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Morris AA, Masoudi FA, Abdullah AR, Banerjee A, Brewer LC, Commodore-Mensah Y, Cram P, DeSilvey SC, Hines AL, Ibrahim NE, Jackson EA, Joynt Maddox KE, Makaryus AN, Piña IL, Rodriguez-Monserrate CP, Roger VL, Thorpe FF, Williams KA. 2024 ACC/AHA Key Data Elements and Definitions for Social Determinants of Health in Cardiology: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Data Standards. J Am Coll Cardiol 2024; 84:e109-e226. [PMID: 39207317 DOI: 10.1016/j.jacc.2024.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
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Hardy RY, Boch SJ, Davenport MA, Chavez LJ, Kelleher KJ. Rural-urban differences in social and emotional protective factors and their association with child health and flourishing. J Rural Health 2024; 40:314-325. [PMID: 37859615 DOI: 10.1111/jrh.12802] [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: 05/31/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Children in rural communities experience higher mortality rates and less access to health care services than those in urban communities. Protective factors like social support also vary by geography, but their contribution to differences in child health is understudied. Understanding geographic variation in protective health factors could provide insight into their impact on health and guide future intervention strategies. RESEARCH OBJECTIVE To examine protective factors' association with child flourishing and child health status in rural and urban communities. METHODS Publicly available data from the National Survey of Children's Health, 2018-2021, with nonmissing geographic data (N = 150,493) were used to assess the relationship between protective factors and child flourishing and health by rurality. Multivariate survey-weighted probit models examined these relationships, adjusting for child and caregiver characteristics. FINDINGS More than a third of children were not flourishing, according to parental report. An estimated 62% of rural children were flourishing compared to 66% of urban children (P<0.001). Urban caregivers also were more likely to report better adult mental and physical health status. Nevertheless, rural children were reported to receive more social support than urban children, while their caregivers reported more emotional support and living in supportive and safe neighborhoods (P<0.001). Rural caregivers reported more support from places of worship and less from counselors/other mental health care providers than urban caregivers. CONCLUSIONS Despite higher reported caregiver emotional support and child social support, fewer rural children are flourishing. Health systems and community organizations able to leverage these existing social and emotional protective factors in rural communities could help close this gap.
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Affiliation(s)
- Rose Y Hardy
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Samantha J Boch
- College of Nursing, University of Cincinnati, Cincinnati, Ohio, USA
- The James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Mattina A Davenport
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Laura J Chavez
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kelly J Kelleher
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
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Duh-Leong C, Messito MJ, Katzow MW, Kim CN, Mendelsohn AL, Scott MA, Gross RS. Prenatal and Pediatric Primary Care-Based Child Obesity Prevention: Effects of Adverse Social Determinants of Health on Intervention Attendance and Impact. Child Obes 2024. [PMID: 38301173 DOI: 10.1089/chi.2023.0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Background: Adverse social determinants of health (SDoHs), specifically psychosocial stressors and material hardships, are associated with early childhood obesity. Less is known about whether adverse SDoHs modify the efficacy of early childhood obesity prevention programs. Methods: We conducted a secondary analysis of publicly insured birthing parent-child dyads with Latino backgrounds participating in a randomized controlled trial of the Starting Early Program (StEP), a child obesity prevention program beginning in pregnancy. We measured baseline adverse SDoHs categorized as psychosocial stressors (low social support, single marital status, and maternal depressive symptoms) and material hardships (food insecurity, housing disrepair, and financial difficulties) individually and cumulatively in the third trimester. Logistic regression models tested effects of adverse SDoHs on StEP attendance. We then tested whether adverse SDoHs moderated intervention impacts on weight at age 2 years. Results: We observed heterogeneous effects of adverse SDoHs on outcomes in 358 parent-child dyads. While housing disrepair decreased odds of higher attendance [adjusted odds ratio (aOR) 0.52, 95% confidence interval (CI): 0.29-0.94], high levels of psychosocial stressors doubled odds of higher attendance (aOR 2.36, 95% CI: 1.04-5.34). Similarly, while certain adverse SDoHs diminished StEP impact on weight (e.g., housing disrepair), others (e.g., high psychosocial stress) enhanced StEP impact on weight. Conclusions: Effects of adverse SDoHs on intervention outcomes depend on the specific adverse SDoH. Highest engagement and benefit occurred in those with high psychosocial stress at baseline, suggesting that StEP components may mitigate aspects of psychosocial stressors. Findings also support integration of adverse SDoH assessment into strategies to enhance obesity prevention impacts on families with material hardships. Trial Registration: This study is registered on clinicaltrials.gov: Starting Early Obesity Prevention Program (NCT01541761); https://clinicaltrials.gov/ct2/show/NCT01541761.
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Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Mary Jo Messito
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Michelle W Katzow
- Division of General Pediatrics, Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | - Christina N Kim
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Alan L Mendelsohn
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Marc A Scott
- Department of Applied Statistics, Social Science, and Humanities, New York University Steinhardt School of Culture, Education, and Human Development, New York, NY, USA
| | - Rachel S Gross
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Kantz ME, Enah C, Abdallah LM. The relationship between health and housing in low-income older adults: A secondary analysis of survey data. Public Health Nurs 2023; 40:931-939. [PMID: 37644887 DOI: 10.1111/phn.13248] [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: 05/11/2023] [Revised: 08/03/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE To examine the health-housing relationship in low-income older adults, and differences by income and receipt of housing assistance. DESIGN Secondary analysis of longitudinal survey data. SAMPLE About 10,858 adults aged 62+ who completed at least one wave of the 2014 Survey of Income and Program Participation (SIPP) (n = 37,333 observations). MEASUREMENTS SIPP variables representing demographics and housing quality, affordability, stability, and neighborhood were analyzed. Low-income and higher-income participants were differentiated by the household income-to-poverty ratio. RESULTS Low-income participants were significantly more likely to be in poor health and report problems with housing quality, affordability, and neighborhood safety compared to higher-income participants (p < .001). Increased household size and problems with housing quality and neighborhood safety were associated with poor health in both groups (p < .05). Low-income participants who received housing assistance were significantly poorer, less healthy, and food insecure than participants not receiving assistance (p < .001); however, the health-housing relationship was not different in the two groups. CONCLUSIONS Results provide additional support for housing as a social determinant of older adult health. Though housing assistance programs reached a subset of low-income older adults, the results suggest a housing assistance shortfall. Implications for public health nurses and researchers are explored.
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Affiliation(s)
- Mary E Kantz
- Susan and Alan Solomont School of Nursing, University of Massachusetts Lowell, Lowell, USA
| | - Comfort Enah
- Susan and Alan Solomont School of Nursing, University of Massachusetts Lowell, Lowell, USA
| | - Lisa M Abdallah
- Susan and Alan Solomont School of Nursing, University of Massachusetts Lowell, Lowell, USA
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Zhang X, Luo Y, Chen W, Huang J. Relative acquisition evaluation of health poverty alleviation project: a quantitative study of data from different regions of China. BMC Public Health 2022; 22:2204. [PMID: 36443740 PMCID: PMC9707105 DOI: 10.1186/s12889-022-14703-7] [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: 12/28/2021] [Accepted: 11/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Poverty is the greatest obstacle to the realization of human rights, among which illness is the leading cause in China. In 2015, China began to implement the health poverty alleviation project (HPAP). By 2020, all rural households living below the current poverty level (2300 yuan per person per year) have been lifted out of poverty. METHODS This study introduces the concept of relative acquisition and constructs a scale based on the capability approach to measure the relative acquisition and compares its fairness of HPAP. RESULTS The findings show that the values of the relative acquisition of HPAP in survey areas are all reached middle level (0.4-0.6), with 0 indicating the worst level and 1 indicating the best level. Specifically, the values of the functional activities of "health care", "health ability", "equal treatment opportunities" and "social support" are all above 0.4, while the values of "economic conditions" and "health education" are below 0.4. CONCLUSIONS The HPAP plays a significant role in reducing the economic burden of disease on patients. However, due to insufficient social support and health education, the HPAP objects lack endogenous motivation to fight against poverty, and the fairness also needs to be improved.
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Affiliation(s)
- Xinjie Zhang
- Department of Public Administration, School of Management, Jiangsu University, Zhenjiang, China.
| | - Ying Luo
- Department of Public Administration, School of Management, Jiangsu University, Zhenjiang, China
| | - Wei Chen
- Department of Personnel and Social Security, School of Governmentment, Nanjing University, Nanjing, China
| | - Jingru Huang
- Administration Office, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Thompson JS, Hudson CD, Huxley JN, Kaler J, Robinson RS, Woad KJ, Bollard N, Gibbons J, Green MJ. A randomised controlled trial to evaluate the impact of indoor living space on dairy cow production, reproduction and behaviour. Sci Rep 2022; 12:3849. [PMID: 35264670 PMCID: PMC8907246 DOI: 10.1038/s41598-022-07826-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
Abstract
As a global society, we have a duty to provide suitable care and conditions for farmed livestock to protect animal welfare and ensure the sustainability of our food supply. The suitability and biological impacts of housing conditions for intensively farmed animals is a complex and emotive subject, yet poorly researched, meaning quantitative evidence to inform policy and legislation is lacking. Most dairy cows globally are housed for some duration during the year, largely when climatic conditions are unfavourable. However, the impact on biology, productivity and welfare of even the most basic housing requirement, the quantity of living space, remains unknown. We conducted a long-term (1-year), randomised controlled trial (CONSORT 10 guidelines) to investigate the impact of increased living space (6.5 m2 vs 3 m2 per animal) on critical aspects of cow biology, behaviour and productivity. Adult Holstein dairy cows (n = 150) were continuously and randomly allocated to a high or control living space group with all other aspects of housing remaining identical between groups. Compared to cows in the control living space group, cows with increased space produced more milk per 305d lactation (primiparous: 12,235 L vs 11,592 L, P < 0.01; multiparous: 14,746 L vs 14,644 L, P < 0.01) but took longer to become pregnant after calving (primiparous: 155 d vs 83 d, P = 0.025; multiparous: 133 d vs 109 d). In terms of behaviour, cows with more living space spent significantly more time in lying areas (65 min/d difference; high space group: 12.43 h/day, 95% CI = 11.70-13.29; control space group: 11.42 h/day, 95% CI = 10.73-12.12) and significantly less time in passageways (64 min/d), suggesting enhanced welfare when more space was provided. A key physiological difference between groups was that cows with more space spent longer ruminating each day. This is the first long term study in dairy cows to demonstrate that increased living space results in meaningful benefits in terms of productivity and behaviour and suggests that the interplay between farmed animals and their housed environment plays an important role in the concepts of welfare and sustainability of dairy farming.
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Affiliation(s)
- Jake S Thompson
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, UK
| | - Christopher D Hudson
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, UK
| | - Jonathan N Huxley
- School of Veterinary Science, Massey University, Palmerston North, 4474, New Zealand
| | - Jasmeet Kaler
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, UK
| | - Robert S Robinson
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, UK
| | - Kathryn J Woad
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, UK
| | - Nicola Bollard
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, UK
| | - Jenny Gibbons
- Agriculture and Horticulture Development Board (AHDB), Stoneleigh, Kenilworth, CV8 2TL, UK
| | - Martin J Green
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, UK.
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Health and Housing Energy Expenditures: A Two-Part Model Approach. Processes (Basel) 2021. [DOI: 10.3390/pr9060943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Interest in the interaction between energy and health within the built environment has been increasing in recent years, in the context of sustainable development. However, in order to promote health and wellbeing across all ages it is necessary to have a better understanding of the association between health and energy at household level. This study contributes to this debate by addressing the case of Portugal using data from the Household Budget Survey (HBS) microdata database. A two-part model is applied to estimate health expenditures based on energy-related expenditures, as well as socioeconomic variables. Additional statistical methods are used to enhance the perception of relevant predictors for health expenditures. Our findings suggest that given the high significance and coefficient value, energy expenditure is a relevant explanatory variable for health expenditures. This result is further validated by a dominance analysis ranking. Moreover, the results show that health gains and medical cost reductions can be a key factor to consider on the assessment of the economic viability of energy efficiency projects in buildings. This is particularly relevant for the older and low-income segments of the population.
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Whitaker BI, Walderhaug M, Hinkins S, Steele WR, Custer B, Kessler D, Leparc G, Gottschall JL, Bialkowski W, Stramer SL, Dodd RY, Crowder L, Vahidnia F, Shaz BH, Kamel H, Rebosa M, Stern M, Anderson SA. Use of a rapid electronic survey methodology to estimate blood donors' potential exposure to emerging infectious diseases: Application of a statistically representative sampling methodology to assess risk in US blood centers. Transfusion 2020; 60:1987-1997. [PMID: 32743798 PMCID: PMC7436713 DOI: 10.1111/trf.15941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/24/2022]
Abstract
Risk assessments of transfusion-transmitted emerging infectious diseases (EIDs) are complicated by the fact that blood donors' demographics and behaviors can be different from the general population. Therefore, when assessing potential blood donor exposure to EIDs, the use of general population characteristics, such as U.S. travel statistics, may invoke uncertainties that result in inaccurate estimates of blood donor exposure. This may, in turn, lead to the creation of donor deferral policies that do not match actual risk. STUDY DESIGN AND METHODS This article reports on the development of a system to rapidly assess EID risks for a nationally representative portion of the U.S. blood donor population. To assess the effectiveness of this system, a test survey was developed and deployed to a statistically representative sample frame of blood donors from five blood collecting organizations. Donors were directed to an online survey to ascertain their recent travel and potential exposure to Middle East respiratory syndrome coronavirus (MERS-CoV). RESULTS A total of 7128 responses were received from 54 256 invitations. The age-adjusted estimated total number of blood donors potentially exposed to MERS-CoV was approximately 15 640 blood donors compared to a lower U.S. general population-based estimate of 9610 blood donors. CONCLUSION The structured donor demographic sample-based data provided an assessment of blood donors' potential exposure to an emerging pathogen that was 63% larger than the U.S. population-based estimate. This illustrates the need for tailored blood donor-based EID risk assessments that provide more specific demographic risk intelligence and can inform appropriate regulatory decision making.
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Affiliation(s)
- Barbee I Whitaker
- U.S. Food and Drug Administration/Center for Biologics Evaluation and Research/Office of Biostatistics and Epidemiology, Silver Spring, Maryland, USA
| | - Mark Walderhaug
- U.S. Food and Drug Administration/Center for Biologics Evaluation and Research/Office of Biostatistics and Epidemiology, Silver Spring, Maryland, USA
| | - Susan Hinkins
- NORC at the University of Chicago, Chicago, Illinois, USA
| | | | - Brian Custer
- Vitalant Research Institute, Scottsdale, Arizona, USA
| | | | | | | | - Walter Bialkowski
- Blood Research Institute, Versiti Wisconsin, Milwaukee, Wisconsin, USA
| | | | | | | | | | - Beth H Shaz
- New York Blood Center, New York, New York, USA
| | - Hany Kamel
- Vitalant Research Institute, Scottsdale, Arizona, USA
| | - Mark Rebosa
- New York Blood Center, New York, New York, USA
| | - Michael Stern
- NORC at the University of Chicago, Chicago, Illinois, USA
| | - Steven A Anderson
- U.S. Food and Drug Administration/Center for Biologics Evaluation and Research/Office of Biostatistics and Epidemiology, Silver Spring, Maryland, USA
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