groups such as different racial groups. We used data from respondents to the Southeastern Pennsylvania Household Health Survey in 2004, who lived in Philadelphia (n = 2,048), a city with a large Black population. We used item response theory analysis to test for racial DIF. We found DIF across the items, indicating measurement error, which could be related to the way these items were developed (i.e., based on cultural assumptions tested in mainstream White America). Hence, our findings underscore the need to interrogate the assumptions that underly existing social capital items through an equity-based lens, and to take corrective action when developing new items to ensure that they are racially and culturally congruent.
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Clark EM, Ma L, Williams BR, Ghosh D, Park CL, Schulz E, Woodard N, Knott CL. A longitudinal study of social, religious, and spiritual capital and physical and emotional functioning in a national sample of African-Americans. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:978-997. [PMID: 36115065 PMCID: PMC10006284 DOI: 10.1002/jcop.22936] [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] [Received: 03/29/2022] [Revised: 07/12/2022] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
The present study builds on prior research by examining the moderating relationships between different types of capital on physical functioning, emotional functioning, and depressive symptoms using a 2.5-year longitudinal design with a national sample of African-American adults. Results indicated a significant T1 social capital × T1 religious capital interaction such that among low T1 religious capital participants, those with high T1 social capital had lower T2 physical functioning than those with lower T1 social capital. There was also a marginally significant T1 social capital × T1 spiritual capital interaction suggesting that among low T1 spiritual capital participants, those with higher T1 social capital reported a decline in depressive symptoms compared to those with lower T1 social capital. Future research and implications for intervention and policy development are discussed.
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Affiliation(s)
- Eddie M Clark
- Department of Psychology, Department of Psychology, Saint Louis University, St. Louis, Missouri, USA
| | - Lijing Ma
- Department of Psychology, University of San Fransciso, USA
| | - Beverly R Williams
- Department of Medicine, University of Alabama - Birmingham, Birmingham, Alabama, USA
| | - Debarchana Ghosh
- Department of Geography, University of Connecticut, Storrs, Connecticut, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Emily Schulz
- Department of Occupational Therapy, University of Northern Arizona, Flagstaff, Arizona, USA
| | - Nathaniel Woodard
- Department of Behavioral and Community Health, University of Maryland, College Park, Maryland, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, University of Maryland, College Park, Maryland, USA
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Lu J, Wang X, Fei L, Chen G, Feng Y. Effects of social media empowerment on COVID-19 preventive behaviors in China. INFORMATION TECHNOLOGY & PEOPLE 2023. [DOI: 10.1108/itp-05-2022-0412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
PurposeDuring the coronavirus disease 2019 (COVID-19) pandemic, ubiquitous social media has become a primary channel for information dissemination, social interactions and recreational activities. However, it remains unclear how social media usage influences nonpharmaceutical preventive behavior of individuals in response to the pandemic. This paper aims to explore the impacts of social media on COVID-19 preventive behaviors based on the theoretical lens of empowerment.Design/methodology/approachIn this paper, survey data has been collected from 739 social media users in China to conduct structural equation modeling (SEM) analysis.FindingsThe results indicate that social media empowers individuals in terms of knowledge seeking, knowledge sharing, socializing and entertainment to promote preventive behaviors at the individual level by increasing each person's perception of collective efficacy and social cohesion. Meanwhile, social cohesion negatively impacts the relationship between collective efficacy and individual preventive behavior.Originality/valueThis study provides insights regarding the role of social media in crisis response and examines the role of collective beliefs in the influencing mechanism of social media. The results presented herein can be used to guide government agencies seeking to control the COVID-19 pandemic.
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Ransome Y, Hayashi K, Gamble-George JC, Dean LT, Villalonga-Olives E. Racial and ethnic differences in the association of social cohesion and social capital with HIV testing. SSM Popul Health 2023; 21:101327. [PMID: 36618543 PMCID: PMC9811247 DOI: 10.1016/j.ssmph.2022.101327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/24/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
HIV testing rates vary by race and ethnicity. Whether social capital indicators are related to HIV testing and whether these associations differ by race or ethnicity is unknown. Multivariable analysis was used to examine whether social capital (collective engagement and civic and social participation), including social cohesion (trust in neighbors, neighbors willing to help, feelings of belongingness) were associated with testing for HIV in the past 12 months. Participants were white, Black or African American, and Hispanic/Latino adults ages 18 to 44 (N = 2823) from the general population, in Philadelphia, PA who participated in the Southeastern Pennsylvania Household Health Surveys 2010 and 2012. Overall HIV testing in this sample was 42%, and was higher among women, and Black compared to white people. Mean social capital scores were significantly highest among whites. Greater trust in neighbors was associated with lower odds of testing for HIV (adjusted Odds Ratio[aOR]:0.61, 95% CI = 0.49-0.74), and this relationship varied by race/ethnicity, with stronger inverse associations among Hispanic/Latino (aOR = 0.43, p < 0.001) and white adults (aOR = 0.50, p < -0.001) than among Black adults (aOR = 0.75, p < 0.05). Greater neighborhood belongingness (aOR = 1.31, 95% CI = 1.11-1.54) and working together to improve the neighborhood (aOR = 1.33, 95%CI = 1.03-1.73) were associated with higher odds of testing for HIV. Different indicators of social capital were associated with higher as well as lower odds of testing for HIV. These patterns did not vary statistically by race or ethnicity. HIV testing prevention interventions will need to address social capital in design and implementation strategies.
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Affiliation(s)
- Yusuf Ransome
- Social and Behavioral Sciences, Yale University, School of Public Health, 60 College Street, LEPH 4th Floor, New Haven, CT, 06520, USA
- Corresponding author. Yale School of Public Health, 60 College Street, LEPH 4 th Floor, New Haven, CT, 06520, USA.
| | - Kamden Hayashi
- Department of Health Behavior, University of North Carolina, Gillings School of Global Public Health, 135 Dauer Drive, Chapel Hill, NC, 27599, USA
| | - Joyonna C. Gamble-George
- Behavioral Science Training in Drug Abuse Research, New York University Rory Meyers College of Nursing, 380 2nd Avenue, Suite 306, NY, 10010, USA
- Center for Interdisciplinary Research on AIDS, Yale University, School of Public Health, 135 College Street, Suite 200, New Haven, CT, 06510, USA
| | - Lorraine T. Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6650, Baltimore, MD, 21205, USA
| | - Ester Villalonga-Olives
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD, 21201, USA
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12
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Rodriguez de Lisenko NC, Gray HL, Bohn J. Optimizing Outcomes: A Systematic Review of Psychosocial Risk Factors Affecting Perinatal Black/African-American Women with Substance Use Disorder in the United States. Matern Child Health J 2022; 26:2090-2108. [PMID: 35947278 DOI: 10.1007/s10995-022-03503-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Despite studies having examined and discussed the various multifaceted risk factors affecting perinatal women with substance use disorder (SUD), the limited amount of research on Black/African-American (B/AA) women allows health disparities in this population to widen. Segmenting the needs of the low-income B/AA female population with SUD is crucial when creating multi-layered and multi-faceted innovative upstream evidence-based interventions. This review assesses and examines studies that investigate psychosocial, environmental, and systemic level risk factors related to implicit bias, trauma, toxic stress, food issues, and SUD. METHODS The principal investigator (PI) utilized PubMed, Google Scholar, ProQuest Dissertations and Theses Global to perform a systematic scoping review of the published literature. Research focused on risks factors affecting low-income perinatal B/AA women. The literature review examined articles published January 2010 through December 2020. Inclusion criteria incorporated risk factors, health disparities, and SUD. Studies selected for this review have been published in English and conducted in the USA. RESULTS Our research identified 509 articles, of which we chose to include 75. The literature highlights health disparities influenced by risks factors of implicit biases, trauma, and toxic stress, which construct physical and emotional barriers to healthy food and food resources in B/AA women with SUD. CONCLUSION The PI found limited or non-existent research on innovative interventions targeting perinatal B/AA women with SUD. This review recommends deconstructing hidden psychosocial, environmental, and systematic risk factors to assist in developing novel comprehensive strategies and wraparound support services.
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Affiliation(s)
- Norma C Rodriguez de Lisenko
- Innovative Health Solutions, P.O. Box 183, Benicia, CA, 94510, USA.
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA.
| | - Heewon L Gray
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Joseph Bohn
- College of Public Health, University of South Florida, 13201 Bruce B Downs Blvd, Tampa, FL, 33612, USA
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13
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Jaehn P, Bergholz A, Holmberg C. Regional inequalities of tumour size at diagnosis in Germany: An ecological study in eight federal states. Int J Cancer 2022; 151:1684-1695. [PMID: 35723083 DOI: 10.1002/ijc.34185] [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: 04/06/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022]
Abstract
There is growing recognition of the importance of the residential environment for early detection of cancer. However, few studies have investigated area socioeconomic deprivation, social capital, and rurality in combination. Therefore, we aimed to estimate mutually adjusted associations of these characteristics with tumour size at diagnosis in Germany. We included incident cases of female breast cancer, colorectal cancer, malignant melanoma, uterine cancer, and male bladder cancer, collected by the cancer registries of eight German federal states between 2010 and 2014. Using information on T status, we defined an advanced tumour size for each cancer type. Sex-specific mutually adjusted associations of area socioeconomic deprivation, social capital, and rurality with advanced tumour size and variance partition coefficients were estimated in multilevel logistic regression. Missing data of the outcome were addressed by multiple imputation. Overall, 386,223 cases were included in this analysis. High area socioeconomic deprivation was associated with advanced tumour size at diagnosis of colorectal cancer and malignant melanoma. For malignant melanoma, low social capital was associated with an advanced tumour size among females and males, while a rural settlement structure was associated with advanced tumour size among males only. Since meaningful general contextual effects were found for malignant melanoma, our results underscore that the context of an area is an important predictor of melanoma tumour size. Secondary prevention programs for this cancer type should target areas with high area socioeconomic deprivation, low social capital, and a rural settlement structure in order to reach those most vulnerable.
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Affiliation(s)
- Philipp Jaehn
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.,Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Potsdam, Germany
| | - Andreas Bergholz
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.,Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Potsdam, Germany
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.,Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Potsdam, Germany
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14
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Moudatsou M, Vouyiouka P, Karagianni-Hatziskou E, Rovithis M, Stavropoulou A, Koukouli S. Knowledge and Use of Cervical Cancer Prevention Services among Social Work and Nursing University Students. Healthcare (Basel) 2022; 10:healthcare10061140. [PMID: 35742191 PMCID: PMC9222924 DOI: 10.3390/healthcare10061140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 12/31/2022] Open
Abstract
The present study examines: (a) the knowledge of healthcare students on cervical cancer (CC) issues and the use of related preventive services, as well as their association with the field of study and other sociodemographic characteristics; (b) the possible effect of social capital and its parameters. A cross-sectional study was conducted, using a convenience non-probability sampling technique. The final sample consisted of forty-nine social work and fifty-one nursing students. The two groups were similar regarding their sociodemographic characteristics and the knowledge and use of gynecological preventive services. However, the nursing students undertook a PAP smear check-up to a lesser extent (48.6%) compared to social work students (51.4%) (p = 0.026). The social capital scores were high for both groups, but social work students were significantly more ‘Tolerant to diversity’. For the total sample, only the ‘Family and friends connections’ subscale correlated with knowledge about the existing gynecological preventive services. Among the main reasons explaining university students’ avoidance of preventive testing were the feelings of fear and embarrassment associated with the PAP smear test. Given the significance of the future professional roles of healthcare students as information sources and leaders in women’s CC preventive behavior, understanding the individual factors contributing to their own adherence is essential. It is equally important to increase their scientific knowledge through the improvement of academic curricula regarding these issues.
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Affiliation(s)
- Maria Moudatsou
- Social Work Department, School of Health Sciences, Hellenic Mediterranean University, GR-71410 Heraklion, Greece; (P.V.); (E.K.-H.); (S.K.)
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Hellenic Mediterranean University, GR-71410 Heraklion, Greece; (M.R.); (A.S.)
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Hellenic Mediterranean University, GR-71410 Heraklion, Greece
- Correspondence: ; Tel.: +30-6938980463
| | - Panayiota Vouyiouka
- Social Work Department, School of Health Sciences, Hellenic Mediterranean University, GR-71410 Heraklion, Greece; (P.V.); (E.K.-H.); (S.K.)
| | - Eleni Karagianni-Hatziskou
- Social Work Department, School of Health Sciences, Hellenic Mediterranean University, GR-71410 Heraklion, Greece; (P.V.); (E.K.-H.); (S.K.)
| | - Michael Rovithis
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Hellenic Mediterranean University, GR-71410 Heraklion, Greece; (M.R.); (A.S.)
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Hellenic Mediterranean University, GR-71410 Heraklion, Greece
- Nursing Department, School of Health Sciences, Hellenic Mediterranean University, GR-71410 Heraklion, Greece
| | - Areti Stavropoulou
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Hellenic Mediterranean University, GR-71410 Heraklion, Greece; (M.R.); (A.S.)
- Nursing Department, School of Health and Care Sciences, University of West Attica, GR-12243 Athens, Greece
| | - Sofia Koukouli
- Social Work Department, School of Health Sciences, Hellenic Mediterranean University, GR-71410 Heraklion, Greece; (P.V.); (E.K.-H.); (S.K.)
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life, Hellenic Mediterranean University, GR-71410 Heraklion, Greece; (M.R.); (A.S.)
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Hellenic Mediterranean University, GR-71410 Heraklion, Greece
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15
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Connor AE, Kaur M, Dibble KE, Visvanathan K, Dean LT, Hayes JH. Racialized Economic Segregation and Breast Cancer Mortality among Women in Maryland. Cancer Epidemiol Biomarkers Prev 2022; 31:413-421. [PMID: 34862211 PMCID: PMC8825681 DOI: 10.1158/1055-9965.epi-21-0923] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/11/2021] [Accepted: 12/01/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Our objective was to determine the association between racialized economic segregation and the hazard of breast cancer mortality in Maryland. METHODS Among 35,066 women (24,540 White; 10,526 Black) diagnosed with incident invasive breast cancer in Maryland during 2007 to 2017, exposure to racialized economic segregation was measured at the census tract level using Index of Concentration at the Extremes metrics. HRs and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression for the association between racialized economic segregation and the hazard of breast cancer mortality, accounting for clustering at the census tract level. Models were adjusted for age and stratified by race, median age (<60 years, ≥60 years), and clinical characteristics. RESULTS Overall, the hazard of breast cancer mortality was 1.84 times as high (95% CI, 1.64-2.06) for the least privileged quintile of racialized economic segregation compared with the most privileged quintile. This association differed significantly (P interaction< 0.05) by race and age, with 1.20 (95% CI, 0.90-1.60) times the hazard of breast cancer mortality for Black women versus 1.66 (95% CI, 1.41-1.95) times the hazard for White women, and with greater hazards for younger women (HR, 2.17; 95% CI, 1.83-2.57) than older women (HR, 1.62; 95% CI, 1.40-1.88). CONCLUSIONS Our results suggest that breast cancer survival disparities exist in Maryland among women residing in the least privileged census tracts with lower income households and higher proportions of Black residents. IMPACT Our findings provide new insights into the breast cancer mortality disparities observed among women in Maryland.
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Affiliation(s)
- Avonne E Connor
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
- The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Maneet Kaur
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kate E Dibble
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kala Visvanathan
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Lorraine T Dean
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland
| | - Jennifer H Hayes
- Maryland Cancer Registry and Prevention & Health Promotion Administration, Maryland Department of Health, Baltimore, Maryland
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16
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Oakley-Girvan I, Watterson JL, Jones C, Houghton LC, Gibbons MP, Gokal K, Magsamen-Conrad K. Use of Social Media for Cancer Prevention Through Neighborhood Social Cohesion: Protocol for a Feasibility Study. JMIR Res Protoc 2021; 10:e28147. [PMID: 34328445 PMCID: PMC8367166 DOI: 10.2196/28147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/11/2021] [Accepted: 06/09/2021] [Indexed: 12/17/2022] Open
Abstract
Background Social cohesion is associated with healthier behaviors and better health outcomes, and therefore may offer a mechanism for promoting better health. Low socioeconomic status (SES) communities face higher rates of chronic disease due to both community- and individual-level factors. Objective The aim of this study is to leverage social cohesion to promote healthier behaviors and prevent chronic disease in a low SES community. This protocol outlines the methodology for a pilot study to assess the feasibility of an intervention (Free Time For Wellness [FT4W]) using a social networking platform (Nextdoor) with mothers living in an urban, low-income community to improve social cohesion and promote healthy behaviors. Methods The study will involve three phases: (I) co-designing the intervention with mothers in the neighborhoods of interest, (II) implementing the intervention with community leaders through the social networking platform, and (III) evaluating the intervention’s feasibility. Phase I of the study will include qualitative data collection and analysis from in-depth, semistructured interviews and a co-design group session with mothers. Phases II and III of the study include a pre- and postintervention survey of participating mothers. Neighborhood-level data on social cohesion will also be collected to enable comparison of outcomes between neighborhoods with higher and lower baseline social cohesion. Results As of March 2021, recruitment and data collection for this study are complete. This protocol outlines our original study plan, although the final enrollment numbers and intervention implementation deviated from our initial planned methodology that is outlined in this protocol. These implementation learnings will be shared in subsequent publications of our study results. Conclusions Ultimately, this study aims to: (1) determine the barriers and facilitators to finding free time for wellness among a population of low-income mothers to inform the co-design process, and (2) implement and study the feasibility of an intervention that leverages social cohesion to promote physical activity in a community of low-income mothers. The results of this study will provide preliminary feasibility evidence to inform a larger effectiveness trial, and will further our understanding of how social cohesion might influence well-being. International Registered Report Identifier (IRRID) RR1-10.2196/28147
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Affiliation(s)
- Ingrid Oakley-Girvan
- Medable, Palo Alto, CA, United States.,The Data and Technology Proving Ground Program, The Public Health Institute, Oakland, CA, United States
| | - Jessica L Watterson
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia.,Center for Healthcare Organizational and Innovation Research, School of Public Health, University of California Berkeley, Berkeley, CA, United States
| | - Cheryl Jones
- Manchester Centre for Health Economics, The University of Manchester, Manchester, United Kingdom
| | - Lauren C Houghton
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.,Herbert Irving Comprehensive Cancer Center, New York, CA, United States
| | - Marley P Gibbons
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Kajal Gokal
- School of Sport, Exercise, and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, United Kingdom
| | - Kate Magsamen-Conrad
- Department of Communication Studies, The University of Iowa, Iowa City, IA, United States
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17
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Kim J, Gray JA, Johnson H. The Effect of a Web-Based Deep Breathing App on Stress of Direct Care Workers: Uncontrolled Intervention Study. J Altern Complement Med 2021; 27:876-883. [PMID: 34227854 DOI: 10.1089/acm.2020.0541] [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: 11/12/2022] Open
Abstract
Objectives: Studies have demonstrated success in reducing stress levels in complex interventions including deep breathing components. Breathing exercise interventions, however, tend not to be studied in isolation. The aim of the study was to examine the impact of a breathing exercise using a web-based app on the stress levels of direct care workers (DCWs) who serve people with intellectual and developmental disabilities. Design: Uncontrolled one-group intervention. Settings/Location: DCWs were recruited from intellectual and developmental disability service providers in a US Midwestern state. Subjects: Sixty-four DCWs who used the breathing exercise app at least 2 times. Interventions: Breathing exercise using a web-based app for a month. Outcome measures: Five measures were obtained from the data recorded in the app: initial stress level before exercise, exercise duration in minutes, change in stress level between before and after each breathing exercise, and frequency and number of days the app was used during a month. Participants' self-report of the number of days of app use was collected in a 1-month follow-up survey. Results: The participants appear to have a moderate stress level indicated by the initial stress level 5 out of 10. After the breathing exercise, the stress level decreased by 1.2 points from 5.0 (standard deviation [SD] = 1.8) to 3.7 (SD = 1.6) on average (paired t-test, p < 0.00005). Cohen's d 0.72 indicates a large effect size. Among within-individual factors, a higher initial stress level and longer app use per occasion were significantly associated with stress reduction. Among between-individual factors, only race was associated with stress reduction. Although there was no effect of being an African American alone on stress level change (coefficient = 0.44, 95% confidence interval = -0.29 to 1.18, p > 0.05), there was an additional reduction among African Americans in relation to the initial stress level, controlling for exercise duration. The number of breathing exercise days recorded in the app was not correlated with that of self-report (Pearson's correlation r = 0.12, p > 0.05). Although the app was used for 4.4 (SD = 4.2) days, participants reported using it for 10.7 (SD = 8.2) days on average in the follow-up survey. Conclusions: The findings suggest the benefit of breathing exercises using an app for reducing DCWs' stress levels. Regular use of such apps may assist with stress management and bolster overall health and well-being among DCWs.
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Affiliation(s)
- Jinsook Kim
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA
| | - Jennifer A Gray
- School of Health Studies, Northern Illinois University, DeKalb, IL, USA
| | - Hannah Johnson
- School of Health Professions, Concordia University Wisconsin, Mequon, WI, USA
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18
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Casanova F, Knaul FM, Rodriguez NM. Harvesting Health Knowledge: Breast Cancer Perceptions in the South Florida Latinx Farmworker Community. QUALITATIVE HEALTH RESEARCH 2021; 31:1423-1436. [PMID: 33834911 PMCID: PMC8277692 DOI: 10.1177/10497323211003542] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
South Florida agricultural regions, home to Latinx immigrant farmworkers, report higher rates of late-stage breast cancer diagnosis than national, state, and county-level averages. We conducted a community-based qualitative study on the needs, health knowledge gaps, barriers to breast cancer screening, and the role of community health workers (CHWs) in supporting the community's access to early detection services. We conducted three CHW focus groups (FGs) (n = 25) and in-depth interviews (n = 15), two FGs (n = 18) and in-depth interviews (n = 3) with farmworker community members, and informal interviews with cancer clinicians (n = 7). Using a grounded theory approach, five core themes regarding the community's barriers to accessing health care services emerged: (a) lack of information; (b) social and economic barriers; (c) cultural factors; (d) fears and mistrust; and (e) psychosocial concerns. Findings yield implications for community health practice, the potential impact of CHWs, and the production of breast cancer education to improve health equity along with the care continuum.
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19
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Takahashi N, Nakao M. Social-life factors associated with participation in screening and further assessment of colorectal cancer: A nationwide ecological study in Japanese municipalities. SSM Popul Health 2021; 15:100839. [PMID: 34189242 PMCID: PMC8215283 DOI: 10.1016/j.ssmph.2021.100839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 12/24/2022] Open
Abstract
The burden of colorectal cancer in developed countries is high, and it is a major public health concern in Japan. Improving the quality of evidence on colorectal cancer screening participation and further assessment participation rates is important to reduce this burden. This study examined the social-life factors that influence colorectal cancer screening programs in Japan, particularly the effects of the proportion of elderly people and social capital, using a municipality-level national database and existing health reports. Data from a national municipality-based study were analyzed to identify social-life factors associated with participation in colorectal cancer screening and further assessment. Administrative data on the Japanese municipal screening programs were drawn from the Report on Regional Public Health Services and Health Promotion Services 2017. Available data used as predictors of interest for all 1719 municipalities as of 2017 were from the national census, statistical reports on the land area by prefecture and municipality, municipal financial surveys, a survey of physicians, dentists and pharmacists, and other databases. The mean rate of participation in colorectal cancer screening was 13.8%, and that of further assessment was 73.6%. Multiple linear regression analyses of the two outcomes showed that the proportion of elderly people was most significantly positively associated with colorectal cancer screening programs (β = 0.51 for participation, β = 0.13 for further assessment participation), and the proportion of single-elderly-person households was most significantly negatively associated (β = −0.45 and −0.19, respectively). It is suggested that the health behaviors required for participation in colorectal cancer programs in Japanese elderly populations are greatly affected by family members. The disease burden of colorectal cancer is increasing in developed countries. An ecological study of the colorectal cancer screening program was conducted. The proportion of elderly people was positively associated with the screening rates. The single-elderly-person households was negatively associated with the screening rates.
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Affiliation(s)
- Noriaki Takahashi
- Division of Screening Assessment and Management, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Graduate School of Public Health, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo, 107-8402, Japan
| | - Mutsuhiro Nakao
- Graduate School of Public Health, International University of Health and Welfare, 4-1-26 Akasaka, Minato-ku, Tokyo, 107-8402, Japan.,Department of Psychosomatic Medicine, School of Medicine, International University of Health and Welfare, Hatakeda 852, Narita, Chiba, 286-8686, Japan
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20
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Gibbons J. Distancing the socially distanced: Racial/ethnic composition's association with physical distancing in response to COVID-19 in the U.S. PLoS One 2021; 16:e0251960. [PMID: 34038459 PMCID: PMC8153499 DOI: 10.1371/journal.pone.0251960] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/06/2021] [Indexed: 12/05/2022] Open
Abstract
Social distancing prescribed by policy makers in response to COVID-19 raises important questions as to how effectively people of color can distance. Due to inequalities from residential segregation, Hispanic and Black populations have challenges in meeting health expectations. However, segregated neighborhoods also support the formation of social bonds that relate to healthy behaviors. We evaluate the question of non-White distancing using social mobility data from Google on three sites: workplaces, grocery stores, and recreational locations. Employing hierarchical linear modeling and geographically weighted regression, we find the relation of race/ethnicity to COVID-19 distancing is varied across the United States. The HLM models show that compared to Black populations, Hispanic populations overall more effectively distance from recreation sites and grocery stores: each point increase in percent Hispanic was related to residents being 0.092 percent less likely (p< 0.05) to visit recreational sites and 0.127 percent less likely (p< 0.01) to visit grocery stores since the onset of COVID-19. However, the GWR models show there are places where the percent Black is locally related to recreation distancing while percent Hispanic is not. Further, these models show the association of percent Black to recreation and grocery distancing can be locally as strong as 1.057 percent (p< 0.05) and 0.989 percent (p< 0.05), respectively. Next, the HLM models identified that Black/White residential isolation was related to less distancing, with each point of isolation residents were 11.476 percent more likely (p< 0.01) to go to recreational sites and 7.493 percent more likely (p< 0.05) to visit grocery stores compared to before COVID-19. These models did not find a measurable advantage/disadvantage for Black populations in these places compared to White populations. COVID-19 policy should not assume disadvantage in achieving social distancing accrue equally to different racial/ethnic minorities.
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Affiliation(s)
- Joseph Gibbons
- Sociology, San Diego State University, San Diego, California, United States of America
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21
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Gu J, Zhu R. Social Capital and Self-Rated Health: Empirical Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239108. [PMID: 33291271 PMCID: PMC7729480 DOI: 10.3390/ijerph17239108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/25/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022]
Abstract
This study assesses the relationship between social capital and self-reported health (SRH) by comparing different genders and ages. It utilizes data from the 2016 China Family Panel Study data with a sample of 30,657 adult individuals from 25 provincial-level administrative regions in China. This was a cross-sectional study conducted with computer-assisted face-to-face interviews to assess social capital and self-rated health among Chinese adults. A multi-level Poisson regression model is employed to model social capital-related dependent variables using the independent variable of fair/poor health status. In terms of social relations, mobile phone use can improve men's health. However, this effect is insignificant for women. Moreover, gender and age interact with the relationship between social capital and individual health. The relationship between trust and self-rated health is not significantly different between men and women. The frequency of feeling lonely and the lack of feelings for the community in which they live have a negative impact on self-rated health, but there are no obvious differences in terms of gender. The number of meals per week with family members is negatively correlated with men's SRH, but there is no correlation with adult women 41 and above. Lack of help from neighbors is negatively correlated with men's health, but not with that of adult women 40 and below. Being a member of the Chinese Communist Party or a member of the Chinese Communist Youth League is positively correlated with SRH for women 60 and above.
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Affiliation(s)
- Jiafeng Gu
- Institute of Social Survey Study, Peking University, Beijing 100871, China
- Correspondence: ; Tel.: +86-186-181-464-98
| | - Ruiyu Zhu
- Antai College of Economics and Management, Shanghai Jiao Tong University, Shanghai 200030, China;
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Emerson MA, Golightly YM, Aiello AE, Reeder-Hayes KE, Tan X, Maduekwe U, Johnson-Thompson M, Olshan AF, Troester MA. Breast cancer treatment delays by socioeconomic and health care access latent classes in Black and White women. Cancer 2020; 126:4957-4966. [PMID: 32954493 DOI: 10.1002/cncr.33121] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/10/2020] [Accepted: 07/06/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Breast cancer mortality is higher for Black and younger women. This study evaluated 2 possible contributors to disparities-time to treatment and treatment duration-by race and age. METHODS Among 2841 participants with stage I-III disease in the Carolina Breast Cancer Study, we identified groups of women with similar patterns of socioeconomic status (SES), access to care, and tumor characteristics using latent class analysis. We then evaluated latent classes in association with treatment delay (initiation >60 days after diagnosis) and treatment duration (in quartiles by treatment modality). RESULTS Thirty-two percent of younger Black women were in the highest quartile of treatment duration (versus 22% of younger White women). Black women experienced a higher frequency of delayed treatment (adjusted relative frequency difference [RFD], 5.5% [95% CI, 3.2%-7.8%]) and prolonged treatment duration (RFD, 8.8% [95% CI, 5.7%-12.0%]). Low SES was significantly associated with treatment delay among White women (RFD, 3.5% [95% CI, 1.1%-5.9%]), but treatment delay was high at all levels of SES in Black women (eg, 11.7% in high SES Black women compared with 10.6% and 6.7% among low and high SES White women, respectively). Neither SES nor access to care classes were significantly associated with delayed initiation among Black women, but both low SES and more barriers were associated with treatment duration across both groups. CONCLUSIONS Factors that influence treatment timeliness persist throughout the care continuum, with prolonged treatment duration being a sensitive indicator of differences by race, SES, and care barriers.
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Affiliation(s)
- Marc A Emerson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Yvonne M Golightly
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Katherine E Reeder-Hayes
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Xianming Tan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ugwuji Maduekwe
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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23
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Gibbons J, Yang TC, Brault E, Barton M. Evaluating Residential Segregation's Relation to the Clustering of Poor Health across American Cities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3910. [PMID: 32492811 PMCID: PMC7312480 DOI: 10.3390/ijerph17113910] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 12/11/2022]
Abstract
Residential segregation by race/ethnicity is widely recognized as a leading source of health disparities. Not clear from past research, however, is the overall health burden cities face due to clustering brought about by segregation. This study builds on previous research by directly measuring how spatially unequal health outcomes are within segregated cities. Utilizing Census-tract data from the Center for Disease Control and Prevention's 500 Cities project, we examine how different dimensions of spatial segregation are associated with the clustering of poor self-rated health in cities. We make novel usage of the Global Moran's I statistic to measure the spatial clustering of poor health within cities. We find spatial segregation is associated with poor health clustering, however the race/ethnicity and dimension of segregation matter. Our study contributes to existing research on segregation and health by unpacking the localized associations of residential segregation with poor health clustering in U.S. cities.
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Affiliation(s)
- Joseph Gibbons
- Department of Sociology, San Diego State University, San Diego, CA 92182, USA
| | - Tse-Chuan Yang
- Department of Sociology, University at Albany, SUNY, Albany, NY 12222, USA;
| | - Elizabeth Brault
- Department of Sociology, Louisiana State University, Baton Rouge, LA 70802, USA; (E.B.); (M.B.)
| | - Michael Barton
- Department of Sociology, Louisiana State University, Baton Rouge, LA 70802, USA; (E.B.); (M.B.)
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24
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Bell CN, Owens-Young JL. Self-Rated Health and Structural Racism Indicated by County-Level Racial Inequalities in Socioeconomic Status: The Role of Urban-Rural Classification. J Urban Health 2020; 97:52-61. [PMID: 31898201 PMCID: PMC7010895 DOI: 10.1007/s11524-019-00389-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recent attention to the interrelationship between racism, socioeconomic status (SES) and health has led to a small, but growing literature of empirical work on the role of structural racism in population health. Area-level racial inequities in SES are an indicator of structural racism, and the associations between structural racism indicators and self-rated health are unknown. Further, because urban-rural differences have been observed in population health and are associated with different manifestations of structural racism, explicating the role of urban-rural classification is warranted. This study examined the associations between racial inequities in SES and self-rated health by county urban-rural classification. Using data from County Health Rankings and American Communities Surveys, black-white ratios of SES were regressed on rates of fair/poor health in U.S. counties. Racial inequities in homeownership were negatively associated with fair/poor health (β = -0.87, s.e. = 0.18), but racial inequities in unemployment were positively associated with fair/poor health (β = 0.03, s.e. = 0.01). The associations between structural racism and fair/poor health varied by county urban-rural classification. Potential mechanisms include the concentration of resources in racially segregated counties with high racial inequities that lead to better health outcomes, but are associated with extreme black SES disadvantage. Racial inequities in SES are a social justice imperative with implications for population health that can be targeted by urban-rural classification and other social contextual characteristics.
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Affiliation(s)
- Caryn N Bell
- Department of African American Studies, University of Maryland, College Park, MD, USA.
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25
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Guo Y, Cheng TC, Yun Lee H. Factors Associated with Adherence to Preventive Breast Cancer Screenings among Middle-aged African American Women. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:646-656. [PMID: 31411130 DOI: 10.1080/19371918.2019.1649226] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Medical and other health professionals recommend biyearly screening for breast cancer for women 40-74 years of age. However, the breast cancer screening rate of African American women aged 45 and up is lower than that of other ethnicities. The present study intended to identify factors impacting African American women's participation in breast cancer screening. This study is a longitudinal secondary data analysis of 3,911 African American participants of the Study of Women's Health Across the Nation. By using Systems Model of Clinical Preventive Care, multinomial logistic regression was applied to explore the likelihood of having breast cancer screenings (breast exam and/or mammogram) associating with predisposing factors, enabling factors, referencing factors, and situational factors. Participants with older age, with higher education, having a healthcare provider for female health, in far distance, and with a cancer(s) were significantly more likely to adhere to the recommendations of breast cancer screenings. However, participants who did not have time to visit doctors, did not trust the physicians, and who smoked regularly were significantly less likely to adhere to the recommendations of breast cancer screenings. Implications for policy and practice are discussed.
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Affiliation(s)
- Yuqi Guo
- School of Social Work, University of North Carolina at Charlotte , Charlotte , North Carolina , USA
| | - Tyrone C Cheng
- Department of Social Work and Human Services, Kennesaw State University , Kennesaw , Georgia , USA
| | - Hee Yun Lee
- School of Social Work, University of Alabama , Tuscaloosa , Alabama , USA
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26
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Ransome Y, Thurber KA, Swen M, Crawford ND, German D, Dean LT. Social capital and HIV/AIDS in the United States: Knowledge, gaps, and future directions. SSM Popul Health 2018; 5:73-85. [PMID: 29892697 PMCID: PMC5991916 DOI: 10.1016/j.ssmph.2018.05.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/30/2018] [Accepted: 05/23/2018] [Indexed: 11/15/2022] Open
Abstract
Purpose Social capital is a well-established predictor of several behavioral health outcomes. However, we know less about the relationship with prevention, transmission, and treatment of HIV/AIDS outcomes in the United States (US). Methods In 2017, we conducted a scoping review of empirical studies investigating the relationships between social capital and HIV/AIDS in the US by searching PubMed, Embase, PsycINFO, Web of Science, and Sociological Abstracts with no restriction on publication date, for articles in English language. Sample search terms included: HIV infections OR HIV OR AIDS OR acquired immunodeficiency syndrome OR human immunodeficiency virus AND social capital OR social control, informal OR social participation OR social cohesion OR generalized trust OR social trust OR collective efficacy OR community mob* OR civic participation. Results We identified 1581 unique manuscripts and reviewed 13 based on eligibility criteria. The earliest eligible study was published in 2003. More than half (n=7/13) focused on HIV or AIDS diagnosis, then prescribing ART and/or adherence (n=5/13), then linkage and or engagement in HIV care (n=4/13). Fifty eight percent (58%) documented a protective association between at least one social capital measure and an HIV/AIDS outcome. Seven studies used validated social capital scales, however there was substantial variation in conceptual/operational definitions and measures used. Most studies were based on samples from the Northeast. Three studies directly focused on or stratified analyses among subgroups or key populations. Studies were cross-sectional, so causal inference is unknown. Conclusion Our review suggests that social capital may be an important determinant of HIV/AIDS prevention, transmission, and treatment outcomes. We recommend future research assess these associations using qualitative and mixed-methods approaches, longitudinally, examine differences across subgroups and geographic region, include a wider range of social capital constructs, and examine indicators beyond HIV diagnosis, as well as how mechanisms like stigma link social capital to HIV/AIDS.
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Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, LEPH Rm 403, New Haven, CT 06510, USA
| | - Katherine A. Thurber
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Melody Swen
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Natalie D. Crawford
- Department of Behavioral Sciences and Health Education Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Danielle German
- Department of Health, Behavior and Society Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lorraine T. Dean
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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27
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Yang TC, Chen D. A multi-group path analysis of the relationship between perceived racial discrimination and self-rated stress: how does it vary across racial/ethnic groups? ETHNICITY & HEALTH 2018; 23:249-275. [PMID: 27852107 PMCID: PMC5589514 DOI: 10.1080/13557858.2016.1258042] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE The objective of this study was to answer three questions: (1) Is perceived discrimination adversely related to self-rated stress via the social capital and health care system distrust pathways? (2) Does the relationship between perceived discrimination and self-rated stress vary across race/ethnicity groups? and (3) Do the two pathways differ by one's race/ethnicity background? DESIGN Using the Philadelphia Health Management Corporation's Southeastern Pennsylvania Household Survey, we classified 9831 respondents into 4 race/ethnicity groups: non-Hispanic White (n = 6621), non-Hispanic Black (n = 2359), Hispanic (n = 505), and non-Hispanic other races (n = 346). Structural equation modeling was employed to simultaneously estimate five sets of equations, including the confirmatory factor analysis for both social capital and health care distrust and both direct and indirect effects from perceived discrimination to self-rated stress. RESULTS The key findings drawn from the analysis include the following: (1) in general, people who experienced racial discrimination have higher distrust and weaker social capital than those without perceived discrimination and both distrust and social capital are ultimately related to self-rated stress. (2) The direct relationship between perceived discrimination and self-rated stress is found for all race/ethnicity groups (except non-Hispanic other races) and it does not vary across groups. (3) The two pathways can be applied to non-Hispanic White and Black, but for Hispanic and non-Hispanic other races, we found little evidence for the social capital pathway. CONCLUSIONS For non-Hispanic White, non-Hispanic Black, and Hispanic, perceived discrimination is negatively related to self-rated stress. This finding highlights the importance of reducing interpersonal discriminatory behavior even for non-Hispanic White. The health care system distrust pathway can be used to address the racial health disparity in stress as it holds true for all four race/ethnicity groups. On the other hand, the social capital pathway seems to better help non-Hispanic White and Black to mediate the adverse effect of perceived discrimination on stress.
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Affiliation(s)
- Tse-Chuan Yang
- a Department of Sociology , Center for Social and Demographic Analysis, University at Albany, State University of New York , Albany , NY , USA
| | - Danhong Chen
- b Department of Agricultural Sciences and Engineering Technology , Sam Houston State University , Huntsville , TX , USA
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Zahnd WE, McLafferty SL. Contextual effects and cancer outcomes in the United States: a systematic review of characteristics in multilevel analyses. Ann Epidemiol 2017; 27:739-748.e3. [PMID: 29173579 DOI: 10.1016/j.annepidem.2017.10.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 08/19/2017] [Accepted: 10/02/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE There is increasing call for the utilization of multilevel modeling to explore the relationship between place-based contextual effects and cancer outcomes in the United States. To gain a better understanding of how contextual factors are being considered, we performed a systematic review. METHODS We reviewed studies published between January 1, 2002 and December 31, 2016 and assessed the following attributes: (1) contextual considerations such as geographic scale and contextual factors used; (2) methods used to quantify contextual factors; and (3) cancer type and outcomes. We searched PubMed, Scopus, and Web of Science and initially identified 1060 studies. One hundred twenty-two studies remained after exclusions. RESULTS Most studies utilized a two-level structure; census tracts were the most commonly used geographic scale. Socioeconomic factors, health care access, racial/ethnic factors, and rural-urban status were the most common contextual factors addressed in multilevel models. Breast and colorectal cancers were the most common cancer types, and screening and staging were the most common outcomes assessed in these studies. CONCLUSIONS Opportunities for future research include deriving contextual factors using more rigorous approaches, considering cross-classified structures and cross-level interactions, and using multilevel modeling to explore understudied cancers and outcomes.
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Affiliation(s)
- Whitney E Zahnd
- Office of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL; Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL.
| | - Sara L McLafferty
- Department of Geography and Geographic Information Science, University of Illinois Urbana-Champaign, Urbana, IL
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29
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Kim ES, Kawachi I. Perceived Neighborhood Social Cohesion and Preventive Healthcare Use. Am J Prev Med 2017; 53:e35-e40. [PMID: 28214249 PMCID: PMC5522638 DOI: 10.1016/j.amepre.2017.01.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/18/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Neighborhood social cohesion has been linked with better health and health behaviors, but its association with patterns of preventive healthcare use remains understudied. The hypothesis was that people with higher perceived neighborhood social cohesion would display increased use of preventive healthcare services. METHODS Participants (N=7,168) were drawn from the 2006 wave of the Health and Retirement Study-a prospective and nationally representative panel study of American adults aged >50 years-and tracked for one wave (2 years). Analyses were conducted in 2016. RESULTS After adjusting for sociodemographic factors and baseline health, each SD increase in neighborhood social cohesion was associated with a higher likelihood that people would obtain influenza vaccinations (OR=1.09, 95% CI=1.04, 1.15) or cholesterol tests (OR=1.10, 95% CI=1.02, 1.19). Further, women were more likely to receive mammograms/x-rays (OR=1.10, 95% CI=1.01, 1.19) or Pap tests (OR=1.08, 95% CI=1.00, 1.17). However, men were not more likely to receive prostate exams (OR=1.06, 95% CI=0.96, 1.17). CONCLUSIONS With additional research, findings from this study may inform the development of new strategies that increase the use of preventive healthcare services and enhance the quality of life among people moving through the ranks of this aging society.
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Affiliation(s)
- Eric S Kim
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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30
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Banas JR, Victorson D, Gutierrez S, Cordero E, Guitleman J, Haas N. Developing a Peer-to-Peer mHealth Application to Connect Hispanic Cancer Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:158-165. [PMID: 27364905 PMCID: PMC7770498 DOI: 10.1007/s13187-016-1066-6] [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: 06/06/2023]
Abstract
Cancer and its treatment can significantly impact health-related quality of life (HRQOL) (J Pain Symptom Manag 9 (3):186-192, 1994; Soc Sci Med 46:1569-1584, 1998), particularly for Hispanics (Healthcare Financ Rev 29 (4):23-40, 2008; Psycho-Oncology 21 (2):115-124, 2012). Moreover, providers of cancer support for this population may encounter unique challenges. Grounded in social capital theory, this study identified Spanish-speaking, Hispanic breast cancer survivor support needs and preferences for a mHealth intervention. A user-centered, community-engaged research design was employed, consisting of focus groups made up of constituents from a local Hispanic-serving, cancer support organization. Focus group audio-recordings, translated into English, were coded using a grounded theory analytic approach. First, lead researchers read the complete transcripts to obtain a general sense of the discussion. Next, coding rules were established (e.g., code at the most granular level; double and triple code if necessary, code exhaustively) and initial codebook was created through open-coding. Three new coders were trained to establish requisite kappa statistic levels (≥.70) for inter-rater reliability. With training and discussion, kappa estimates reached .81-.88. Focus group (n = 31) results revealed a mHealth intervention targeting Hispanic cancer patients should not only offer information and support on disease/treatment effects but also respond to the individual's HRQOL, particularly emotional and social challenges. Specifically, participants expressed a strong desire for Spanish content and to connect with others who had gone through a similar experience. Overall, participants indicated they would have access to and would use such an intervention. Findings indicate positive support for a mHealth tool, which is culturally tailored to Spanish speakers, is available in Spanish, and connects cancer patients with survivors.
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Affiliation(s)
- Jennifer R Banas
- Department of Health, Physical Education, Recreation, and Athletics, Northeastern Illinois University, 5500 North St. Louis Avenue, Chicago, IL, 60625, USA.
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sandra Gutierrez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Evelyn Cordero
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Judy Guitleman
- ALAS-WINGS Latina Cancer Support Organization, Chicago, IL, USA
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31
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Ransome Y, Kawachi I, Dean LT. Neighborhood Social Capital in Relation to Late HIV Diagnosis, Linkage to HIV Care, and HIV Care Engagement. AIDS Behav 2017; 21:891-904. [PMID: 27752875 PMCID: PMC5306234 DOI: 10.1007/s10461-016-1581-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
High neighborhood social capital could facilitate earlier diagnosis of HIV and higher rates of linkage and HIV care engagement. Multivariate analysis was used to examine whether social capital (social cohesion, social participation, and collective engagement) in 2004/2006 was associated with lower 5-year average (2007-2011) prevalence of (a) late HIV diagnosis, (b) linked to HIV care, and (c) engaged in HIV care within Philadelphia, PA, United States. Census tracts (N = 332). Higher average neighborhood social participation was associated with higher prevalence of late HIV diagnosis (b = 1.37, se = 0.32, p < 0.001), linked to HIV care (b = 1.13, se = 0.20, p < 0.001) and lower prevalence of engaged in HIV care (b = -1.16, se = 0.30, p < 0.001). Higher collective engagement was associated with lower prevalence of linked to HIV care (b = -0.62, se = 0.32, p < 0.05).The findings of different directions of associations among social capital indicators and HIV-related outcomes underscore the need for more nuanced research on the topic that include longitudinal assessment across key populations.
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Affiliation(s)
- Yusuf Ransome
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge 7th Floor, Boston, MA, 02115, USA.
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge 7th Floor, Boston, MA, 02115, USA
| | - Lorraine T Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Abstract
There exists controversy as to the impact gentrification of cities has on the well-being of minorities. Some accuse gentrification of causing health disparities for disadvantaged minority populations residing in neighborhoods that are changing as a result of these socioeconomic shifts. Past scholarship has suggested that fears of displacement and social isolation associated with gentrification lead to poorer minority health. However, there is a lack of research that directly links gentrification to minority health outcomes. We address this gap with individual data from the 2008 Philadelphia Health Management Corporation's Southeastern Pennsylvania Household Health Survey and census tract data from the 2000 Decennial Census and the 2006-2010 American Community Survey. We implement logistic multilevel models to determine whether and how a resident's self-rated health is affected by gentrification of their neighborhoods. We find that while gentrification does have a marginal effect improving self-rated health for neighborhood residents overall, it leads to worse health outcomes for Blacks. Accounting for racial change, while gentrification leading to increases in White population has no measurable effect on minority health, "Black gentrification" leads to marginally worse health outcomes for Black respondents. These results demonstrate the limitations that improvements of neighborhood socioeconomic character have in offsetting minority health disparities.
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Affiliation(s)
- Joseph Gibbons
- Department of Sociology, San Diego State University, San Diego, CA USA
| | - Michael S. Barton
- Department of Sociology, Louisiana State University, Baton Rouge, LA USA
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Gibbons J, Schiaffino MK. Determining the spatial heterogeneity underlying racial and ethnic differences in timely mammography screening. Int J Health Geogr 2016; 15:39. [PMID: 27825351 PMCID: PMC5101650 DOI: 10.1186/s12942-016-0067-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 10/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The leading cause of cancer death for women worldwide continues to be breast cancer. Early detection through timely mammography has been recognized to increase the probability of survival. While mammography rates have risen for many women in recent years, disparities in screening along racial/ethnic lines persist across nations. In this paper, we argue that the role of local context, as identified through spatial heterogeneity, is an unexplored dynamic which explains some of the gaps in mammography utilization by race/ethnicity. METHODS We apply geographically weighted regression methods to responses from the 2008 Public Health Corporations' Southeastern Household Health Survey, to examine the spatial heterogeneity in mammograms in the Philadelphia metropolitan area. RESULTS We find first aspatially that minority identity, in fact, increases the odds of a timely mammogram: 74% for non-Hispanic Blacks and 80% for Hispanic/Latinas. However, the geographically weighted regression confirms the relation of race/ethnicity to mammograms varies by space. Notably, the coefficients for Hispanic/Latinas are only significant in portions of the region. In other words, the increased odds of a timely mammography we found are not constant spatially. Other key variables that are known to influence timely screening, such as the source of healthcare and social capital, measured as community connection, also vary by space. CONCLUSIONS These results have ramifications globally, demonstrating that the influence of individual characteristics which motivate, or inhibit, cancer screening may not be constant across space. This inconsistency calls for healthcare practitioners and outreach services to be mindful of the local context in their planning and resource allocation efforts.
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Affiliation(s)
- Joseph Gibbons
- Department of Sociology Health, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182-4493 USA
| | - Melody K. Schiaffino
- Graduate School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182-4493 USA
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Calo WA, Vernon SW, Lairson DR, Linder SH. Area-level Socioeconomic Inequalities in the Use of Mammography Screening: A Multilevel Analysis of the Health of Houston Survey. Womens Health Issues 2016; 26:201-7. [PMID: 26809487 DOI: 10.1016/j.whi.2015.11.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/21/2015] [Accepted: 11/11/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND An emerging literature reports that women who reside in socioeconomically deprived communities are less likely to adhere to mammography screening. This study explored associations between area-level socioeconomic measures and mammography screening among a racially and ethnically diverse sample of women in Texas. METHODS We conducted a cross-sectional, multilevel study linking individual-level data from the 2010 Health of Houston Survey and contextual data from the U.S. Census. Women ages 40 to 74 years (n = 1,541) were included in the analyses. We examined tract-level poverty, unemployment, education, Hispanic and Black composition, female-headed householder families, and crowding as contextual measures. Using multilevel logistic regression modeling, we compared most disadvantaged tracts (quartiles 2-4) to the most advantaged tract (quartile 1). RESULTS Overall, 64% of the sample was adherent to mammography screening. Screening rates were lower (p < .05) among Hispanics, those foreign born, women aged 40 to 49 years, and those with low educational attainment, unemployed, and without health insurance coverage. Women living in areas with high levels of poverty (quartile 2 vs. 1: odds ratio [OR], 0.50; 95% CI, 0.30-0.85), Hispanic composition (quartile 3 vs. 1: OR, 0.54; 95% CI, 0.32-0.90), and crowding (quartile 4 vs. 1: OR, 0.53; 95% CI, 0.29-0.96) were less likely to have up-to-date mammography screening, net of individual-level factors. CONCLUSION Our findings highlight the importance of examining area-level socioeconomic inequalities in mammography screening. The study represents an advance on previous research because we examined multiple area measures, controlled for key individual-level covariates, used data aggregated at the tract level, and accounted for the nested structure of the data.
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Affiliation(s)
- William A Calo
- Department of Management, Policy and Community Health, The University of Texas School of Public Health, Houston, Texas.
| | - Sally W Vernon
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, Houston, Texas
| | - David R Lairson
- Center for Health Services Research, The University of Texas School of Public Health, Houston, Texas
| | - Stephen H Linder
- Institute for Health Policy, The University of Texas School of Public Health, Houston, Texas
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Perceptions of One's Neighborhood and Mammogram Use among a Sample of Low-Income Women at Risk for Human Immunodeficiency Virus and Sexually Transmitted Infections. Womens Health Issues 2015; 26:196-200. [PMID: 26391228 DOI: 10.1016/j.whi.2015.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 08/11/2015] [Accepted: 08/13/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Neighborhood disorder, signs of physical and social disorganization, has been related to a range of poor mental and physical health outcomes. Although individual factors have been widely associated with getting a mammogram, little is known about the impact of the neighborhood environment on a woman's decision to get a mammogram. METHODS In a sample of women at risk for human immunodeficiency virus and sexually transmitted infections, we explored the role of perceptions of one's neighborhood on getting a mammogram. The study included two samples: women 40 to 49 years (n = 233) and women 50 years and older (n = 83). Data were collected from May 2006 through June 2008. RESULTS Women age 50 years and older who lived in a neighborhood with disorder were 72% less likely to get a mammogram compared with women who lived in neighborhoods without disorder. There was no relationship for women age 40 to 49 years. CONCLUSIONS Interventions are needed to increase awareness and encourage women living in neighborhoods with disorder to get a mammogram. In addition to interventions to increase mammography, programs are needed to decrease neighborhood disorder. Increasing neighborhood cohesion, social control, and empowerment could integrate health promotion programs to both reduce disorder and increase health behaviors.
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Dean LT, Hillier A, Chau-Glendinning H, Subramanian SV, Williams DR, Kawachi I. Can you party your way to better health? A propensity score analysis of block parties and health. Soc Sci Med 2015; 138:201-9. [PMID: 26117555 DOI: 10.1016/j.socscimed.2015.06.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
While other indicators of social capital have been linked to health, the role of block parties on health in Black neighborhoods and on Black residents is understudied. Block parties exhibit several features of bonding social capital and are present in nearly 90% of Philadelphia's predominantly Black neighborhoods. This analysis investigated: (1) whether or not block parties are an indicator of bonding social capital in Black neighborhoods; (2) the degree to which block parties might be related to self-rated health in the ways that other bonding social indicators are related to health; and (3) whether or not block parties are associated with average self-rated health for Black residents particularly. Using census tract-level indicators of bonding social capital and records of block parties from 2003 to 2008 for 381 Philadelphia neighborhoods (defined by census tracts), an ecological-level propensity score was generated to assess the propensity for a block party, adjusting for population demographics, neighborhood characteristics, neighborhood resources and violent crime. Results indicate that in multivariable regression, block parties were associated with increased bonding social capital in Black neighborhoods; however, the calculation of the average effect of the treatment on the treated (ATT) within each propensity score strata showed no effect of block parties on average self-rated health for Black residents. Block parties may be an indicator of bonding social capital in Philadelphia's predominantly Black neighborhoods, but this analysis did not show a direct association between block parties and self-rated health for Black residents. Further research should consider what other health outcomes or behaviors block parties may be related to and how interventionists can leverage block parties for health promotion.
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Affiliation(s)
- Lorraine T Dean
- University of Pennsylvania School of Medicine, Department of Biostatistics and Epidemiology, 909 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA.
| | - Amy Hillier
- University of Pennsylvania, School of Design, 102 Meyerson Hall, 210 South 34th Street, Philadelphia, PA 19104, USA.
| | - Hang Chau-Glendinning
- Valley Medical Center, Department of Family Medicine, 3915 Talbot Rd South, Suite 401, Renton, WA 98055, USA.
| | - S V Subramanian
- Harvard School of Public Health, Department of Social and Behavioral Sciences, 7th Floor, 677 Huntington Ave, Boston, MA 02115, USA.
| | - David R Williams
- Harvard School of Public Health, Department of Social and Behavioral Sciences, 6th Floor, 677 Huntington Ave, Boston, MA 02115, USA.
| | - Ichiro Kawachi
- Harvard School of Public Health, Department of Social and Behavioral Sciences, 7th Floor, 677 Huntington Ave, Boston, MA 02115, USA.
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