1
|
Cundiff JM, Lin SSH, Faulk RD, McDonough IM. Educational quality may be a closer correlate of cardiometabolic health than educational attainment. Sci Rep 2022; 12:18105. [PMID: 36302824 PMCID: PMC9613691 DOI: 10.1038/s41598-022-22666-3] [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: 07/12/2022] [Accepted: 10/18/2022] [Indexed: 12/30/2022] Open
Abstract
Educational quality may be a closer correlate of physical health than more commonly used measures of educational attainment (e.g., years in school). We examined whether a widely-used performance-based measure of educational quality is more closely associated with cardiometabolic health than educational attainment (highest level of education completed), and whether perceived control (smaller sample only), executive functioning (both samples), and health literacy (smaller sample only) link educational quality to cardiometabolic health. In two samples (N = 98 and N = 586) collected from different regions of the US, educational quality was associated with cardiometabolic health above and beyond educational attainment, other demographic factors (age, ethnoracial category, sex), and fluid intelligence. Counter to expectations, neither perceived control, executive function, nor health literacy significantly mediated the association between educational quality and cardiometabolic health. Findings add to the growing literature suggesting that current operationalizations of the construct of education likely underestimate the association between education and multiple forms of health. To the extent that educational programs may have been overlooked based on the apparent size of associations with outcomes, such actions may have been premature.
Collapse
Affiliation(s)
- Jenny M. Cundiff
- grid.411015.00000 0001 0727 7545University of Alabama, Tuscaloosa, AL USA
| | - Shayne S.-H. Lin
- grid.411015.00000 0001 0727 7545University of Alabama, Tuscaloosa, AL USA
| | - Robert D. Faulk
- grid.411015.00000 0001 0727 7545University of Alabama, Tuscaloosa, AL USA
| | - Ian M. McDonough
- grid.411015.00000 0001 0727 7545University of Alabama, Tuscaloosa, AL USA
| |
Collapse
|
2
|
Wong MS, Upchurch DM, Steers WN, Haderlein TP, Yuan AT, Washington DL. The Role of Community-Level Factors on Disparities in COVID-19 Infection Among American Indian/Alaska Native Veterans. J Racial Ethn Health Disparities 2022; 9:1861-1872. [PMID: 34491563 PMCID: PMC8422953 DOI: 10.1007/s40615-021-01123-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES American Indian and Alaska Native (AI/AN) communities have been disproportionately affected by the coronavirus disease 2019 (COVID-19) pandemic. This study examines whether neighborhood characteristics mediate AI/AN versus White-non-Hispanic Veteran COVID-19 infection disparities, and whether mediation differs based on proximity to reservations. METHODS Using Veteran Health Administration's (VHA) national database of VHA users evaluated for COVID-19 infection (3/1/2020-8/25/2020), we examined whether census tract neighborhood characteristics (percent households overcrowded, without complete plumbing, without kitchen plumbing, and neighborhood socioeconomic status [n-SES]) mediated racial disparities in COVID-19 infection, using inverse odds-weighted logistic models controlling for individual-level characteristics. Using moderated mediation analyses, we assessed whether neighborhood mediating effects on disparities differed for those residing in counties containing/near federally recognized tribal lands (i.e., Contract Health Service Delivery Area [CHSDA] counties) versus not. RESULTS The percent of households without complete plumbing, percent without kitchen plumbing, and n-SES partially mediated AI/AN-White-non-Hispanic COVID-19 infection disparities (accounting for 17-35% of disparity) to a similar extent in CHSDA and non-CHSDA counties. The percent of households without kitchen plumbing had stronger mediating effects for CHSDA than non-CHSDA residents. CONCLUSIONS Neighborhood-level social determinants of health may contribute to the disproportionate COVID-19 infection burden on AI/ANs; differences are exacerbated among AI/ANs living near reservations.
Collapse
Affiliation(s)
- Michelle S Wong
- VA HSR&D Center for, the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
| | - Dawn M Upchurch
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - W Neil Steers
- VA HSR&D Center for, the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Taona P Haderlein
- VA HSR&D Center for, the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Anita T Yuan
- VA HSR&D Center for, the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Donna L Washington
- VA HSR&D Center for, the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California Los Angeles Geffen School of Medicine, Los Angeles, CA, USA
| |
Collapse
|
3
|
Gao Z, Liu C, Yang L, Mei X, Wei X, Kuang J, Zhou K, Xu M. Longitudinal Association Between Depressive Symptoms and Cognitive Function Among Older Adults: A Latent Growth Curve Modeling Approach. Int J Public Health 2022; 67:1605124. [PMID: 36213141 PMCID: PMC9537360 DOI: 10.3389/ijph.2022.1605124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/08/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives: Although the evidence from numerous longitudinal studies has indicated a remarkable change in cognitive function (CF) and depressive symptoms (DS) over time, the parallel latent growth curve model (LGCM) has seldom been used to simultaneously investigate the relationship between their change trajectories. This study aimed to examine whether a change in DS was associated with CF over time using an LGCM. Methods: Data were collected from the Chinese Longitudinal Healthy Longevity Survey’s 2011, 2014, and 2018 waves. A parallel LGCM examined the association between CF and DS. Results: The multivariate conditioned model’s goodness of fit supported the validity of the longitudinal model (Tucker-Lewis index [TLI] = 0.90, comparative fit index [CFI] = 0.96, root mean square error of approximation [RMSEA] = 0.04). The results showed that the CF intercept was positively to the DS slope (β = 0.42, p = 0.004). The CF and DS slopes were significantly linked (β = −0.65, p = 0.002). Conclusion: The findings expand the knowledge about CF’s effect on DS in older adults.
Collapse
Affiliation(s)
- Zihan Gao
- School of Nursing, Qingdao University, Qingdao, China
| | - Cuiping Liu
- School of Nursing, Qingdao University, Qingdao, China
| | - Li Yang
- School of Nursing, Qingdao University, Qingdao, China
- *Correspondence: Li Yang,
| | - Xinyi Mei
- School of Nursing, Wuhan University of Science and Technology, Wuhan, China
| | - Xiao Wei
- School of Nursing, Qingdao University, Qingdao, China
| | - Jinke Kuang
- School of Nursing, Qingdao University, Qingdao, China
| | - Kexin Zhou
- School of Nursing, Qingdao University, Qingdao, China
| | - Mengfan Xu
- School of Nursing, Qingdao University, Qingdao, China
| |
Collapse
|
4
|
Tehrani H, Vali M, Nejatian M, Moshki M, Charoghchian Khorasani E, Jafari A. The status of depression literacy and its relationship with quality of life among Iranian public population: a cross sectional study. BMC Psychiatry 2022; 22:607. [PMID: 36100889 PMCID: PMC9472397 DOI: 10.1186/s12888-022-04251-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 09/08/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study was designed and conducted to determine the status of depression literacy (D-Lit) and its relationship with the quality of life across the Iranian population. METHODS This cross-sectional study was conducted in 2020 among 1382 participating from the general population in Gonabad, Iran. Participants were selected and recruited using a multistage sampling method. Data were collected using three sets of questionnaires (demographic section, D-Lit scale, and quality of life questionnaire). Data were analyzed by SPSS software version 24 and using independent samples t- test, Chi-square test, One-way ANOVA, and Pearson correlation. RESULTS Based on the results, the mean (± standard deviation) of D-Lit and quality of life were 44.14 (± 4.69) and 35.81 (± 5.17), respectively. Based on the results of Pearson correlation coefficient, there was a significant positive correlation between D-Lit and quality of life (r = 0.104, p < 0.001). D-Lit was significantly higher in those who reported having consulted with a psychiatrist compared with those who did not (p < 0.001). Participants with a family history of mental illness and those whose family members were referred to a psychologist for psychological issues had significantly higher levels of D-Lit than others (p < 0.001). CONCLUSION Based on the results of this study, some D-Lit projects should be improved. Also, the results revealed that D-Lit is a potential factor that can affect people's mental health status and enhance their quality of life. Therefore, it is necessary to develop appropriate educational programs to enhance D-Lit in the community and ultimately improve the quality of life in the community by reducing mental illness.
Collapse
Affiliation(s)
- Hadi Tehrani
- grid.411583.a0000 0001 2198 6209Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohebat Vali
- grid.412571.40000 0000 8819 4698Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahbobeh Nejatian
- grid.411924.b0000 0004 0611 9205Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Moshki
- grid.411924.b0000 0004 0611 9205Department of Health Education and Health Promotion, School of Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Elham Charoghchian Khorasani
- grid.411583.a0000 0001 2198 6209Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
| |
Collapse
|
5
|
WHODAS Assessment Feasibility and Mental Health Impact on Functional Disability in Systemic Lupus Erythematosus. Healthcare (Basel) 2022; 10:healthcare10061053. [PMID: 35742104 PMCID: PMC9222861 DOI: 10.3390/healthcare10061053] [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: 05/17/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023] Open
Abstract
Systemic lupus erythematosus (SLE), besides rheumatological dysfunction, manifests in neuropsychiatric disorders like depression and anxiety. Mental health illnesses in SLE patients have a high prevalence and a profound impact on quality of life, generating an increased disability and premature mortality. This study aimed to establish the degree of disability in patients with SLE and the impact of depression and anxiety on patients’ functioning. Additionally, the study aimed to verify whether World Health Organization-Disability Assessment Schedule (WHODAS) 2.0 is suitable for the evaluation of patients with SLE associating depression and/or anxiety symptoms. Cross-sectional research was performed, including adult patients, diagnosed with SLE. To evaluate depression, anxiety, and functioning, approved questionnaires Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and, World Health Organization-Disability Assessment Schedule (WHODAS) were applied. Confirmatory factor analysis was performed on WHODAS subscales. Sixty-two patients were included in the research, with a mean of SLE diagnosis of 12.48 years; 53 patients (85%) had depression (p < 0.001). Anxiety was found in 38 patients (61.29%, p < 0.05). WHODAS assessment results depicted that 39 patients (62.90%, p < 0.05) manifested disability, from which 26 (66.66%, p < 0.05) presented moderate and severe disability. A strong correlation between the severity of anxiety and the degree of disability (r > 0.6, p < 0.001) was found. The WHODAS scale assessment proved to be a valuable tool for SLE patient’s functioning assessment. This study suggests that depression and anxiety negatively impact WHODAS disability scores, decreasing the quality of life in SLE patients.
Collapse
|
6
|
Yelton B, Friedman DB, Noblet S, Lohman MC, Arent MA, Macauda MM, Sakhuja M, Leith KH. Social Determinants of Health and Depression among African American Adults: A Scoping Review of Current Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031498. [PMID: 35162519 PMCID: PMC8834771 DOI: 10.3390/ijerph19031498] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023]
Abstract
Depression in the United States (US) is increasing across all races and ethnicities and is attributed to multiple social determinants of health (SDOH). For members of historically marginalized races and ethnicities, depression is often underreported and undertreated, and can present as more severe. Limited research explores multiple SDOH and depression among African American adults in the US. Guided by Healthy People (HP) 2030, and using cross-disciplinary mental health terminology, we conducted a comprehensive search to capture studies specific to African American adults in the US published after 2016. We applied known scoping review methodology and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. From 12,315 initial results, 60 studies were included in our final sample. Most studies explored the HP 2030 Social and Community Context domain, with a heavy focus on discrimination and social support; no studies examined Health Care Access and Quality. Researchers typically utilized cross-sectional, secondary datasets; no qualitative studies were included. We recommend research that comprehensively examines mental health risk and protective factors over the life course within, not just between, populations to inform tailored health promotion and public policy interventions for improving SDOH and reducing racial and ethnic health disparities.
Collapse
Affiliation(s)
- Brooks Yelton
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (B.Y.); (S.N.); (M.A.A.); (M.M.M.); (M.S.); (K.H.L.)
| | - Daniela B. Friedman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (B.Y.); (S.N.); (M.A.A.); (M.M.M.); (M.S.); (K.H.L.)
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA;
- Correspondence:
| | - Samuel Noblet
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (B.Y.); (S.N.); (M.A.A.); (M.M.M.); (M.S.); (K.H.L.)
- Prevention Research Center, Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Matthew C. Lohman
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA;
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Michelle A. Arent
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (B.Y.); (S.N.); (M.A.A.); (M.M.M.); (M.S.); (K.H.L.)
| | - Mark M. Macauda
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (B.Y.); (S.N.); (M.A.A.); (M.M.M.); (M.S.); (K.H.L.)
- Center for Applied Research and Evaluation, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
| | - Mayank Sakhuja
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (B.Y.); (S.N.); (M.A.A.); (M.M.M.); (M.S.); (K.H.L.)
| | - Katherine H. Leith
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; (B.Y.); (S.N.); (M.A.A.); (M.M.M.); (M.S.); (K.H.L.)
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA;
| |
Collapse
|
7
|
Muñoz IG, Santos-Lozada AR. Educational Attainment and Psychological Distress Among Working-Age Adults in the United States. SSM - MENTAL HEALTH 2021; 1:100003. [PMID: 38571576 PMCID: PMC10989279 DOI: 10.1016/j.ssmmh.2021.100003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
This study builds on a growing body of literature analyzing the education-health gradient across detailed educational categories, which documents that US working-age adults who attended college but did not earn a bachelor's degree report equal or worse health than adults with a high school diploma. This is known as the "anomaly" in the education-health gradient. The purpose of this study is to test whether this pattern extends to measures of serious psychological distress (SPD) and individual symptoms by using data from the National Health Interview Survey (NHIS, 1997-2018) and a series of logistic regression models. We find that the anomaly in the education-health gradient is present for a summary measure of SPD as well as for five of the six symptoms that make up this measure. The exception was reporting feeling sad most or all the time during the last month, where adults with "some college" were found to have lower odds than those with a high school diploma. Further stratified analysis by sex revealed that this result for feeling sad was driven by women. In terms of associate degrees, our models show that adults with a vocational/technical associate degree have statically similar odds of SPD and reporting four out of six symptoms (exceptions were feeling hopeless and sadness), while those with an academic associate degree have significantly lower odds in all outcomes. The robustness of the models used is supported by an extensive sensitivity analysis. Overall, we find evidence of the anomaly in the education-health gradient in SPD and individual symptoms of psychological distress at the sub-baccalaureate level, adding to previous studies that document the anomaly in markers of physiological dysregulation, health conditions, vision problems, functional limitations, and pain.
Collapse
Affiliation(s)
- Ismael G. Muñoz
- Department of Education Policy Studies, Pennsylvania State University
- Population Research Institute, Pennsylvania State University
| | - Alexis R. Santos-Lozada
- Population Research Institute, Pennsylvania State University
- Department of Human Development and Family Studies, Pennsylvania State University
| |
Collapse
|
8
|
Shih TY, Cheng SL, Chang SH, Sun HF. Perceived social support and depression symptoms in patients with major depressive disorder in Taiwan: An association study. Arch Psychiatr Nurs 2020; 34:384-390. [PMID: 33032762 DOI: 10.1016/j.apnu.2020.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/21/2020] [Accepted: 06/02/2020] [Indexed: 11/16/2022]
Abstract
This study analyzes the association between social support and depression symptoms of inpatients with major depressive disorder. A total of 160 inpatients were recruited from the acute psychiatric ward of a medical center in northern Taiwan between July 1, 2015, and December 31, 2016. Data were analyzed using descriptive statistics, simple linear regression and multiple linear regression. Our results reveal that patient depression level is significantly associated with gender, age, marital status, education, occupation and number of admissions due to depression. Social support is significantly associated with marital status and number of admissions due to depression. The depression symptoms of the patients were significantly and negatively associated with overall perceived social support and perceived social support from family, friends and a significant other. These results could serve as a reference for the clinical practice of clinical specialists and argue for the inclusion of social support as an intervention for patients with depression.
Collapse
Affiliation(s)
| | - Shu-Li Cheng
- Department of Nursing, Mackay Medical College, Taiwan, ROC
| | - Shu-Hui Chang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan, ROC
| | - Huey-Fang Sun
- School of Nursing, National Defense Medical Center, Taiwan, ROC.
| |
Collapse
|
9
|
Cohen AK, Nussbaum J, Weintraub MLR, Nichols CR, Yen IH. Association of Adult Depression With Educational Attainment, Aspirations, and Expectations. Prev Chronic Dis 2020; 17:E94. [PMID: 32857033 PMCID: PMC7478148 DOI: 10.5888/pcd17.200098] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction Social factors across one’s lifespan may contribute to the relationship between low educational attainment and depression, but this relationship has been understudied. Previous studies assessing the association between educational attainment and depression did not fully account for prior common determinants across the life course and possible interactions by sex or race/ethnicity. It is also unclear whether the link between educational attainment and depression is independent of the role of aspired educational attainment or expected educational attainment. Methods We used generalized linear log link models to examine the association between educational attainment at age 25 and depression at age 40 in the National Longitudinal Survey of Youth 1979 cohort, adjusting for confounders and mediators from childhood, adolescence, and adulthood. Results Members of each educational attainment group were less likely to be depressed at age 40 than those with less education. After adjusting for educational aspirations and educational expectations, the risk ratios became closer to the null. Neither sex nor race/ethnicity interacted with educational attainment. Additionally, low educational expectations in adolescence, but not low educational aspirations, was associated with a higher risk of depression at age 40. Conclusion Our study provides a nuanced understanding of the role of education, educational expectations, and educational aspirations as part of education’s effect on risk of depression after controlling for a thorough set of confounders and mediators. Our findings may help advance the study of social determinants of depression.
Collapse
Affiliation(s)
- Alison K Cohen
- Department of Public and Nonprofit Administration, School of Management, University of San Francisco, 2130 Fulton Street, San Francisco, CA, 94117.
| | - Juliet Nussbaum
- School of Public Health, University of California, Berkeley, Berkeley, California
| | | | - Chloe R Nichols
- Department of Public and Nonprofit Administration, School of Management, University of San Francisco, San Francisco, California
| | - Irene H Yen
- Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, California
| |
Collapse
|
10
|
Kino S, Kawachi I. How much do preventive health behaviors explain education- and income-related inequalities in health? Results of Oaxaca–Blinder decomposition analysis. Ann Epidemiol 2020; 43:44-50. [DOI: 10.1016/j.annepidem.2020.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/09/2020] [Accepted: 01/16/2020] [Indexed: 11/17/2022]
|
11
|
Hamad R, Nguyen TT, Bhattacharya J, Glymour MM, Rehkopf DH. Educational attainment and cardiovascular disease in the United States: A quasi-experimental instrumental variables analysis. PLoS Med 2019; 16:e1002834. [PMID: 31237869 PMCID: PMC6592509 DOI: 10.1371/journal.pmed.1002834] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/21/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There is ongoing debate about whether education or socioeconomic status (SES) should be inputs into cardiovascular disease (CVD) prediction algorithms and clinical risk adjustment models. It is also unclear whether intervening on education will affect CVD, in part because there is controversy regarding whether education is a determinant of CVD or merely correlated due to confounding or reverse causation. We took advantage of a natural experiment to estimate the population-level effects of educational attainment on CVD and related risk factors. METHODS AND FINDINGS We took advantage of variation in United States state-level compulsory schooling laws (CSLs), a natural experiment that was associated with geographic and temporal differences in the minimum number of years that children were required to attend school. We linked census data on educational attainment (N = approximately 5.4 million) during childhood with outcomes in adulthood, using cohort data from the 1992-2012 waves of the Health and Retirement Study (HRS; N = 30,853) and serial cross-sectional data from 1971-2012 waves of the National Health and Nutrition Examination Survey (NHANES; N = 44,732). We examined self-reported CVD outcomes and related risk factors, as well as relevant serum biomarkers. Using instrumental variables (IV) analysis, we found that increased educational attainment was associated with reduced smoking (HRS β -0.036, 95%CI: -0.06, -0.02, p < 0.01; NHANES β -0.032, 95%CI: -0.05, -0.02, p < 0.01), depression (HRS β -0.049, 95%CI: -0.07, -0.03, p < 0.01), triglycerides (NHANES β -0.039, 95%CI: -0.06, -0.01, p < 0.01), and heart disease (HRS β -0.025, 95%CI: -0.04, -0.002, p = 0.01), and improvements in high-density lipoprotein (HDL) cholesterol (HRS β 1.50, 95%CI: 0.34, 2.49, p < 0.01; NHANES β 0.86, 95%CI: 0.32, 1.48, p < 0.01), but increased BMI (HRS β 0.20, 95%CI: 0.002, 0.40, p = 0.05; NHANES β 0.13, 95%CI: 0.01, 0.32, p = 0.05) and total cholesterol (HRS β 2.73, 95%CI: 0.09, 4.97, p = 0.03). While most findings were cross-validated across both data sets, they were not robust to the inclusion of state fixed effects. Limitations included residual confounding, use of self-reported outcomes for some analyses, and possibly limited generalizability to more recent cohorts. CONCLUSIONS This study provides rigorous population-level estimates of the association of educational attainment with CVD. These findings may guide future implementation of interventions to address the social determinants of CVD and strengthen the argument for including educational attainment in prediction algorithms and primary prevention guidelines for CVD.
Collapse
Affiliation(s)
- Rita Hamad
- Philip R. Lee Institute for Health Policy Studies, Department of Family & Community Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Thu T. Nguyen
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Jay Bhattacharya
- Department of Medicine, Stanford University, Stanford, California, United States of America
| | - M. Maria Glymour
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - David H. Rehkopf
- Department of Medicine, Stanford University, Stanford, California, United States of America
| |
Collapse
|
12
|
Zahodne LB, Kraal AZ, Zaheed A, Farris P, Sol K. Longitudinal effects of race, ethnicity, and psychosocial disadvantage on systemic inflammation. SSM Popul Health 2019; 7:100391. [PMID: 31193191 PMCID: PMC6520605 DOI: 10.1016/j.ssmph.2019.100391] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/14/2019] [Accepted: 03/21/2019] [Indexed: 12/27/2022] Open
Abstract
Objective Psychosocial factors likely contribute to racial and ethnic inequalities in cardiovascular diseases (CVDs). However, precise social, psychological, and physiological pathways linking race and ethnicity to the development of CVDs are not well understood. Systemic inflammation, commonly indexed by C-reactive protein (CRP), is a biomarker for CVD risk and progression. The objective of this study was to identify mediating pathways from race and ethnicity to CRP through social, psychological, and behavioral variables. Methods Using data from 12,382 participants aged 51 and older in the Health and Retirement Study, structural equation models tested for direct and indirect effects of race and ethnicity on CRP measured over four years through educational disadvantage, everyday discrimination, depressive symptoms, external locus of control, and smoking. Results Educational disadvantage mediated Black-White and Hispanic-White disparities in baseline CRP directly, as well as indirectly through elevated depressive symptoms, higher external locus of control, and smoking. Educational disadvantage also mediated Black-White and Hispanic-White disparities in CRP change directly, as well as indirectly through higher external locus of control and smoking. Independent of education, discrimination mediated Black-White differences in baseline CRP via elevated depressive symptoms, higher external locus of control, and smoking. Discrimination also mediated Black-White disparities in CRP change via external locus of control. Conclusions Results from this population-based, longitudinal study support the view that racially patterned social disadvantage is prospectively associated with longitudinal inflammatory processes, and some of these effects are independently mediated by psychological and behavioral factors. Biopsychosocial pathways to health disparities also differ between minority groups.
Collapse
Affiliation(s)
- Laura B Zahodne
- University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA
| | - A Zarina Kraal
- University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA
| | - Afsara Zaheed
- University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA
| | - Penelope Farris
- University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA
| | - Ketlyne Sol
- University of Michigan, 530 Church St., Ann Arbor, MI 48109, USA
| |
Collapse
|
13
|
Fernández-Niño JA, Bonilla-Tinoco LJ, Astudillo-García CI, Manrique-Hernández EF, Giraldo-Gartner V. Association between the employment status and the presence of depressive symptoms in men and women in Mexico. CAD SAUDE PUBLICA 2018; 34:e00219617. [DOI: 10.1590/0102-311x00219617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/03/2018] [Indexed: 11/22/2022] Open
Abstract
Abstract: This study aims to estimate the relationship between employment status and depressive symptoms among Mexican adults, as well as to explore its differential effect by gender. Cross-sectional study of 36,516 adults between 20 and 59 years of age taken from the 2012 Mexican National Health and Nutrition Survey. Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale (CES-D), and the employment status was determined a week before the survey. Logistic regression models were stratified by gender and education level and adjusted by sociodemographic and health-related conditions to estimate the association between depressive symptoms and employment status. The prevalence of clinically depressive symptoms was 7.59% for men and 18.62% for women. In the case of men, those who were unemployed were more likely to present depressive symptoms (OR = 1.66; 95%CI: 1.08-2.55) than those who were working. For women, employment status is not associated with the presence of depressive symptoms, except in students (OR = 1.57; 95%CI: 1.02-2.43) compared with those who were working. In both genders, disability preventing one from working was associated with depressive symptoms. Although being employed has been reported to be associated with lower levels of psychiatric morbidity, the estimated effect is different for men and women. Occupational health policies should consider these conditions.
Collapse
|
14
|
Grochans E, Szkup M, Kotwas A, Kopeć J, Karakiewicz B, Jurczak A. Analysis of Sociodemographic, Psychological, and Genetic Factors Contributing to Depressive symptoms in Pre-, Peri- and Postmenopausal Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040712. [PMID: 29642625 PMCID: PMC5923754 DOI: 10.3390/ijerph15040712] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/05/2018] [Accepted: 04/07/2018] [Indexed: 12/13/2022]
Abstract
Depressive symptoms that are faced by women in the pre-, peri-, and postmenopausal periods are determined by a wide array of sociodemographic, psychological, and biological variables. The aim of our study was to identify factors that contribute to depressive problems at this stage of life. The study included 815 healthy Polish women aged 45–60 years. The survey part was conducted using the Beck Depression Inventory (BDI), the State–Trait Anxiety Inventory (STAI), the Neuroticism–Extroversion–Openness Five Factor Inventory (NEO-FFI), and a self-developed questionnaire. Genetic analysis was also performed. Depressive symptoms were observed in 25.5% of participants. 70% of the women were postmenopausal. No statistically significant differences in the severity of depressive symptoms were demonstrated with regard to genetic variables (p > 0.05). Reproductive capacity (p < 0.001), employment (p < 0.001), and being married (p < 0.018) were found to reduce the incidence of depressive symptoms. The contribution of personality and anxiety as a trait to depressive symptoms varied. Conclusions: The factors predisposing pre-, peri-, and postmenopausal women to depressive symptoms include lower education, lack of a life partner, unemployment, high anxiety, and neurotic personality. No evidence was found for the contribution of genetic factors to depressive symptoms in the examined women.
Collapse
Affiliation(s)
- Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Małgorzata Szkup
- Department of Nursing, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Artur Kotwas
- Department of Public Health, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Jacek Kopeć
- Faculty of Medicine, School of Population and Public Health, The University of British Columbia, 2206 East Mall Vancouver, BC V6T 1Z3, Canada.
| | - Beata Karakiewicz
- Department of Public Health, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| | - Anna Jurczak
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland.
| |
Collapse
|