1
|
Chen D, Ejlskov L, Laustsen LM, Weye N, Sørensen CLB, Momen NC, Dreier JW, Zheng Y, Damgaard AJ, McGrath JJ, Sørensen HT, Plana-Ripoll O. The Role of Socioeconomic Position in the Association Between Mental Disorders and Mortality: A Systematic Review and Meta-Analysis. JAMA Psychiatry 2024; 81:125-134. [PMID: 37966825 PMCID: PMC10652216 DOI: 10.1001/jamapsychiatry.2023.4316] [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: 06/15/2023] [Accepted: 09/14/2023] [Indexed: 11/16/2023]
Abstract
Importance Studies are lacking summarizing how the association between mental disorders and mortality varies by socioeconomic position (SEP), particularly considering different aspects of SEP, specific types of mental disorders, and causes of death. Objective To investigate the role of SEP in the association between mental disorders and mortality and the association between SEP and mortality among people with mental disorders. Data Sources MEDLINE, Embase, PsycINFO, and Web of Science were searched from January 1, 1980, through April 3, 2023, and a snowball search of reference and citation lists was conducted. Study Selection Inclusion criteria were observational studies estimating the associations between different types of mental disorders and mortality, stratified by SEP and between SEP and mortality in people with mental disorders. Data Extraction and Synthesis Pairs of reviewers independently extracted data using a predefined data extraction form and assessed the risk of bias using the adapted Newcastle-Ottawa scale. Graphical analyses of the dose-response associations and random-effects meta-analyses were performed. Heterogeneity was explored through meta-regressions and sensitivity analyses. Main Outcomes and Measures All-cause and cause-specific mortality. Results Of 28 274 articles screened, 71 including more than 4 million people with mental disorders met the inclusion criteria (most of which were conducted in high-income countries). The relative associations between mental disorders and mortality were similar across SEP levels. Among people with mental disorders, belonging to the highest rather than the lowest SEP group was associated with lower all-cause mortality (pooled relative risk [RR], 0.79; 95% CI, 0.73-0.86) and mortality from natural causes (RR, 0.73; 95% CI, 0.62-0.85) and higher mortality from external causes (RR, 1.18; 95% CI, 0.99-1.41). Heterogeneity was high (I2 = 83% to 99%). Results from subgroup, sensitivity, and meta-regression analyses were consistent with those from the main analyses. Evidence on absolute scales, specific diagnoses, and specific causes of death was scarce. Conclusion and Relevance This study did not find a sufficient body of evidence that SEP moderated the relative association between mental disorders and mortality, but the underlying mortality rates may differ by SEP group, despite having scarcely been reported. This information gap, together with our findings related to SEP and a possible differential risk between natural and external causes of death in individuals with specific types of mental disorders, warrants further research.
Collapse
Affiliation(s)
- Danni Chen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Linda Ejlskov
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Lisbeth Mølgaard Laustsen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Nanna Weye
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | | | - Natalie C. Momen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | | | - Yan Zheng
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Astrid Jensen Damgaard
- Master Program in Health Science, Rehabilitation and Prevention, Aarhus University, Aarhus, Denmark
| | - John J. McGrath
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Queensland Centre for Mental Health Research, University of Queensland, Wacol, Queensland, Australia
- Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Oleguer Plana-Ripoll
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| |
Collapse
|
2
|
Cornman JC, Witt J, Glei DA, Weinstein M. Exposure to childhood maltreatment predicts adult physiological dysregulation, particularly inflammation. PLoS One 2023; 18:e0294667. [PMID: 38033127 PMCID: PMC10688890 DOI: 10.1371/journal.pone.0294667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
Although a growing literature describes the effects of negative childhood experiences on biological outcomes, it is difficult to compare results across studies because of differences in measures of childhood experiences, biological markers, sample characteristics, and included covariates. To ensure comparability across its analyses, this study used a single national survey of adults in the United States-the Midlife in the United States (MIDUS) study-to examine comprehensively the association between adverse childhood experiences, operationalized as childhood maltreatment (CM), and biological markers of risk for poor health and to assess whether these associations differ by type of maltreatment, sex, or race. The sample included 1254, mostly White (78%), adults aged 34-86 years (mean age 57 years), 57% of whom were female. We present incidence rate ratios (IRR) from negative binomial and Poisson regressions to examine the relationships between exposure to CM (emotional, physical, and sexual abuse; emotional and physical neglect; and a CM-index reflecting frequency across all five types of maltreatment) and four biological risk summary scores (overall physiological dysregulation, cardiometabolic risk, inflammation, and hypothalamic pituitary axis/sympathetic nervous system (HPA/SNS) function). We also tested whether the effect of each type of CM varied by sex and by race. The CM-index was associated with higher overall physiological dysregulation and inflammation, but the associations were weaker and not statistically significant for cardiometabolic risk and HPA/SNS function. With the exception of a possible sex difference in the association between sexual abuse and overall physiological dysregulation, there was little evidence that the associations varied systematically by type of CM or by sex or race. We conclude that exposure to CM predicts adult biological risk, particularly inflammation. Inconsistency with previous research suggests that additional research is needed to confirm findings regarding sex and race differences.
Collapse
Affiliation(s)
| | - Jacob Witt
- Center for Population and Health, Graduate School of Arts and Sciences, Georgetown University, Washington, D.C., United States of America
| | - Dana A. Glei
- Center for Population and Health, Graduate School of Arts and Sciences, Georgetown University, Washington, D.C., United States of America
| | - Maxine Weinstein
- Center for Population and Health, Graduate School of Arts and Sciences, Georgetown University, Washington, D.C., United States of America
| |
Collapse
|
3
|
Nargis N, Xue Z, Asare S, Bandi P, Jemal A. Declining trend in cigarette smoking among U.S. adults over 2008-2018: A decomposition analysis. Soc Sci Med 2023; 328:115982. [PMID: 37269745 DOI: 10.1016/j.socscimed.2023.115982] [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: 02/20/2023] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 06/05/2023]
Abstract
The United States (U.S.) witnessed considerable reduction in cigarette smoking prevalence in the recent past. While the correlates of smoking prevalence and related disparities among U.S. adults are well documented, there is limited information on how this success was shared among different population sub-groups. Based on data from the National Health Interview Surveys, 2008 and 2018, representative of non-institutionalized U.S. adults (18 years and above), we applied the threefold Kitawaga-Oaxaca-Blinder linear decomposition analysis. We decomposed the trends in cigarette smoking prevalence, smoking initiation, and successful cessation into changes in population characteristics holding smoking propensities constant (compositional change), changes in smoking propensities by population characteristics holding population composition constant (structural change), and the unmeasured macro-level changes affecting smoking behavior in different population sub-groups at differential rates (residual change) to quantify the shares of population sub-groups by sex, age, race/ethnicity, education, marital status, employment status, health insurance coverage, family income, and region of residence in the overall change in smoking rates. The analysis shows that decreases in smoking propensities regardless of the changes in population composition accounted for 66.4% of the reduction in smoking prevalence and 88.7% of the reduction in smoking initiation. The major reductions in smoking propensity were among Medicaid recipients and young adults (ages 18-24 years). The 25-44-year-olds experienced moderate increase in successful smoking cessation, while the overall successful smoking cessation rate remained steady. Taken together, consistent reduction in smoking among U.S. adults by all major population characteristics, accompanied by disproportionately larger reduction in smoking propensities among the population sub-groups with initially higher smoking propensity compared to the national average, characterized the decline in overall cigarette smoking. Strengthening proven tobacco control measures with targeted interventions to reduce smoking propensities among underserved populations is key to continued success in reducing smoking overall and remedying inequities in smoking and population health.
Collapse
Affiliation(s)
- Nigar Nargis
- American Cancer Society, 3380 Chastain Meadows Pkwy NW Suite 200, Kennesaw, GA, 30144, USA.
| | - Zheng Xue
- American Cancer Society, 3380 Chastain Meadows Pkwy NW Suite 200, Kennesaw, GA, 30144, USA
| | - Samuel Asare
- American Cancer Society, 3380 Chastain Meadows Pkwy NW Suite 200, Kennesaw, GA, 30144, USA
| | - Priti Bandi
- American Cancer Society, 3380 Chastain Meadows Pkwy NW Suite 200, Kennesaw, GA, 30144, USA
| | - Ahmedin Jemal
- American Cancer Society, 3380 Chastain Meadows Pkwy NW Suite 200, Kennesaw, GA, 30144, USA
| |
Collapse
|
4
|
Britton M, Martinez Leal I, Jafry MZ, Chen TA, Rogova A, Kyburz B, Williams T, Reitzel LR. Influence of Provider and Leader Perspectives about Concurrent Tobacco-Use Care during Substance-Use Treatment on Their Tobacco Intervention Provision with Clients: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5260. [PMID: 37047876 PMCID: PMC10094458 DOI: 10.3390/ijerph20075260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 06/19/2023]
Abstract
People with substance-use disorders have elevated rates of tobacco use compared with the general population, yet rarely receive tobacco-dependence treatment within substance-use treatment settings (SUTS). One barrier to delivering evidence-based interventions in SUTS is providers' misconception that treating tobacco use and non-nicotine substance use concurrently jeopardizes clients' substance-use recovery, although research indicates that it enhances support for recovery and relapse prevention. A total of 86 treatment providers employed in SUTS (i.e., 9 Federally Qualified Health Centers, 16 Local Mental Health Authorities (LMHAs), 6 substance-use treatment programs in LMHAs, and 55 stand-alone substance-use treatment centers) in Texas, USA, answered survey questions about their (1) thoughts about treating tobacco during substance-use treatment, and (2) delivery of the 5A's tobacco-use intervention (Ask, Advise, Assess, Assist, Arrange). Twenty-six providers and leaders were interviewed about attitudes toward tobacco-free workplace policies and tobacco dependence and the relative importance of treating tobacco (vs. other substance-use disorders) at their center. Providers who did not believe tobacco use should be addressed as soon as clients begin treatment (i.e., endorsed responses of after 1 year, it depends on the client, or never) had lower odds of Asking clients about their tobacco use (OR = 0.195), Advising clients to quit smoking (OR = 0.176), and Assessing interest in quitting smoking (OR = 0.322). Qualitative results revealed barriers including beliefs that clients need to smoke to relieve the stress of substance-use recovery, are disinterested in quitting, fears that concurrent treatment would jeopardize substance use, and limited resources; additional training and education resources was the key facilitator theme. The results demonstrate a critical need to eliminate barriers to tobacco-treatment provision for clients in SUTS through education to correct misperceptions, specialized training to equip providers with knowledge and skills, and resources to build center capacity. Integrating evidence-based smoking interventions into routine care is key to support the recovery efforts of clients in SUTS.
Collapse
Affiliation(s)
- Maggie Britton
- Department of Health Disparities Research, The University of Texas at MD Anderson Cancer Center, 1400 Pressler Street, Unit 1440, Houston, TX 77030, USA
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
- Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
| | - Isabel Martinez Leal
- Department of Health Disparities Research, The University of Texas at MD Anderson Cancer Center, 1400 Pressler Street, Unit 1440, Houston, TX 77030, USA
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
- Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
| | - Midhat Z. Jafry
- Department of Health Disparities Research, The University of Texas at MD Anderson Cancer Center, 1400 Pressler Street, Unit 1440, Houston, TX 77030, USA
| | - Tzuan A. Chen
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
- Health Research Institute, The University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
| | - Anastasia Rogova
- Department of Health Disparities Research, The University of Texas at MD Anderson Cancer Center, 1400 Pressler Street, Unit 1440, Houston, TX 77030, USA
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
| | - Bryce Kyburz
- Integral Care, 1430 Collier Street, Austin, TX 78704, USA
| | | | - Lorraine R. Reitzel
- Department of Health Disparities Research, The University of Texas at MD Anderson Cancer Center, 1400 Pressler Street, Unit 1440, Houston, TX 77030, USA
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd Stephen Power Farish Hall, Houston, TX 77204, USA
| |
Collapse
|
5
|
Lee C, Sain D, Harari L, Kürüm E. Social Mobility and Sense of Purpose From Midlife to Old Age: Examining the Role of Major Life Events. Res Aging 2022:1640275221121588. [PMID: 36053240 DOI: 10.1177/01640275221121588] [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: 11/17/2022]
Abstract
Purpose in life (PIL) has been linked with numerous health benefits and adaptive aging, yet it diminishes with age, possibly due to loss of social or familial roles through life transitions. Drawing from the longitudinal surveys of the Midlife in the US study (n = 3418), we use time-varying coefficient models to investigate how the trajectory of PIL differs across cumulatively (dis)advantaged, upwardly mobile, and downwardly mobile groups and the role of major life events in shaping these trajectories. We found the upwardly mobile group exhibits higher PIL than the cumulatively disadvantaged and downwardly mobile groups. The consistently disadvantaged group experiences more adverse events at non-normative times. Socioeconomic status disparities in PIL during old age decrease after controlling for life events. We discuss how and why well-being changes and the role of structural and social factors in facilitating or impeding the development or maintenance of PIL over the life course.
Collapse
Affiliation(s)
- Chioun Lee
- 8790Department of Sociology, University of California-Riverside, Riverside, CA, USA
| | | | - Lexi Harari
- 8790Department of Sociology, University of California-Riverside, Riverside, CA, USA
| | | |
Collapse
|
6
|
Miyamoto Y, Ryff CD. Culture and Health: Recent Developments and Future Directions
1. JAPANESE PSYCHOLOGICAL RESEARCH 2021; 64:90-108. [PMID: 35509718 PMCID: PMC9060271 DOI: 10.1111/jpr.12378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Evidence of cultural differences in relationships and emotions has accumulated over the past few decades. As findings on cultural differences in psychological processes have accumulated, there has been growing interest in investigating whether they have implications for other phenomena such as health. Using scientific advances from the MIDUS and MIDJA studies, both publicly available, we examine links between culture and health. We first briefly review the accumulated evidence on cultural influences on health correlates of psychosocial factors. We then feature two recent developments - a more micro-level perspective on biological factors that may be involved in the culture and health linkage, and a more macro-level view of socioeconomic inequality, which also matters for health. Both perspectives inform the pathways through which health effects occur. Finally, we conclude our review by highlighting the changing historical contexts surrounding these cross-cultural investigations. Specifically, we draw attention to widening of economic inequality across cultures and the world-wide COVID-19 pandemic. These happenings bring notable implications for future research on health across cultural contexts.
Collapse
|